Probably 5 to 10% of colon cancers appear to be genetically inherited,
a number that's likely to increase. Familial colonic polyposis is the
best known of these inherited tumors, with almost all affected
individuals getting colon cancer at an early age. Hereditary
nonpolyposis cancer is more recently described, and there are several
other inherited tumor syndromes that increase the risk of colon
cancer, including Lynch syndrome 2.
The use of tests such as microsatellite instability and k-ras remains
somewhat controversial, but we may expect more requests for
immunohistochemical or molecular tests for hereditary colon cancer,
particularly for patients diagnosed with colon cancer at an early age.
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