Living affected individual (proband) where the individual +/- family history meets one of the criteria. The
proband has:
1. Any colorectal cancer OR endometrial cancer diagnosis under 40 years
2. Any small bowel cancer diagnosis under 40 years
3. Proband has endometrial or colorectal cancer (CRC) with ≥2 siblings with CRC/EC, where at least 1
diagnosed <50 3. 4. 5. 6. 7. ≥5 adenomatous polyps and colorectal cancer, OR ≥5 adenomatous polyps (age <40 years), OR ≥10 adenomatous polyps (age <60 years, OR ≥20 adenomatous polyps (age ≥ 60 years), OR ≥5 adenomatous polyps (age <60 years) and first degree relative with ≥5 adenomatous polyps or CRC (age <60 years), OR 8. A clinical diagnosis of serrated polyposis syndrome* IF: a. patient aged < 50 OR b. family history of ≥1 affected FDR with SPS OR c. evidence of dysplasia within any polyp *Clinical diagnosis of Serrated Polyposis Syndrome: a. Five or more serrated lesions/polyps proximal to the rectum all being at least 5 mm in size with two or more being at least 10mm in size, b. More than 20 serrated lesions/polyps of any size distributed through the large bowel with at least five being proximal to the rectum. 9. Hamartomatous polyposis syndromes: a. b. c. ≥ 5 hamartomatous polyps of the colorectum, OR ≥ 2 hamartomatous polyps throughout the GI tract, OR ≥ 1 hamartomatous polyp and a first / second degree relative has hamartomatous polyp. Deceased affected individual (proband) where all the following are met; (i) the individual +/- family history meets one of the above criteria, AND (ii) a previously stored constitutional blood/DNA sample is available, AND (iii) no living affected individual is available for genetic testing, AND (iv) after discussion at specialist cancer genetics MDT NOTE: The majority of polyps are histologically confirmed Genetic testing may occasionally be appropriate outside these criteria following discussion at a specialist MDT with a cancer geneticist present

Testing Criteria
Living affected individual (proband) where the individual +/- family history meets one of the criteria. The
proband has:
1. Any colorectal cancer OR endometrial cancer diagnosis under 40 years
2. Any small bowel cancer diagnosis under 40 years
3. Proband has endometrial or colorectal cancer (CRC) with ≥2 siblings with CRC/EC, where at least 1
diagnosed <50 3. 4. 5. 6. 7. ≥5 adenomatous polyps and colorectal cancer, OR ≥5 adenomatous polyps (age <40 years), OR ≥10 adenomatous polyps (age <60 years, OR ≥20 adenomatous polyps (age ≥ 60 years), OR ≥5 adenomatous polyps (age <60 years) and first degree relative with ≥5 adenomatous polyps or CRC (age <60 years), OR 8. A clinical diagnosis of serrated polyposis syndrome* IF: a. patient aged < 50 OR b. family history of ≥1 affected FDR with SPS OR c. evidence of dysplasia within any polyp *Clinical diagnosis of Serrated Polyposis Syndrome: a. Five or more serrated lesions/polyps proximal to the rectum all being at least 5 mm in size with two or more being at least 10mm in size, b. More than 20 serrated lesions/polyps of any size distributed through the large bowel with at least five being proximal to the rectum. 9. Hamartomatous polyposis syndromes: a. b. c. ≥ 5 hamartomatous polyps of the colorectum, OR ≥ 2 hamartomatous polyps throughout the GI tract, OR ≥ 1 hamartomatous polyp and a first / second degree relative has hamartomatous polyp. Deceased affected individual (proband) where all the following are met; (i) the individual +/- family history meets one of the above criteria, AND (ii) a previously stored constitutional blood/DNA sample is available, AND (iii) no living affected individual is available for genetic testing, AND (iv) after discussion at specialist cancer genetics MDT NOTE: The majority of polyps are histologically confirmed Genetic testing may occasionally be appropriate outside these criteria following discussion at a specialist MDT with a cancer geneticist present