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Gastrointestinal Cancer Prevention and Genetics Program

Our goal at the Gastrointestinal Cancer Prevention and Genetics Program is to prevent cancer or detect the earliest signs of cancer in our patients.

Every patient in our program benefits from an immense breadth of specialized knowledge, coming from a multidisciplinary team that is drawn from across Columbia University and includes gastroenterologists, geneticists, medical oncologists, gynecologists, surgeons, and genetic counselors.

A patient’s consultation in the office includes time with both a gastroenterologist and a certified genetic counselor, both of whom have expertise in inherited gastrointestinal cancer syndromes. The genetic risk evaluation is individualized to each patient’s unique personal and family cancer history.  Recommendations are made based on the acquired information and may include procedures for cancer screening and prevention.  Patients are educated about cancer risks and the implications not only for them, but for their family members as well.

The team provides patients and their referring physicians with individualized cancer screening data and prevention strategies. Counselors interpret genetic testing results and keep patients and providers up-to-date with new genetic testing options.  It is often the case that we follow patients and their families for many years!

Additional procedures and examinations are available for associated non-gastrointestinal malignancies (such as breast, thyroid, uterus/ovaries, etc.) and coordinating such testing is available through our program.

Conditions We Treat

The genetic evaluation related to gastrointestinal cancers is rapidly changing. We provide the most current options available in genetic testing that include but are not limited to the following inherited cancer syndromes:

  • Lynch Syndrome or Hereditary Nonpolyposis Colorectal Cancer: This condition is the most common inherited colorectal cancer syndrome which affects multiple family members in each generation.  It also includes a constellation of cancers other than the colon.
  • Familial Adenomatous Polyposis (FAP) and Attenuated Familial Adenomatous Polyposis or MYH Polyposis:  This condition is usually characterized by multiple polyps in the colon and often the stomach and small intestine.
  • Familial Pancreatic Cancer: Some families have multiple relatives in several generations affected by pancreatic cancer.
  • Hereditary Gastric Cancer: Some families have multiple relatives in successive generations affected with stomach cancer and/or polyps and there is an association with breast cancer.

Other rare conditions for which genetic evaluation and testing is available include:

  • Cowden Syndrome which is characterized by hamartomatous intestinal polyps and cancers of the breast, uterus, thyroid and involves the gene, PTEN
  • Peutz-Jeghers Syndrome which is characterized by hamartomatous intestinal polyps, freckling of the mouth or lips, gynecological cancers, and cancers of the pancreas.
  • Juvenile Polyposis which is associated with pancreatic cancer and polyps of the stomach, intestine and colon.
  • Li-Fraumeni Syndrome which includes multiple cancers such as sarcomas, colon, breast, adrenals, and the development of cancer in childhood.

Our Services

  • Personalized cancer risk assessment
  • Genetic counseling and testing
  • Cancer Screening:  Some of the screening procedures we provide for cancer prevention and early detection include:
    • endoscopy/colonoscopy
    • endoscopic ultrasound
    • Endoscopic retrograde cholangiopancreatogram (ERCP)
    • Magnetic resonance imaging (MRI)
  • Cancer Prevention Strategies