Colorectal Polyps and Cancer

Question 1

What are the 4 pathological groups of CP?

Answer 1

• Mucosal adenomatous polyps
• Mucosal serrated polyps
• Mucosal nonneoplastic polyps
• Submucosal lesions

Question 1

What is the definition of a colorectal polyp (CP)?

Answer 1

Discrete mass lesions that protrude into the intestinal lumen.
Commonly sporadic, they may be inherited as part of a familial polyposis syndrome.

Question 2

Over 70% of polyps removed during colonoscopy are___?

Answer 2

adenomatous and the remainder are serrated.

Question 3

What are the histological classifications of CP ?

Answer 3

• Tubular – account for more than 80% of colonic adenomas.
• Villous – account for 5% to 15% of adenomas. They are characterized by glands that are long and extend straight down from the surface to the center of the polyp.
• Tubulovillous – account for 5 to 15% of adenomas.

Question 4

What is the size of benign adenoma

Answer 4

<1 cm

Question 5

What are the characteristics of advanced adenomas and serrated polyps ?

Answer 5

– 1 cm or larger
– contain villous features
– high-grade dysplasia

Question 6

What are the signs and symptoms of colorectal polyps ?

Answer 6

– Most patients with adenomatous and serrated polyps are completely asymptomatic.
– Chronic occult blood loss may lead to iron deficiency anemia.
– Large polyps may ulcerate, resulting in intermittent hematochezia.

Question 7

What is the imaging of choice in colorectal polyps ?

Answer 7

Colonoscopy.

Question 8

What is the epidemiology of colon cancer ?

Answer 8

Colorectal cancer is the 3rd most common form of cancer and is the most common GI cancer with a M: F ratio of 3:1. Peak age of incidence is 55-75 years and the primary ones are adenocarcinomas.

Question 9

What are the risk factors for colon cancer?

Answer 9

• Family History
• History of polyps
  *Low fibre diet, low vegetable intake, smoking
• UC

Question 10

What are the 3 ways of colon-cancer presentation?

Answer 10

– Suspicious signs and/or symptoms
– Asymptomatic individuals discovered by routine screening
– Emergency admission for Intestinal obstruction, Peritonitis, Acute gastrointestinal bleed.

Question 11

What is the main symptom of left-sided Colon CA ?

Answer 11

change in bowel habits

Question 12

What is the main symptom of right-sided Colon CA ?

Answer 12

Iron deficiency anaemia

Question 13

What are the other symptoms of colon CA ?

Answer 13

• Bleeding per rectum
• Lower abdominal pain
• Tenesmus
• Weight loss
• Emergency presentation such as Obstructions and Perforation.

Question 14

What is the distribution of Colon CA / location of the colon ?

Answer 14

• Rectum 40%
• Sigmoid 35%
• Caecum 20%
• Transverse/
  Descending 5%

Question 15

What are the locations of metaststasis of colon CA ?

Answer 15

https://www.mdpi.com/2072-6694/14/4/1019

Question 16

What is the duke classification of colon cancer ?

Answer 16

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