GI epidemiology

Question 1

CRC

Answer 1

3rd most common malignant neoplasm of men and women

- 2nd leading cause of death combined for men and women

Question 2

Primary Prevention

Answer 2

Diet/Exercise --> controlling BMI
ASA/NSAIDs/Cox-2
Calcium/Vit D
Hormone Replacement therapy
Statins --> contributes to BMI

Question 3

Secondary Prevention

Answer 3

Polyp/Cancer Relationship –> take all polyps out

95% of CRC arises from adenomatous and serrated polyps overtime

Question 4

Screening Average Risk

Answer 4

begin at 50 y.o. --> 45 for African Americans
stop at 75 y.o.
Colonoscopy every 10 years
FOBT and Flex Scope every 5 years
Enema --> not at good

Question 5

Risk factors for CRC

Answer 5

Age >50

History of CRC, UC, Crohn’s

Question 6

If patient is symptomatic?

Answer 6

It is not screening anymore –> it is diagnostic!!!

- change in BM, rectal bleeding, stool test (+), ab pain, anemia, weight loss

Question 7

Esophageal Cancer

Answer 7

Upper and middle –> squamous cell carcinoma

Lower –> adenocarcinoma from Barrett’s

Question 8

Risk factors of esophageal squamous cell cancer

Answer 8

Tobacco, alcohol, African-American, male, mucosal irritants, carcinogen, poor diet

Question 9

Risk factors for esophageal adenocarcinoma

Answer 9

GERD, Barrett’s, white, male, obese, diet

Question 10

Hepatocellular Carcinoma

Answer 10

4th most common cancer worldwide

- 5 year survival without tx –> less than 5%