Colon Cancer Screening Flashcards
what’s the Frequency of Screening/
Routine testing
should have a colonoscopy every 10 years beginning
at age 50.
when to.. do Screening with a Family History of Colon Cancer if
Single family member
Begin 10 years earlier than the age at which the family
member developed their cancer or age 40, whichever is younger. Repeat the
scope every 5 years if the family member is under age 60
when to.. do Screening with a Family History of Colon Cancer if
3 members, 2 generations, 1 premature (before 50):
Hereditary
nonpolyposis colon cancer syndrome (HNPCC) comprises these factors. Start
screening at age 25 with colonoscopy every 1 to 2 years.
when to.. do Screening with a Family History of Colon Cancer if Familial adenomatous polyposis (FAP):
FAP is defined as the presence of
thousands of polyps with an abnormal genetic test known as the adenomatous
polyposis coli (APC) test. Start screening with sigmoidoscopy at age 12 every
year.
when to.. do Screening if Previous adenomatous polyp:
Patient should have a colonoscopy every 3 to 5
years.
when to.. do Screening if Previous history of colon cancer
Patient should have colonoscopy at 1 year
after resection, then at 3 years, then every 5 years.
Peutz- Jeghers Syndrome path and asoc. w
multiple hamartomatous polyps in association with: Melanotic spots on the lips and skin Increased frequency of breast cancer Increased gonadal and pancreatic cancer
polyposis screening
Age 8: Peutz-Jeghers
Age 12: FAP, juvenile polyposis
Frequency of colonoscopy screening is increased to every 3 years starting at age
8.
Gardner Syndrome associated diseases
is colon cancer in association with:
Osteomas
Desmoid tumors
Other soft tissue tumors
also risk ok cancer of the thyroid, pancreas, and small bowel
Gardner Syndrome screening
age of 12 with
sigmoidoscopy.
Turcot Syndrome ?
colon cancer in association with:
CNS malignancy
TURBAN IN MY HEAD
Juvenile Polyposis? patho
colon cancer in association with:
Multiple hamartomatous polyps
Juvenile Polyposis screening
Screen both upper and lower GI tracts at same intervals as FAP
Anticoagulation in Colonoscopy: NOACs
Stop NOACs one day before colonoscopy, restart them the day after
colonoscopy
Anticoagulation in Colonoscopy: warfarin
Stop warfarin 3–5 days before colonoscopy
3 if metal heart
valves.
colon cancer patho
premalignant lesion ->inflamation process + genetics ->
what makes a good polyp
tubular
peduncular
small
what makes a bad polyp
sessile
villous
large
iron def anemia on man and postmenopausal woman is indicative of_______
colon cancer
how do you stage colon cancer
PAN CT. chet abd pelvis. depending on that you do chemo or not.
what you give for chemo and for biologics
FOLFOX / FOLFIRI is chemo
Vegf-inhibitors bevacizumab Bio
what to do if after first screeening yo found 1-2 polyps
rescope in 5-10 years. This is just low risk
whats high risk?
And when to rescope
any of these >=3 polyps >1cm villous high grade displasya.
Rescope in 1-3y
what’s mega risk?
Amboss: “Very high risk”
> =10 polyps
piecemeal sessile polyp
wath’s no risk
ya find nothing at colonoscopy
FAP management
as CA can start at 30+death at 40, you can profilactic colectomy
Lynch Sx: or hereditary non -polyposis colorectal CA etiology
DNA mismatch repair defect
Lynch Sx: or hereditary non -polyposis colorectal CA and other CAs asociate
CEO
colorectal
endometrial
ovarian
Lynch Sx: or hereditary non -polyposis colorectal CA . Relation to family Hx
3 member of their family
in two generations w some CEO (colon, endometrium, ovary) Ca’s
and 1 younger/premature
peutx jegher sx
dots on the lips, freckles. He does not have colon cancer, but small bowel CA instead. Even with polyps
When to screen for Peutz- Jeghers Syndrome ?
at age 8
