Medicolegal Aspects of Endoscopic Screening and Genetic Testing in Hereditary Colon Cancer Syndromes

Hereditary colorectal cancer syndromes are increasingly being recognized. Genetic mutation testing affords the possibility of pinpointing patients who are and are not carriers of susceptibility. The genetic testing process is, however, technically complex and time consuming. Published professional practice guidelines have been produced by an array of professional organizations. These provide for clinical recognition for subjects who may have FAP, HNPCC, and related conditions. More or less directed genetic workup of suspected patients are included. Detailed algorithms for endoscopic surveillance and management exist and should be familiar to GI endoscopists. Practice guidelines may be considered to codify standards of care, deviation from which may carry risk of medical malpractice litigation. Detailed consideration of these issues and related matters are discussed.