Colon Flashcards
Dominant risk factor for colorectal cancer
Aging is the dominant risk factor for colorectal cancer, with incidence rising steadily after age 50 years. More than 90% of cases diagnosed are in people older than age 50 years.
Sporadic vs familial coloorectal ca
Approximately 80% of colorectal cancers occur sporadically, while 20% arise in patients with a known family history of colorectal cancer.
Is cigarette smoking a risk factor for colorectal ca?
Yes. Cigarette smoking is associated with an increased risk of colonic adenomas, especially after more than 35 years of use.
Screening guideline for the average risk population
Initial age @ 50y Annual FOBT or Flexible sigmoidoscopy every 5y or Combination of the above or Air-contrast barium eneme every 5y, or Colonoscopy e10y
Screening guideline for adenomatous polyps
Initial age at 50y Colonoscopy at first detection, Then colonoscopy in 3y, If no further popys, colonoscopy every 5y. If with polyps, colonoscopy every 3y Annual colonoscopy for >5 adenomas
Screening guideline for colorectal CA
Initial age is at diagnosis
Pretreatment colonoscopy;
Then at 12 months after curative resection,
Then colonoscopy after 3y,
Then colonoscopy every 5y if no new lesions
Screening guideline for UC, crohn’s colitis
Initial age at diagnosis;
Then after 8 years in px with pancolitis,
And after 15y for patients with left-sided colitis
Colonoscopy with multiple biopsies every 1-2y
Screening guideline for FAP
Initial age at 10-12y
Annual flexible sigmoidoscopy
Upper endoscopy every 1-3y after polyps appear
Screening guideline for attenuated FAP
Initial age at 20y
Annual flexible sigmoidoscopy
Upper endoscopy every 1-3 y after polyps appear
Screening guideline for
HNPCC
Initial age at diagnosis at 20-25 y
Colonoscopy every 1-2y
Endometrial aspiration biopsy every 1-2y
Screening guideline for
Familial colorecta CA
First degree relative
Initial age at 40 y or 10y before the age of the youngest affected relative
Colonosopy every 5 y
Increase frequency if multiple family members are affected, especially before 50y
TX
Primary tumor cannot be assessed
T0
no evidence of primary tumor
Tis
Carcinoma in situ, intramucosal carcinoma (involvement of lamina propria with no extesion through muscularis mucosa)
T1
Tumor invades the submucosa (through the muscularis mucosa but NOT into the muscularis PROPRIA)
