Hereditary Nonpolyposis Colon Cancer

Treatment

Treatment of HNPCC is removal of the polyps. It can often be done during screening procedures, such as colonoscopy. In some cases, colon removal (colectomy) may be recommended. Mayo Clinic is one of the most experienced medical centers in performing this procedure with minimally invasive surgery. Read more under treatment of colon cancer.

Continued screening for polyps and other cancers associated with HPNCC is the other important part of treatment.

Screening for HNPCC

Doctors will tailor screening for each patient, but some general guidelines often apply:

For People Diagnosed with HNPCC

• Colonoscopy every 1-2 years starting between ages 20-30 (or 10 years before the earliest age of diagnosis in the family, whichever is earlier) and every year after age 40. If polyps are found, colonoscopy at least yearly.
• For women:
  • Pelvic exam every year starting at age 18 or at onset of sexual activity
  • Endometrial biopsy and/or ultrasound to screen for endometrial cancer every year starting at age 25-35
  • Blood test and transvaginal ultrasound to screen for ovarian cancer every year starting at age 25-30
  • Careful investigation of any bleeding between menstrual periods or after menopause
• Annual tests to check for blood and cancer cells in urine
• American Cancer Society guidelines for all other cancer screening
• Aggressive evaluation of any persistent, unexplained symptoms

For People at Risk for HNPCC (close relatives of people with HNPCC who have not had cancer themselves)

• Colonoscopy every 1-3 years starting between ages 20-30; if polyps are found, colonoscopy at least yearly (the presence of polyps, especially in a young person with relatives with HNPCC, may be a sign the genetic mutation was inherited)
• For women:
  • Pelvic exam every year starting at age 18 or at onset of sexual activity
  • Endometrial biopsy and/or ultrasound to screen for endometrial cancer every year starting at age 25-35
  • Blood test and transvaginal ultrasound to screen for ovarian cancer every year starting at age 25-40 if ovaries are not easy to examine by pelvic exam
  • Careful investigation of any bleeding between menstrual periods or after menopause
• Urine tests to check for blood every year and possibly urine cytology tests to check for cancer cells in urine
• American Cancer Society guidelines for all other cancer screening
• Aggressive evaluation of any persistent, unexplained symptoms