Medical Oncologist
CION Cancer Clinics
After a positive APC result: the next steps, in order | CION Cancer Clinics
A positive APC result usually means familial adenomatous polyposis, a condition where many polyps grow in the bowel. It is serious, but it is well understood, and a clear plan protects most people. This page walks through what happens in the months and years after the result: bowel checks, the timing of surgery, checks higher up the gut, and testing the rest of the family. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
On this page
- What does a positive APC result mean for me?
- Which parts of the body need watching after an APC result?
- What happens in the months after the result?
- The terms in your clinic letters, in plain language
- What needs deciding now, and what can wait?
- Four fears families bring, and what is actually true
- What this page cannot tell you
- Common questions after a positive APC result
The short answer
What does a positive APC result mean for me?
It means you carry a faulty copy of the APC gene that lets polyps grow in the lining of the large bowel. This condition is called familial adenomatous polyposis, or FAP. Without care, one of those polyps would very likely become cancer. With regular checks and well-timed surgery, most people with FAP never develop bowel cancer.
A plan, not an emergency
Very few people need anything done in the first week. The first step is a meeting with a genetic counsellor and a gastroenterologist who knows FAP. They look at your colonoscopy findings, your age and your family history, and set out the order of what comes next.
Why the exact variant matters
Where in the gene the fault sits changes how many polyps form and how early. Some faults cause a severe form with thousands of polyps. Others cause attenuated FAP, a milder form that appears later in life. Your team reads the variant alongside the colonoscopy to set the pace of your care.
If your report names APC I1307K rather than a classic APC fault, this page is not about you. That variant carries a far smaller risk.The four parts of care
Which parts of the body need watching after an APC result?
FAP is known as a bowel condition, but the plan covers more than the bowel.
The large bowel
Regular colonoscopy counts and removes polyps. When they become too many to manage safely, surgery to remove the large bowel is planned. The timing is a decision made with you, not for you.
The upper gut
Polyps can also grow in the duodenum, the first part of the small bowel just after the stomach. An upper endoscopy looks there, and it is repeated at a pace set by what it finds.
The thyroid and deeper tissue
Thyroid cancer is more common in FAP, especially in young women, so a neck ultrasound is often added. Your team may also watch for desmoid tumours, which are firm growths in the tummy wall or deeper tissue.
Tell your team about
- A lump in the neck
- A firm swelling in the tummy
- Pain or swelling near an old scar
The family
Parents, brothers, sisters and children can be tested for your exact fault. Those who do not carry it can stop the extra checks. Those who do can start them in time.
Not sure whether this applies to you?
Ask an oncologistStep by step
What happens in the months after the result?
-
A counselling appointment
The counsellor explains the result, draws your family tree and answers the questions you did not know to ask. Bring the report, any colonoscopy notes and a list of relatives with bowel problems.
-
A colonoscopy with an FAP specialist
If you have not had one recently, it is arranged early. The doctor counts and maps the polyps and removes the largest. This sets the starting point for everything after.
-
A conversation with a surgeon
A colorectal surgeon explains the options and when each makes sense. Some people need surgery soon. Many can wait, with close checks, until a time that suits exams, work or marriage.
-
Upper gut and thyroid checks
An upper endoscopy and a neck ultrasound are booked, at a time that fits around the bowel plan.
-
Family testing begins
Once your exact variant is known, relatives can have a single, targeted blood test. Children are usually tested in late childhood, before bowel checks would need to begin.
Words you will hear
The terms in your clinic letters, in plain language
- FAP
- Familial adenomatous polyposis. An inherited condition in which many polyps grow in the large bowel.
- Attenuated FAP
- A milder form, with fewer polyps appearing later in life. It still needs regular checks.
- Colectomy
- An operation to remove the large bowel. It is the main way FAP-related bowel cancer is prevented.
- Ileorectal anastomosis
- Removing the large bowel but keeping the rectum, then joining the small bowel to it. The rectum still needs checks afterwards.
- Pouch surgery
- Removing the rectum too, and making a new reservoir from the small bowel. Most people do not need a permanent stoma bag.
- Duodenal polyps
- Polyps in the first part of the small bowel, watched through an upper endoscopy.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
What is urgent and what is not
What needs deciding now, and what can wait?
Decide in the coming weeks
Can wait for a calmer moment
Meeting a counsellor and an FAP specialist
The exact type of bowel surgery
A starting colonoscopy, if not recent
The timing of surgery, for most people
Telling brothers, sisters and parents
Testing children who are still very young
Checking what your insurance covers
Family planning choices
Commonly believed
Four fears families bring, and what is actually true
"A positive result means I already have cancer."
It means your bowel lining is prone to polyps. Most people are found before any polyp has turned into cancer, especially when the result comes from family testing rather than symptoms.
"Surgery means a bag for the rest of my life."
Most operations for FAP join the bowel back up, so a permanent stoma bag is not needed. A bag is sometimes used for a short time while healing. Your surgeon will explain which option fits your case.
"Once the bowel is removed, the checks are over."
Surgery removes the main risk, but the rectum or pouch, the upper gut and the thyroid still need regular checks. Stopping them is one of the most common ways problems are missed later.
"My father tested negative, so my children are safe."
Some APC faults start fresh in one person and were never in either parent. If that is you, your children still each have a one in two chance of carrying it. They can be tested for your exact fault.
Being straight with you
What this page cannot tell you
It cannot tell you when you personally should have surgery, or which operation suits you. That depends on your polyp count, their size, your age and your plans, and it is decided with a surgeon who treats FAP regularly. What your specific variant means is a question for the counsellor who ordered the test.
It cannot predict how your own FAP will behave
Even within one family, the number of polyps and the age they appear can differ. The variant gives a rough guide. The colonoscopy gives the real picture, and it is the colonoscopy that drives most decisions.
Who this does not apply to
If your report shows APC I1307K, or an APC variant of uncertain significance, this page does not describe you. Neither of those is FAP. Many people who read about APC online do not have FAP at all, and a counsellor will tell you plainly if you are one of them.
If you have a report and are not sure which of these it is, call the helpline and someone will arrange for it to be read.Questions we are asked
Common questions after a positive APC result
Do I need surgery straight away?
Usually not. Most people have time to meet a specialist, have a starting colonoscopy and plan surgery around studies, work or marriage. A few, with many large polyps or worrying changes, are advised to move sooner. The colonoscopy findings decide which group you are in.
Can polyps be removed instead of the bowel?
For a while, yes. Removing the largest polyps during colonoscopy buys time. In classic FAP the polyps eventually become too many to control this way, and surgery becomes the safer choice. In attenuated FAP some people manage with colonoscopy alone for many years.
Will I be able to eat normally after surgery?
Most people return to a normal diet. Bowel habits change, often with more frequent, looser stools, and they usually settle over the following months. A dietitian can help while things adjust. Your surgeon will tell you what to expect from your specific operation.
When should my children be tested?
For classic FAP, testing is usually offered in late childhood, before bowel checks would need to begin. Testing much earlier rarely changes anything. Your counsellor will suggest a time and help you explain the result to your child in a way that suits their age.
Is there a medicine that stops polyps growing?
Some medicines have been studied to slow polyp growth, and the results so far are modest. None replaces colonoscopy or surgery, and none is routine for everyone with FAP. Ask your gastroenterologist whether any trial or option applies to you.
Does FAP affect pregnancy?
Most women with FAP have normal pregnancies. Some types of bowel surgery can affect fertility a little, which is one reason the type and timing of the operation are discussed with family plans in mind. Testing before or during pregnancy is also possible, and a counsellor can explain those choices.
Is care covered by Aarogyasri or Ayushman Bharat?
Some procedures, including certain bowel operations, may fall under government schemes, depending on the package and the hospital. The genetic test itself is often not covered. Ask the CION helpline to check your eligibility before you book, so there are no surprises.
Who should I call first?
If you have the report in hand, start with a genetic counsellor or the doctor who ordered the test. If you are unsure where to go, call the CION helpline and describe your report. Someone will point you to the nearest centre and arrange counselling, in Telugu if you prefer.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- GeneReviews (NCBI) — APC-Associated Polyposis Conditions
- MedlinePlus Genetics — Familial adenomatous polyposis
- National Cancer Institute — Genetics of Colorectal Cancer (PDQ)
- NCCN — Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Talk to us
Just been told your APC result is positive?
We can arrange a genetic counsellor and an FAP-experienced gastroenterologist to go through the report and set out the next steps with you. One helpline serves every CION centre.