MUTYH-associated polyposis surveillance vs FAP.

• A. Surveillance mirrors FAP with intensive colonoscopy
• B. Surveillance is limited to upper GI tract
• C. Only genetic counseling
• D. No surveillance required

Answer: (A)

MUTYH-associated polyposis is a hereditary colorectal polyposis caused by biallelic MUTYH mutations, and the colorectal cancer risk and polyp burden are managed similarly to classic FAP. Because the main danger is the colon, the surveillance strategy focuses on regular colonoscopic monitoring from late adolescence or early adulthood, with short intervals (often yearly to every 1–2 years) depending on the number and size of polyps and how easily they can be removed. If polyp burden becomes too high or there is dysplasia or cancer, colectomy is considered. Upper GI involvement can occur in MAP but is less predictable than in FAP, so routine intensive upper GI surveillance is not assumed to be mandatory for all MAP patients. Genetic counseling remains important, but it doesn’t replace the need for ongoing colonoscopic surveillance to prevent colorectal cancer.