Table 4.

Factors Determining Timing of Surgery

Presentation	Timing
Symptomatic disease	Next available time
Severe disease by family history	Soon after diagnosis
Mild disease, asymptomatic	When convenient, ages 16–18 years
Attenuated disease by family history Phenotype or genotype	21–25 years
High risk of desmoids by family history, clinical exam, or genetic test results	Defer as long as is safe
Discovery of a polyp that cannot be removed endoscopically or with severe dysplasia; cancer	Immediately