Familial adenomatous polyposis (FAP) syndrome is a complex entity, which includes FAP, attenuated FAP, and MUTYH-associated polyposis. These patients are at significant risk for colorectal cancer and carry additional risks for extracolonic malignancies. In this guideline, we reviewed the most recent literature to formulate recommendations on the role of endoscopy in this patient population. Relevant clinical questions were how to identify high-risk individuals warranting genetic testing, when to start screening examinations, what are appropriate surveillance intervals, how to identify endoscopically high-risk features, and what is the role of chemoprevention. A systematic literature search from 2005 to 2018 was performed, in addition to the inclusion of seminal historical studies. Most studies were from worldwide registries, which have compiled years of data regarding the natural history and cancer risks in this cohort. Given that most studies were retrospective, recommendations were based on epidemiologic data and expert opinion. Management of colorectal polyps in FAP has not changed much in recent years, as colectomy in FAP is the standard of care. What is new, however, is the developing body of literature on the role of endoscopy in managing upper GI and small-bowel polyposis, as patients are living longer and improved endoscopic technologies have emerged.

中文翻译：

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美国胃肠道内窥镜协会关于内镜在家族性腺瘤性息肉病综合征中的作用的指南。

家族性腺瘤性息肉病（FAP）综合征是一个复杂的实体，包括FAP，FAP减毒和MUTYH相关性息肉。这些患者罹患大肠癌的风险很高，并带有结肠外恶性肿瘤的其他风险。在本指南中，我们回顾了最新文献，以就内镜在该患者人群中的作用提出建议。相关的临床问题是如何确定需要进行基因检测的高风险个体，何时开始筛查检查，什么是合适的监测间隔，如何确定内镜高危特征以及化学预防的作用是什么。除了包括开创性的历史研究外，还对2005年至2018年的文献进行了系统的检索。大多数研究来自全球注册管理机构，他们收集了有关该人群自然史和癌症风险的多年数据。鉴于大多数研究都是回顾性的，因此建议是根据流行病学数据和专家意见得出的。近年来，由于FAP结肠切除术是护理的标准，因此FAP中大肠息肉的治疗没有太大变化。然而，随着患者寿命的延长和内窥镜技术的不断发展，有关内窥镜检查在控制上消化道和小肠息肉中的作用的文献正在不断更新。