Colorectal Cancer

Question 1

Risk factors for colorectal cancer?

Answer 1

FH colorectal cancer
Familial adenomateous polyposis (FAP)
Hereditary nonpolyposis colorectal cancer (HNPCC)
IBD
Increased age
Diet high in red/processed meat, low fibre
Obesity/sedentary
Smoking
Alcohol

Question 2

What is the inheritance pattern of FAP?

Answer 2

Autosomal dominant

Question 3

Signs and symptoms of colorectal cancer?

Answer 3

Change in bowel habit
UWL
Rectal bleeding/blood in stool
Abdominal pain
Iron deficiency anaemia
Abdominal/rectal mass
Obstruction - acute abdominal pain, vomiting, obstipation

Question 4

What is the indications of 2-week wait referral for suspected colorectal cancer?

Answer 4

Involves colonoscopy…
FIT result of 10 mcg or above
Adult with a rectal mass

Question 5

Indications for a Faecal Immunochemical Test?

Answer 5

Adults with abdominal mass, change in bowel habit, or IDA
Aged 40 and above with UWL and abdominal pain
Aged under 50 with rectal bleeding PLUS abdominal pain OR UWL
Aged 50 and above with either rectal bleeding, abdominal pain OR weight loss
Aged 60 and over with anaemia without iron deficiency

Question 6

Investigations for colorectal cancer?

Answer 6

Blood test: FBC for anaemia, iron studies, Carcinoembryonic antigen (CEA) will be elevated
Gold standard: Colonoscopy to identify tumours and take biopsies
CT colonography: if patient is less fit for colonoscopy

Question 7

Following curative surgery for colorectal cancer what follow up is needed?

Answer 7

3 years checking CEA levels and CT TAP