Updated 3 October 2007

Given the rarity of small bowel carcinoma in the general population, screening has no significant role to play in trying to diagnose the condition at an earlier stage than manifested through clinical signs and symptoms.

Duodenal Polyposis

With the successful management of patients with FAP, the risk of colorectal cancer has fallen, but the risk of duodenal carcinoma has risen. Within the population of FAP patients at risk for duodenal polyposis, the use of regular endoscopic surveillance is well established at St. Mark’s Hospital in the UK as well as in Heidelberg, Germany. Depending on the extent of polyposis based on a staging system developed by Spigelman, patients are subjected to regular endoscopic surveillance in an attempt to detect duodenal carcinoma as early as possible. Other options include the use of polyp removal by snare, photodynamic therapy, argon plasma coagulation or sulindac for early stage polyps.