Colorectal Cancer

Question 1

Who is at average risk for colorectal carcinoma?

Answer 1

General population

No hx of:

• IBD
• Polyps
• Heredity Syndromes

Question 2

Colorectal cancer screening recommended at age..

Answer 2

50

..recently 45

Question 3

Direct visualization options for screening CRC

Answer 3

• Colonoscopy every 10 yrs (if clean)

Alternatives (Scope if suspicious finding):

• CT colonography Or capsule endoscopy x 5 yrs
• Flexible sigmoidoscopy every 5 - 10 yrs

Question 4

Stool based screening for CRC methods:

Answer 4

• FIT Annually
• FOBT Annually
• Multitargeted still DNA test x 3yrs

(All positive test require confirmation with Scope)

Question 5

High risk CRC individuals screening protocol in..

> /= 2, first degree relatives with CRC at any age

OR

> /= 1, first degree relative w/ CRC or advanced adenoma < 60 yrs

Answer 5

Colonoscopy at 40 yrs or 10 yrs earlier than index patient’s age

Followed by complete colonoscopy every 5 yrs

Question 6

Screening Protocol for individual with one SECOND Degree relative with CRC or advanced adenoma

Answer 6

• Screening as in Average risk population

Question 7

Screening protocol in FAP

Answer 7

• Annual screening starting a 10 years (sigmoidoscopy/ colonoscopy)
• Annual upper endoscopy screening starting at 25 years

Question 8

Screening protocol in pt with confirmed mutation or meeting Amsterdam II criteria

Answer 8

Colonoscopy every 1-2 yrs

• starting at 20-25 yrs of age
• or 2-5 years before earliest recorded case

(Whichever comes first)