At what age should surveillance colonoscopy begin for individuals with a family history of FAP?

Surveillance colonoscopy for individuals with a family history of familial adenomatous polyposis (FAP) should typically be initiated in early adolescence, often around the age of 10 to 12 years. This is because FAP is characterized by the development of numerous colorectal adenomas at a young age, which can progress to colorectal cancer if not monitored and managed promptly.

Although the provided UK guidelines do not explicitly state the exact age to start surveillance colonoscopy in FAP, standard clinical practice and consensus from expert bodies recommend starting surveillance in childhood or early adolescence due to the high risk and early onset of polyps in FAP.

For precise management, referral to a specialist genetics or gastroenterology service is advised to tailor surveillance timing and frequency based on family history and genetic testing results.