Flashcards in Colon Cancer Deck (17):
Which two polyp types are not precancerous?
2. Pseudopolyps (IBD)
Which two polyp types are precancerous?
-Tubular adenoma*** (MC)
2. Sessile serrated polyps
What 3 characteristics of polyps influence surveillance interval recommendations
3. Histology (degree of dysplastic change)
Most common type of colon cancer?
-MC on left side (sigmoid, rectum)
-Right-sided are increasing in prevalence
Colorectal cancer risk factors
1. Age >50
2. IBD (>8-10 years)
3. African American
4. Family history (familial Adenomatous Polyposis, Hereditary nonpolyposis colon cancer)
7. DM type 2
9. Red meat
What test may be elevated if colorectal cancer spreads to the liver?
What lab is a good prognostic indicator and is used to monitor for recurrence?
Carcinoembryonic antigen (CEA)
Hemoccult SENSA test
-2 specimens on 3 consecutive stools
-Avoid red meat, iron supplements, Vitamin C and NSAIDS before test
FIT (CRC screening test)
Preferred CRC detection test**
-tests for human hemoglobin
-Fewer false positives
FIT DNA (Cologuard)
-Higher false positive rate than the FIT
-Excellent negative predictive value
When should normal healthy folks begin screening for colorectal cancer?
45 if African American
When should you start screening for colorectal cancer in increase risk individuals?
-one first degree relative with CRC, or advanced adenoma before age 60
-two 2nd degree relatives
**Start at 40 or 10 years prior to age of diagnosis
-->Colonoscopy every 5 years
When do you stop screening for colorectal cancer?
age 75 (if they are up to date with screening)
life expectancy <10 years
If a patient has never been screened for colorectal cancer, up to what age can you consider to screen?
How often should the FIT test be done?
Familial Adenomatous Polyposis (FAP)
-Increased risk of other cancers: duodenal and gastronomas**, thyroid (so-->also need endoscopy)
Screening: start annual colonoscopy 10-12 through age 40 if negative
Tx: prophylactic colectomy ****