Spigelman Staging System: Predicting Duodenal and Papillary Cancer Risk in Familial Adenomatous Polyposis

Individuals with familial adenomatous polyposis (FAP) have a 25% risk of duodenal and papillary cancers once duodenal polyposis reaches Spigelman stage IV, although the sensitivity of this stage is low. Factors like polyp size, count, and dysplasia influence cancer risk. The Spigelman staging system lacks specific variables for papillary cancer, suggesting a need for updates to improve sensitivity in predicting these cancers.