Colorectal Cancer (A+ Graded)

What are risk factors for developing colon cancer? Correct Answer 1) Age>50 yrs 2) Personal/fam history of colon polyps/cancer 3) Pre-existing diseases (ulcerative colitis or chrohn's disease) 4) Genetic predisposition 5) Diet high in fat & low in fiber -red meat in particular is risk factor 6) *Alcohol (>2 drinks/day)* 7) Smoking What are the 2 categories of genetic mutations associated with colon cancer? Correct Answer 1) Familial Adenomatous Polyposis (APC gene=100% risk for colon cancer) 2) Hereditary non-polyposis colon cancer (DNA mismatch repair gene mutations in hMLH1/hMLH2) What are the potential sites for colon cancer? Where is the worst cancer? Correct Answer 1) Ascending (right midgut)- worst location 2) Descending (left endgut=NOT as poor of a prognosis) 2) Sigmoid 3) Rectum What is the clinical presentation of colon cancer? Which sxs are associated with advanced disease? Correct Answer -rectal bleeding -blood in stool -changes in bowel function -abdominal pain -anemia/extreme fatigue (advanced disease) -weight loss (advanced disease) What lab tests should be ordered for a patient who is suspected of colon cancer? Correct Answer 1) CBC (look at hemoglobin for anemia) 2) *CEA (carcinoembryonic antigen)=TUMOR MARKER 3) FOBT (fecal occult blood test) 4) Colonoscopy For patients who are at average risk for colon cancer, what are the screening recommendations & frequency recommendations? Correct Answer 1) Begin screening at *50 years* -FOBT (annually) -Sigmoidoscopy (q 5 yrs) -Colonoscopy (q 10 yrs)