What are the referral criteria for genetic counselling in patients with a family history suggestive of FAP?

Referral to a specialist genetic clinic for familial adenomatous polyposis (FAP) should be considered if there is a family history indicating a high risk of a pathogenic variant associated with FAP, such as multiple relatives with colorectal cancer or polyposis at a young age, or a known familial mutation NICE CG164.

Specific criteria include: a family history with multiple relatives diagnosed with colorectal cancer or polyposis, especially if diagnosed at a young age; a family history of colorectal cancer with a pattern suggestive of FAP; or a known familial mutation in the APC gene NICE CG164.