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DU PA Colon Cancer

Duke PA Colon Cancer

95% of primary colon cancers are adenocarcinomas
1/__ people will develop colorectal cancer 18
risk for colorectal cancer __ each decade of life after age 40 doubles
90% of colorectal cancers occur after age __ 50
lifestyle risk factors for colon cancer diets high in red and processed meats, physical inactivity, obesity, smoking, heavy alcohol use
Gardner's syndrome is a type of Familial Adenomatous Polyposis
Familial Adenomatous Polyposis occurs because of an __ gene mutation APC
Familial Adenomatous Polyposis is a __ genetic disorder autosomal dominant
incidence of Familial Adenomatous Polyposis is 1:__ 10,000
Hereditary Non-polyposis Colorectal Cancer has an incidence of 1:__ 2,000
Hereditary Non-polyposis Colorectal Cancer is an __ genetic disorder autosomal dominant
Hereditary Non-polyposis Colorectal Cancer is associated with endometrial, ovarian, gastric, urinary tract, renal cell, biliary, and gallbladder cancers
up to __% of colorectal cancer have some familial component althought the genes have not been defined 30
HNPCC, and FAP account for about __% of all colorectal cancers 6
tools to determine families at risk for colon cancer Amsterdam criteria, Bethesda guidelines
signs and symptoms of colon cancer rectal bleeding, iron deficiency anemia, fatigue and weight loss, obstruction, change in stool quality/caliber, abdominal mass or pain
gold standard for colon cancer screening colonoscopy
most common symptoms for colon cancer abdominal pain, change in bowel habit, hematochezia or melena
tends to be a late symptom of colon cancer weight loss
fistulas happen more often in __ but can also be seen in colon cancer Chron's disease
__% of cases of colon cancer have metastatic disease at the time of diagnosis 22
colon cancer is most often metastatic to __ liver and lung
not part of diagnosis of colon cancer, but is used to tract progress of treatment or recurrance CEA
used for staging of colon cancer CT scan of abdomen and pelvis
relatively short, sharply defined region of annular, constricting colonic narrowing with overhanging margins, ulcerated mucosa, and an eccentric and irregular lumen apple core lesion
stage of cancer is determined from exam, biopsy, imaging, lymph node dissection
most common colon tumore staging AJCC
inner lining of the colon mucosa
first muscle layer of colon, thin layer muscularis mucosa
fibrous tissue beneath the muscle layer of colon submucosa
second, thick muscle layer of colon muscularis propria
outer most layers of colon subserosa, and serosa
tumor that is through muscularis mucosa, extends into submucosa T1
tumor that is through the submucosa into the muscularis propria T2
tumor that is through the muscularis propria and into the subserosa, not to any neighboring organs T3
tumor that is through the wall of the colon or rectum and into nearby tissues or organs T4
cancer cells in 1-3 nearby lymph nodes N1
cancer cells in 4 or more nearby lymph nodes N2
no lymph node involvement N0
metastasis is present M1
no distant spread is seen M0
patients with a stage IV colon cancer have a __% 5 year survival rate 8
metastatic disease with any tumore size and lymph node involvement is a stage __ cancer and has a 5 year survival of 8% IV
__ tumors can be removed endoscopically some very early stage (0-1)
__ is not used for colon cancer butt may be used for rectal cancer radiation
for the average patient colonoscopy screening for colon cancer starts at age __ 50
if family history of CRC in first degree relative or multiple second degree relatives, screening colonoscopy starts when __ the patient is 10 years younger than youngest affected family member with CRC
the only colon cancer screening that has a proven mortality benefit FOBT
all FOBT's need to be followed by __ colonoscopy
never screen with a __ digital rectal exam
negative FOBT's should be repeated __ annually
examines the left colon flexible sigmoidoscopy
most common serious complication of colonoscopy is bleeding post-polypectomy
patients with no family history have a colonoscopy every __ after the age of 50 10 years
once cancer or adenomatous polyps are detected colonoscopy is usually repeated every __ 3-5 years
patients with a family history of CRC get a colonoscopy every __ 5 years
patients with inflammatory bowel disease get a colonoscopy every __ once disease is present for more than 15 years year
__ are not considered pre-malignant hyperplastic polyps
a person with __ does not need a shortened interval between screening exams hyperplastic polyps
CT colonography is sensitive and specific for __ polyps large (1cm or greater)
carcinoma of the colon and rectum is the __ most common cancer third
carcinoma of the colon and rectum is the __ most common cause of cancer deaths in American men and women second
__ has been shown to be an effective strategy for reducing colorectal cancer mortality screening
approximately __% of Americans will develop colorectal cancer during their lifetime 6
colorectal cancer is extremely uncommon in individuals younger than 35
factors associated with a decreased risk for colon cancer physical activity, consumption of certain vegetables, and multivitamins with folic acid
the majority of colorectal cancers are believed to arise from __ benign adenomatous polyps
it takes around __ years for an adenoma to develop into an invasive cancer 10
characterized by inherited mutations in one of the DNA mismatch repair genes (hMLH1 or hMSH2), early onset colorectal cancer (avg. 44 years), and an estimated lifetime risk of colorectal cancers of 80-90% HNPCC (Lynch Syndromes)
characterized by inherited mutations in the APC gene, the appearance of hundreds of colorectal adenomas during the 2nd or 3rd decade of life, and a lifetime risk of colorectal cancer that approaches 100% by the 5th decade of life FAP
__ is a variant of FAP in which affected probandsalso exhibit a variety of extra-intestinal manifestations such as osteomas, desmoids, and other soft tissue tumors Gardner's syndrome
the majority of colorectal neoplasms are __ until advanced asymptomatic
the most common symptom of colorectal cancer GI blood loss
symptoms of colorectal cancer (other than GI blood loss) abdominal pain, change in bowel habits, unexplained anorexia or weight loss
periodic screening by fecal occult blood testing, flexible sigmoidoscopy, barium enema, or colonoscopy is recommended for asymptomatic, average-risk patients beginning at age 50 years
approximately 50% of colorectal adenomas and cancers are located __ between the rectum and splenic flexure
lesions detected on barium enema study necessitate __ colonoscopic evaluation
__ is used perioperatively to assess the extent of metastatic disease abdominal CT
45% of patients first come to medical attention at stage __ disease III or IV
__ is curative for early-stage colorectal cancers surgery alone
__ are recommended for stage III colon cancer surgery and adjuvant chemotherapy with 5 fluorouracil and leucovorin
__ are the mainstays of treatment for stage IV colon cancer palliative surgery, chemotherapy, and or radiation therapy
Created by: bwyche