How do the screening recommendations differ for high-risk groups versus the general population?
It varies again with each of these conditions. In familial polyposis, the recommended screening is actually flexible sigmoidoscopy because these hundreds of polyps are uniformly distributed throughout the colon. If we see them in the lower section of the colon, we are going to know that they are everywhere. Screening actually begins at age 10 to 12, so you are beginning at a very early age. This is a condition that strikes people at a very young age. The average age when polyps start to develop is about age 15, so we want to start screening before the polyps develop. In people who have this condition, once we see those polyps occurring, they actually need to have their colon removed; otherwise, they are going to have that 100 percent lifetime risk of developing colorectal cancer. Screening is very, very intensive in that group.
