12 - Colon Cancer

Question 1

bacteria that inc risk for colon cancer

Answer 1

strep bovis

Question 2

don’t check FIT testing on…

Answer 2

young patients

Question 3

heritable GI cancer syndromes (4)

Answer 3

familial adenomatous polyposis
hereditary nonpolyposis colon cancer
Peutz-Jeghers syndrome
juvenile polyposis

Question 4

familial adenomatous polyposis

Answer 4

1% colon cancer
AD
mutation of APC (adenomatous polyposis coli)
TONS of polyps

Question 5

Gardner’s syndrome

Answer 5

variant of FAP
includes extraintestinal sx like soft tissue and bony tumors, hypertrophy of RPE, mesenteric desmoid tumors, ampullary cancers

Question 6

FHx of FAP - how do you manage screening?

Answer 6

annual flexible sigmoidoscopy starting at age 12 OR DNA testing for mutation of APC

Question 7

hereditary nonpolyposis colon cancer (HNPCC)

Answer 7

AD
mismatch repair gene mutation
early onset, 70-80% lifetime risk of colon cancer
better prognosis than sporadic cases, but also higher risk for endometrial and ovarian malignancy

Question 8

Lynch syndrome

Answer 8

another name for hereditary nonpolyposis colon cancer

Question 9

Amsterdam criteria

Answer 9

risk for HNPCC

3+ relatives w/ CRC, 1 is 1st deg
CRC involving 2 gens
>=1 case dx before age 50

Question 10

Peutz Jeghers Syndrome

Answer 10

AD
Polyps can occur in small/large bowel or stomach, inc risk for GI cancer in general
neoplastic transformation is infrequent though - hamartomas
assoc lesions - mucocutaneous pigmentation, tumors of ovary, breast, pancreas, endometrium

Question 11

juvenile polyposis

Answer 11

AD
hamartomas in stomach, small/large bowel
inc risk for developing colon cancer