We have presented our experience with 19 black patients who had familial polyposis coli, seven of whom had associated cancer. Four of the seven had multiple cancers. Seventeen of the 19 patients were female but most of the patients at risk in our series were female. Sixteen of the 19 had extracolonic manifestations which have been described as part of Gardner's syndrome. Although our series was quite small, larger series do not report as high an incidence of extracolonic manifestations. Follow-up was too short to make any statements concerning the development of cancer in the retained rectal stump.