Colorectal Cancer Flashcards
most common type of colorectal cancer
adenocarcinoma
where are the majority of cancers located
rectum / sigmoid colon (left side)
genetic risk factors for colorectal cancer
familial adenomatous polyposis syndrome (FAP)
hereditary non-polyposis colorectal cancer (HNPCC)
What is FAP
familial adenomatous polyposis
- autosomal dominant disorder of tumour suppressor APC gene
- many adenomatous polyps throughout the colon
what is HNPCC
hereditary non-polyposis colorectal cancer
- autosomal dominant disorder of DNA mismatch repair system
- develop right sided carcinomas (usually most common sigmoid colon- left sided)
- no polyps
risk factors for colorectal cancer
increasing age family hx IBD low fibre diet high processed meat intake smoking + alcohol
most common presenting symptom of colorectal cancer
change in bowel habit
presentation of right sided cancers
often present late
- weight loss
- anaemia
- abdo pain
presentation of left sided cancers
change in bowel habit
PR bleeding
tenesmus
which patients should be referred for urgent investigation of suspected bowel cancer
- > 40 with unexplained weight loss + abdo pain
- > 50 with unexplained rectal bleeding
- > 60 with iron deficiency anaemia / change in bowel habit
- +ve occult blood screening test
what colorectal cancer screening is offered in the UK
FIT test every 2 years for men + woman between 60-75
- detects blood in faeces
gold standard investigation for diagnosing colorectal cancer
colonoscopy with biopsy
tumour marker in colorectal cancer
CEA
- Used to monitor disease progression
management of colorectal cancer
surgery if suitable + chemotherapy
surgical procedure for tumour of the caecum or ascending colon
right hemicolectomy
- extended right hemicolectomy for tumours of transverse colon