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Singapore Polyposis Registry

The St Mark’s Hospital Polyposis Register, started by JP Lockhart-Mummery and C Dukes in 1924, was the first polyposis registry in the world. Since then, many registries have been set up all over the world, leading to reduction of colorectal cancer (CRC) in familial cancer syndromes.

The Singapore Polyposis Registry (SPR) was established in 1989 at the Singapore General Hospital as a central nationwide registry of all genetic and hereditary colorectal cancer patients. The aim was to provide a central registry service to all doctors in Singapore in order to facilitate identification, surveillance and management of families and individuals at high risk of CRC. From an initial emphasis on FAP and hereditary non-polyposis colorectal cancer (HNPCC), we subsequently also started including patients with other polyposis syndromes, such as Peutz Jeghers syndrome and Cowden’s syndrome.

The SPR has evolved over time, from being just a registry to working closely with our molecular and anorectal physiology laboratories, enabling us to provide patients with genetic testing and detailed postsurgical functional assessments for those who undergo pouch operations. Various research projects performed using data from the SPR have also led to advancements in diagnosis, surveillance and genetic counseling for these families and individuals at high risk of CRC. The registry currently has 245 families diagnosed with four known genetic conditions that can cause colorectal cancer, as well as 169 other families with a strong history of the cancer, but with no known abnormal genes yet identified.

An example of a family tree for FAP is as follows: