DUODENAL ADENOMATOSIS IN FAMILIAL ADENOMATOUS POLYPOSIS

In order to evaluate the prevalence of duodenal adenomas in familial a denomatous polyposis (FAP) and the risk of carcinoma development, a mu lticenter study was initiated in Denmark, Finland, Holland, Norway and Sweden, which have national polyposis registers with an almost comple te registration. Patients aged 20 years or more are being examined wit h biennial gastroduodenoscopy during 1990-2000. Multiple duodenal biop sies are examined by one pathologist from each country, and the endosc opic and histological criteria of Spigelman have been adopted, At the end of August 1992, 312 patients with a median age of 37 years (range 20-86) had completed their first endoscopy. The duodenum was examined in 310 patients, of whom 199 (64%) had duodenal adenomas. Twenty-two p atients (11% of all patients with duodenal adenomas) had no endoscopic ally visible polyps. One patient had an asymptomatic adenocarcinoma. T he Spigelman stage worsened significantly (P < 0.05) with time from th e diagnosis of FAP, which may suggest an increasing risk of carcinoma by time.