When we talk about colorectal cancer, most people don’t think of teenagers or young adults. But there’s a rare inherited condition silently increasing the cancer risk among families—Familial Adenomatous Polyposis (FAP).
What is FAP?
Familial Adenomatous Polyposis (FAP) is a genetic disorder that causes hundreds to thousands of small growths called polyps in the lining of the colon and rectum. Left untreated, these polyps almost always turn cancerous, usually by the age of 40.
FAP is caused by a mutation in the APC gene, which normally controls cell growth. With this mutation, cells grow uncontrollably, leading to polyp formation and, eventually, colorectal cancer.
- FAP affects approximately 1 in 8,000 to 10,000 people worldwide.
- It accounts for less than 1% of all colorectal cancer cases, but those who have it face almost a 100% lifetime risk of developing colorectal cancer without preventive treatment.
- In sub-Saharan Africa, limited screening and awareness mean that FAP often goes undiagnosed until it’s too late.
In African households, women are often the primary caregivers and health decision-makers. Understanding hereditary risks like FAP can help protect entire families.
FAP doesn’t just affect men. Women with FAP have the same high risk of colon cancer and may also face additional complications like:
- Desmoid tumors (benign but potentially dangerous growths in the abdomen)
- Ovarian and endometrial polyps
- Thyroid cancer, which is slightly more common in women with FAP
Symptoms to Watch Out For
FAP often develops silently, especially in early life. However, symptoms may include:
- Persistent abdominal pain
- Rectal bleeding
- Change in bowel habits
- Unexplained weight loss
- Family history of colon cancer before age 50
Because FAP starts as early as the teenage years, early detection is critical.
If a close relative (parent, sibling) has FAP or was diagnosed with colorectal cancer at a young age, doctors recommend:
- Genetic testing for the APC gene mutation
- Colonoscopy beginning as early as age 10–12
- Regular screening every 1–2 years if polyps are found
Genetic counseling is essential for families to understand the risk and inheritance patterns.
Treatment Options
While there is no cure, treatment focuses on prevention:
- Surgical removal of the colon (colectomy) is often recommended by the late teens or early 20s.
- Monitoring for other cancers (thyroid, stomach, liver) is ongoing.
- Lifelong follow-up care is critical to stay ahead of polyp recurrence or other complications.
Most African countries lack widespread genetic counseling services and colorectal screening programs. Raising awareness through women’s health platforms is essential.
- According to the World Health Organization, colorectal cancer is among the top 5 cancers in Africa.
- FAP may be underreported due to low screening rates and cultural stigma around cancer and genetic testing.
What You Can Do
- Know your family history: Ask about any relatives with early-onset colon cancer or multiple polyps.
- Talk to a doctor: If you have symptoms or a family history, request a referral to a gastroenterologist.
- Educate others: Share this article, especially with mothers, sisters, and daughters.
- Advocate for screening: Encourage local clinics or NGOs to offer colonoscopy services and genetic testing where available.
**FAP is not a death sentence—**especially when detected early. African women must be empowered with knowledge about hereditary cancer risks. You can be the first in your family to break the silence, take action, and save lives.
“It starts with awareness, it continues with action.”
Sources:
- World Health Organization (WHO)
- American Cancer Society
- Cancer.net
- African Organization for Research and Training in Cancer (AORTIC)
