Familial Risk and Predictors of Gastric Cancer in Familial Adenomatous Polyposis

Mehul Trivedi, MD

• University of Utah Gastroenterology, Hepatology and Nutrition Fellow

Familial Risk and Predictors of Gastric Cancer in Familial Adenomatous Polyposis

Gastric cancer (GC) has been increasingly observed as a significant cause of morbidity among patients with familial adenomatous polyposis (FAP) and estimates of the true incidence appear to be increasing. However, few population-based analyses of GC risk among FAP patients have been conducted. Current upper gastrointestinal surveillance guidelines note that optimal management and surveillance strategies are not known. This demonstrates a significant gap in management of gastric cancer risk. Recent observations from our institution suggest GC may cluster within certain families, raising a question of genetic and/or environmental influences on the APC mutation, and association with phenotypes such as GC risk.

Our objective is to identify genetic and environmental drivers of GC risk in FAP to improve risk stratification for better medical management. We aim to do this by assessing familial patterns of GC by leveraging the extensive genealogy and medical histories in the Utah Population Database (UPDB) and the Utah Cancer Registry (UCR). We will evaluate the incidence of GC in FAP and in 1st, 2nd and 3rd degree relatives of FAP patients. Secondary aims are to identify predictors of GC in FAP.

This study would be among the first to utilize a population-wide genealogical database to investigate the familial risk of GC in this population, and the impact genetics may have on the development of gastric neoplasia. Findings from this work may allow for an improved understanding of GC in FAP and more tailored surveillance strategies