GI Health Maintenance Flashcards
Risk factors for colorectal cancer?
6
- Age > 50
- History of adenomatous polyps
- Personal history of inflammatory bowel disease
- Family history
- African-American or Eastern European Jews
- Type 2 DM
Adenomatous polyps (adenomas) increase colon cancer risk
- What characteristics of these make the risk greater? 2
- What kind of polyps do not increase risk?
- Large in size or multiple polyps increase risk
2. Hyperplastic polyps do not increase risk
Lifestyle related factors:
1. What kind of diet would put you at risk for colon cancer? 2
- What other lifestyle factors would contribute to this? 4
- High in
- red meat (beef, pork, lamb) and processed meats
- Low fruit and vegetable consumption - Physical inactivity
- Obesity
- Smoking
- Heavy alcohol use
Sounds like typical American diet and lifestyle
How does having a first degree relative with colorectal cancer increase your risk of cancer?
First degree relative with colorectal cancer doubles risk
- Even higher risk if that person was 45 years or younger at diagnosis
- Family members with adenomatous polyps also increases risk
What are inherited syndromes that would increase your risk of colon cancer?
4
- Familial Adenomatous Polyposis (FAP)
- 1% of all colorectal cancers - Hereditary non-polyposis colon cancer (HNPCC)
- 2-4% of all colorectal cancers - Turcot syndrome
- Peutz-Jeghers syndrome
Even after adjusting for obesity what disease increases risk of colon cancer and also has a less favorable outcome if they are diagnosed?
Type 2 Diabetes
Previous treatments for other cancers also increase risk. Specially what two?
Testicular cancer
Prostate cancer
Colorectal Cancer Screening Tests
6
- Flexible sigmoidoscopy
- Colonoscopy
- Double-contrast barium enema
- Virtual colonoscopy
- Fecal Occult Blood Test (FOBT)…stool guaiac test
- Fecal Immunochemical Test (iFOBT or FIT)
What does guaiac detect in the stool?
Guaiac detects heme in stool
Advantages of Fecal Immunochemical Test (iFOBT or FIT)?
4
- More accurate measurement
- Less false positives
- No need to avoid meat and vitamin C
- Uses antibodies to detect HB in stool
Flexible Sigmoidoscopy
- Advatnages? 3
- Done every how many years?
- Views how much of the colon?
- Disadvantages? 3
- Small risk of what? 3
- Fairly quick and safe
- Sedation usually not used
- Does not require a specialist to perform
- Done every 5 years
- Views only about a third of the colon
- Can miss small polyps
- Can’t remove all polyps
- Will need a colonoscopy if abnormal
- Small risk of
- bleeding,
- infection or
- bowel tear
What is the preferred method of colon cancer screening?
colonoscopy
Colonoscopy
- Advantages? 2
- Done every how many years?
- Disadvantages? 3
- Small risk of what? 3
- Can usually view the entire colon
- Can biopsy and remove polyps
- Done every 10 years
- Can miss small polyps
- Full bowel prep needed
- Sedation is needed
- Small risk of
- bleeding,
- bowel tears or infection
- Expensive
Double Contrast Barium Enema
- Advantages? 3
- Done every how many years?
- Disadvantges? 5
- Can usually view the entire colon
- Relatively safe
- No sedation needed
- Done every 5 years
- Can miss small polyps
- Full bowel prep needed
- Some false positive test results
- Can’t remove polyps during testing
- Colonoscopy will be needed if abnormal
Double Contrast Barium Enema
- Test has largely been replaced by what?
- Use has also declined with the increasing use of what? 2
- colonscopy
2. endoscopic and CT procedures
Virtual Colonoscopy
- Advanatges? 3
- Done every how many years?
- Disadvantages? 4
- Fairly quick and safe
- Can usually view the entire colon
- No sedation needed
- Done every 5 years
- Full bowel prep needed
- Can miss small polyps
- Some false positive test results
- Colonoscopy will be needed if abnormal
Virtual Colonoscopy
- aka?
- What is given first in the process?
- What kind of imaging is done and how?
- Also known as CT colonography
- Air enema is given
- CT scan of the colon done X 2 (supine and prone positions)
Fecal Occult Blood Test (FOBT)
- Advantages? 4
- Disadvantages? 3
- Should be done how often?
- Process? 2
- No direct risk to the colon
- No bowel prep needed
- Sampling done at home
- Inexpensive
- May produce false positive test results
- May have pre-test dietary restrictions
- Colonoscopy will be done if abnormal
- Should be done yearly
- Need 3 different stool samples
- Patient drops off or mails in cards