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In Western countries, familial adenomatous polyposis (FAP) is not recognized as a risk factor for gastric cancer, although it is well known to cause colon cancer and duodenal/ampullary cancer. However, recent data suggest a rise in gastric cancer incidence in Western FAP patients, often detected at a late stage.
To identify the factors associated with FAP, investigators at a single center studied 10 patients with FAP who developed gastric cancer and 40 age-matched FAP patients without gastric cancer undergoing surveillance. All gastric cancers were noted to arise in the proximal stomach above the incisura within an area of gastric polyposis.
Endoscopic risk factors associated with gastric cancer included carpeting of gastric polyps, solitary …