| Theme |
Polyposis of the colon and rectum, and other related conditions : hereditary colorectal cancer |
| Title |
Clinical problems in management of hereditary non-polyposis colorectal cancer (HNPCC) patients |
| Author |
Naohiro Tomita |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Shu Okamura |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Ken Nakata |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Hiroki Ohzato |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Shigeyuki Tamura |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Keishi Sugimoto |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Tomohiko Aihara |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Hirofumi Miki |
Department of Surgery, Kansai Rosai Hospital |
| Author |
Yuichi Takatsuka |
Department of Surgery, Kansai Rosai Hospital |
| [ Summary ] |
Hereditary non-polyposis colorectal cancer (HNPCC) is a very important clinical entity in respect to several clinical features, such as relatively high incidence, occurrence of multiple cancers at a relatively young age, and the need for continuous long-term surveillance for not only patients but for their family members. However, in Japan, several problems exist in the clinical aspects of the management of HNPCC. (1) The rate of accurate diagnose of this disease in general hospitals is very low. (2) As for the diagnostic criteria, the Japanese clinical criteria is not useful as an efficient screening tool and the Amsterdam criteria also has several problems. (3) Neither the analysis of microsatellite instability as a supportive diagnostic tool nor genetic testing for a final diagnosis is covered by medical insurance. (4) A useful and practical surveillance protocol has not be established thus far. (5) There are very few institutes and specialists able to manage this hereditary diseases in Japan. It is thought that a total social system to support genetic medicine needs to be developed. |