Colorectal Cancer Flashcards
What are 3 kinds of polyps?
Pseuduopolyps/inflammatory, Hyperplastic, Adenomatous
What are pseudopolyps?
Not cancerous, due to IBD
What are hyperplastic polyps?
90% of all polyps, low risk for malignancy
What are adenomatous polyps?
Cancerous, 10% of polyps
How long does it take for adenomatous polyps to become cancerous?
10-20 years
What are the most common adenoma polyps?
Tubulous polyps
What are the adenoma polyps that have the highest risk of being cancerous?
Villous adenoma
What is the pathophys of colorectal cancer?
Progression of adenomatous polyp into malignancy (adenocarcinoma) after about 10-20yrs
Colorectal cancer is the ____ leading cause of cancer deaths
3rd
What is the biggest risk factor?
Age > 50
What kind of diet is a risk factor?
Low fiber, high in red/processed meat
What autosomal dominant disease is a risk factor?
Peutz-Jehgers
What will you see in Peutz-Jehgers disease?
hyper pigmentation of lips, buccal, and hands
What are common clinical manifestations of colorectal disease?
Iron deficiency anemia, change in bowel habits, rectal bleeding, abdominal pain, intestinal obstruction
What side of the colon is proximal and what side is distal?
Right is proximal lesions, left is distal lesions
What s/s are most common with right-sided lesions?
Bleeding seen by anemia & fecal occult blood, diarrhea
What s/s are most common with left-sided lesions?
Bowel obstruction presented later on, changes in stool diameter
How do you Dx?
Colonoscopy with biopsy, barium enema
What is classic for colorectal cancer on colonoscopy?
Apple core lesion classic
What labs will be increased?
Increased CEA marker
What is the main treatment?
5FU is mainstay of chemo
What else can you do?
Surgical resection
What do you monitor throughout treatment?
CEA
At what age does annual stool guaiac test begin for screening?
50y for average risk person, or 40y if 1st degree relative has had been Dx (or 10y before that family member had it)
