BMJ  2005;331:1033-1034 (5 November), doi:10.1136/bmj.331.7524.1033

Editorial

Patients at risk of familial colorectal cancer

Surveillance of patients not covered by established criteria is controversial

The first 150 words of the full text of this article appear below.

What is ordinary? The single case! What is special? Millions of cases!

Johann Wolfgang von Goethe (1749-1832)¹

Management of hereditary non-polyposis colorectal cancer (HNPCC) is a textbook example for the translation of molecular knowledge into clinical decision making. Different mutations in mismatch repair genes were identified on the basis of clustering of colorectal and associated cancers in affected families. In the meantime adequate proof that colonoscopic surveillance indeed reduces incidence of and morbidity from HNPCC had been obtained.² The situation, however, is less clear in individuals at moderate risk of colorectal cancer because of a positive family history but not fulfilling any of the Amsterdam or Bethesda criteria.^{3 4} Dove-Edwin and colleagues have to be commended for providing urgently needed data on this group of patients in their paper in this week's BMJ.⁵

In 1913 Aldred Warthin, a pathologist, published a family pedigree including several hereditary tumours⁶ that matches . . . [Full text of this article]

(hanns-peter.knaebel@med.uni-heidelberg.de)
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

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