The world's first Polyposis Register was set up to monitor and treat successive generations of families carrying a group of cancer-carrying genes collectively known as Familial Adenomatous Polyposis. St Mark's Hospital's pioneering work in this area began in the early 1900s when surgeon Percy Lockhart-Mummery observed a link between polyps in colorectal cancer patients and a high incidence of cancer within their families.
Lockhart-Mummery started a patient register, beginning with 'Patient One,' a 31-year-old woman whose extended family had eight deaths attributed to bowel cancer. This observation led him to enlist the help of pathologist Cuthbert Dukes. Together, they established the Polyposis Registry in 1924.
The registry meticulously tracks families with the inherited condition of cancer-carrying polyps. Offspring of a gene carrier have a 50% chance of inheriting the condition, with cancer risk increasing significantly with age, from 7% in 21-year-olds to 93% in those over 50.
In response to these findings, St Mark's surgeons pioneered two surgical procedures that remain in use today. One involves the removal of the large intestine and rectum, replaced by a 'pouch' constructed from the small intestine. Subsequent investigations by Dukes and other pathologists identified several types of polyposis.
The registry has since gained international renown for its groundbreaking research, with many current medical guidelines stemming from its extensive work and meticulous record-keeping.
