Metagenomic Evaluation of the Gut Microbiome in Patients With Lynch Syndrome and Other Hereditary Colonic Polyposis Syndromes

Inclusion Criteria: * Male or Female age 18 or older * Hereditary colorectal cancer syndrome with one of the following: * Lynch syndrome, as defined by the presence of a deleterious germline mutation in the MLH1, MSH2, MSH6, PMS2 or EPCAM genes * Other hereditary colonic polyposis syndromes, as defined by the presence of a deleterious germline mutation in any one of the following polyposis genes (APC, biallelic MYH, STK11, SMAD4, BMPR1A, or other CRC-risk associated genes at discretion of PI) Exclusion Criteria: * Unable to provide informed consent for testing * Unable to complete English language questionnaire * Receiving active chemotherapy * Having completed active chemotherapy less then 12 months prior to day of scheduled lower endoscopy * No infectious or drug induced colitis less then 12 months prior to day of scheduled lower endoscopy * No history of inflammatory colitis (Crohn's disease or ulcerative colitis)