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GI Colon Cancer
CM Colon Cancer
| Question | Answer |
|---|---|
| 95% of primary colon cancers are | adenocarcinomas |
| _____ is the greatest risk factor for colon cancer | age. Risk doubles each decade of life after age 40. |
| Lifestyle Risk factors | diets high in red meat and processed meats, physical inactivity, obesity, smoking, heavy alcohol use |
| Familial Adenomatous Polyposis Facts | APC gene mutation, autosomal dominant, hundred of colon polyps in teenage years. |
| Hereditary Non-Polyposis Colorectal Cancer or Lynch syndrome | Autosomal dominant, 1:2,000 incidence, Microsatellite instability -->Frame shift mutations--problems wiht mismatch repair. Associated with lots of cancers, eg endometrial |
| Up to _____ percent of colorectal cancers have some familial component | 30% |
| Signs and symptoms of colon cancer | rectal bleeding, iron deficiency anemia, fatigue and weight loss, obstruction (left sided tumors), change in stool quality/caliber, abdominal mass/pain |
| 50% of colorectal cancers occur | in the rectum (30%) and the sigmoid colon (20%) |
| unusual presentations of colon cancers | fistulas, fever or unknown origin or abscesses. Streptococcus bovis bacteremia and Clostridium septicum sepsis |
| ___ % of patients have metastatic dz at time of diagnosis | 22% |
| Common places of mets | colon cancer: liver then lung; Rectal cancer: liver or lung |
| Diagnostic Evaluation of Colon Cancers | Colonoscopy (gold standard), CT abd/pelvis for staging, CXR, Needle biopsy of suspected metastatic dz, Labs, PET only for suspected mets |
| CEA is used to | track someone's tumor over time, not to make a diagnosis |
| Colectomy | hemicolectomy with lymph node dissection (usually 1/4th the colon is removed) |
| radiation is used for | rectal cancer, not colon cancer (colon is too mobile) |
| Role of Vitamin D and Calcium | Possibly protective against Colon cancer |
| For the average patient, colonoscopy starts at | age 50. If a family history of CRC, repeat every 5 years. |
| If a pateint has a first degree family relative or multiple second degree relatives, screening begins | starting 10 years younger than youngest affected family member |
| Gold standard of colon cancer screening | colonoscopy |
| Guaiac-based FOBT | has the best mortality data for CRC screening. Never screen with DRE. Three cards sent home with patient |
| FOBT's must be repeated | every year |
| a positive FOBT must be followed by | a colonoscopy |
| What is the time interval allowed between flex sigmoidoscopies? | 5 year interval between exams |
| What is the colonoscopy miss rate for cancer | 5% |
| Name the most serious complication of colonoscopy | bleeding post-polypectomy |
| How often are colonoscopies performed? | Every 10 years, unless cancer or adenomatous polyps are detected (then 3-5 years). Family hx with CRC (every 5 years). IBD (every 15 years) |
| CT colonography facts | no sedation, bowel prep required, great pictures. Positive results require follow-up colonoscopy |
| Hyperplastic polyps are not considered | pre-malignant. A person with only hyperplastic polyps does not need a shortened interval between screening exams |
Created by:
ltm12