Colorectal screening and cancer, rectal cancer and anal cancer Flashcards
(45 cards)
When do you start obtaining a family history and when do you update it?
Age 20 and update every 5-10years
Who are we suspicious of for colorectal malignancy?
any patient over 40 with bowel changes and hematochezia
Who is average risk patient for colorectal screening?
asymptomatic and over 50 or over 45 if African American
When do we stop colorectal screenings?
over 85
Gold standard cancer prevention test?
colonoscopy every 10 years
Do we offer cancer prevention or cancer detection test first?
cancer prevention tests
Cancer detection tests
Annual fecal immunochemical test - don’t have to change diet, do at home and mail in
Annual fecal occult blood test- ptn can’t take aspirin or certain food; office or at home
Fecal DNA every 1-3 years- most sensitive; need to give a whole stool sample
If a cancer detection test is positive then do what?
cancer prevention test
Patient has one 1st degree relative with CRC or advanced adenoma less than 60yo
begin screening at age 40 or at an age 10 yrs younger than when person diagnosed. Get a colonoscopy every 5 yrs after.
Ex. Mother diagnosed at 45, you start getting tested at 35.
Patient has one first-degree relative with CRC or adenoma over 60 is screened how?
same as average risk person
Patient has over 2 first-degree relative with CRC or advanced adenoma of any age
begin screening at age 40 or at an age 10 yrs younger than when person diagnosed. Get a colonoscopy every 5 yrs after.
Ex. Mother diagnosed at 45, you start getting tested at 35.
Patient with lynch syndrome risk screening
Start at 20-25 or 10 yrs less than youngest affected relative and get colonoscopy every 1-2 yrs until 40, then yearly.
Genetic testing
Patient with FAP risk screening
Age 10-12 get sigmoidoscopy yearly
colonoscopy yearly after first polyp discovered
genetic testing
Patient with personal history of CRC
Total colon examination within 1 yr of resection and repeat at 3 yrs and 5 yrs if normal
Patient with personal history of adenoma
poylps removed and colonoscopy based on timeline
IBD patient
begin 8 years after onset of pancolitis
colonoscopy every 1-2 yrs
Who is most likely to get colorectal cancer?
age 50 -65; males; african americans
Where are colorectal cancers prevalent?
W. industrialized countries due to diet
Location of colorectal cancers
L. colon most common
R. colon is inherited in African Americans
Cause of CRC
genetic and molecular alterations
RF CRC
Modifiable - W. diet (red meat, fats) - obesity - smoking - alcohol - diabetes Non-modifiable - African American - Hereditary Polyposis Syndromes - FHx of colon cancer - increase in age - IBD - Childhood abdominal radiation
Modifiable prevention CRC
diet and macronutrients- veggie, fruit, less red meat, fiber
physical activity
Low dose aspirin
Clinical R. side CRC
- vague abdominal pain
- iron deficient anemia
- fatigue
- GI bleed
- weakness due to blood loss
- rectal bleeding
- cachexia
- weight loss
- back pain
- ascites
- pallor
Clinical L. side CRC
- obstructive symptoms
- colicky abdominal pain
- change in bowel habits
- constipation alternating with loose stools
- stool streaked with blood
- rectal bleeding
- cachexia
- weight loss
- back pain
- ascites
- pallor
