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There are some indications for surgery prior to a diagnosis of cancer, especially with regards of familial adenomatous polyposis. Oftentimes in these patients, we will monitor, but discuss surgery upfront as a preventative measure. Also, patients with inflammatory bowel disease are at increased risk for malignancy. They need to have discussions with their gastroenterologist with regards to screening and surveillance, especially at earlier ages, as the inflammation does increase the chance for malignancy or cancers.