Table 7. Recommended Screening Intervals by Spigelman Stage
| Spigelman Stage | NCCN [84] | Groves et al. [71] |
| 0 (no polyps) | Endoscopy every 4 y | Endoscopy every 5 y |
| I | Endoscopy every 2–3 y | Endoscopy every 5 y |
| II | Endoscopy every 1–3 y | Endoscopy every 3 y |
| CP + ET | ||
| III | Endoscopy every 6–12 mo | Endoscopy every 1–2 y |
| CP + ET (+/- GA) | ||
| IV | Surgical referral | Surgical resection |
| Complete mucosectomy or duodenectomy or Whipple procedure if duodenal papilla is involved | ||
| OR | OR | |
| Endoscopy every 3–6 mo | Endoscopy every 1–2 y | |
| CP + ET (+/- GA) |
| CP = chemoprevention; ET = endoscopic therapy; GA = general anesthetic; NCCN = National Comprehensive Cancer Network. | ||
| Refer to the Interventions/FAP section in the Major Genetic Syndromes section of this summary for more information about chemoprevention. | ||
| Refer below for additional information about the use of surgical resection in Spigelman stage IV disease. |
References
- Groves CJ, Saunders BP, Spigelman AD, et al.: Duodenal cancer in patients with familial adenomatous polyposis (FAP): results of a 10 year prospective study. Gut 50 (5): 636-41, 2002. [PUBMED Abstract]
- National Comprehensive Cancer Network.: NCCN Clinical Practice Guidelines in Oncology: Colorectal Cancer Screening. Version 1.2013. Rockledge, PA: National Comprehensive Cancer Network, 2013. Available online with free registration. Last accessed May 29, 2013.
