OnlineMedEd: Gastroenterology - "Colon Cancer"

Question 1

List the risk factors for colon cancer.

Answer 1

• Advancing age
• Smoking
• Drinking
• Red meat consumption
• Obesity
• Genetics
• Inflammation (UC, IBD)

Question 2

Why are pedunculated polyps “good”?

Answer 2

They are easy to resect. Sessile polyps are difficult because you won’t know if you got them all until pathology reports that the edges are accounted for.

Question 3

Describe the three most common presentations of colon cancer.

Answer 3

• Asymptomatic screen
• Iron-deficiency anemia
• Change in the caliber of stool

Question 4

What monoclonal antibody is commonly used to treat colon cancer?

Answer 4

Bevacizumab (remember the spilling blood beverages in the Sketchy scene)

Question 5

Describe the various screening protocols for colon cancer.

Answer 5

• Colonoscopy every ten years
• Sigmoidoscopy every five years with fecal occult blood test (FOBT) every three
• FOBT every one year
• CT colonography every five years (note: Dustyn doesn’t mention this but this is what I read on UTD)

Question 6

Go through the follow-up for no-risk, low-risk, high-risk, and “mega-“risk colonoscopies.

Answer 6

• No-risk (nothing found: 10 years
• Low-risk (1-2 polyps, all tubular or low-grade dysplasia): 5-10 years
• High-risk (more than 2 polys, some villous or high-grade): 1-3 years
• Mega-risk (more than 10 polyps): 2-6 months

Question 7

What cancers are seen in Lynch syndrome?

Answer 7

• Colorectal (non-polyposis)
• Endometrial
• Ovarian

(Think of Meryl Lynch – the CEO!)

Question 8

Review the 3-2-1 rule.

Answer 8

• 3 family members with cancer
• 2 generations
• 1 young person

Question 9

Why might you get tripped up on Peutz-Jeghers?

Answer 9

It is not colon cancer –it is polyps in the small intestine.