OCCURRENCE OF THYROID-CARCINOMA IN DUTCH PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS - AN EPIDEMIOLOGIC-STUDY AND REPORT OF NEW CASES

Objectives To assess the occurrence of thyroid cancer in Dutch patient s with familial adenomatous polyposis (FAP) and to discuss the value o f surveillance. Design Retrospective analysis of medical records. Sett ing The data were collected from the Dutch FAP registry. Participants 601 patients with FAP, 339 males and 262 females. Results The registry contained four female cases with a thyroid carcinoma. The mean age at diagnosis was 30 years (range: 16-46), In two patients it was the pre senting symptom of FAP, None of the women died from their thyroid carc inoma during a mean follow-up of 13 years (range: 6-31), The histology revealed one papillary carcinoma, one follicular carcinoma and two mi xed papillary/follicular carcinomas. The relative risk (RR) of develop ing thyroid carcinoma compared with the general Dutch population was 2 3 (95% confidence interval: 9-61), At the age of 60 years, the cumulat ive risk (CR) of thyroid carcinoma for female FAP patients was 2.8%. C onclusions Young female FAP patients have a significantly increased RR to develop a thyroid carcinoma. It may even be the presenting symptom of FAP. As the CW of thyroid carcinoma is low and the prognosis seems to be good, we recommend only periodical physical examination of the thyroid. Eur J Gastroenterol Hepatol 10:777-781 (C) 1998 Lippincott Wi lliams & Wilkins.