Hereditary non-polyposis colorectal carcinoma (HNPCC) in a Ghanaian family

Abstract

Colorectal cancer (CRC) is relatively uncommon in sub Saharan Africa because of relative young age of the population, rarity of pre-malignant conditions and favourable dietary factors. The role of heredity in its causation in Africa is, however, unknown. Four first degree relatives were treated for CRC within three years by the same surgical team in Accra. Two presented with colo-colic intussusception, and the other two with partially obstructing hepatic flexure tumours. Family history revealed that six of eight siblings had developed colorectal cancer, with incidence in three consecutive generations. This family satisfied Amsterdam criteria (I and II) for Lynch syndrome: three generations affected, six of them below age 50, with proximal colon tumours. Genetic testing showed loss of mismatched repair protein gene MSL2.