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