Colorectal cancer and polyps

13 Colorectal cancer and polyps





Questions



image How does colorectal cancer present?

image How would you investigate suspected colorectal cancer?

image How is colorectal cancer staged, and what is the significance?

Colorectal carcinoma is the second most common cause of death from malignancy in developed countries (after lung cancer), and its incidence is increasing.




Aetiology


Factors linked to colorectal cancer are:


image polyps: sporadic polyps cause 80–90% of cancers

image genetic conditions with high-penetrance genes: cause 5% of colorectal cancers and occur particularly in the young; identified patients should be monitored with yearly colonoscopy and their families screened
— familial adenomatous polyps (FAP): causes thousands of polyps in the colon and the risk of cancer is near 100%

— hereditary non-polypopis colorectal cancer: involving an autosomal dominant gene, typically causing right-sided cancers in those under 50 years of age; family members often have a history of gynaecological malignancy

image family history: low-penetrance genes

image age: risk increases with age with colorectal cancer most common in those over 60 and maximal in those aged 70–75 years (> 5% in those under 30 years)

image ulcerative colitis: total colitis for > 10 years; 1% of cancers

image diet: low fibre causes slow transit times, which increases carcinogen contact time; red meat and animal fats increase risk (aspirin and NSAIDs are protective).
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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Colorectal cancer and polyps

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