The role of surgery in the prevention of familial cancer syndromes of the gastrointestinal tract.

Familial predisposition is a well-recognised risk factor in many gastrointestinal cancers. New developments in molecular genetics may contribute to the identification of cancer-prone families. Recognition of familial clustering and genetic testing can identify other members of the family with a high potential risk for cancer development. Appropriate surveillance mechanisms and management protocols may be initiated in order to prevent cancer and/or to detect cancer at an early stage. In the present article, various types of familial cancer of the gastrointestinal tract are reviewed and surgical, diagnostic and therapeutic issues for the management of esophageal, gastric, colorectal, and pancreatic cancer are emphasized.