Colorectal+Cancer

Polyps
1. any mass of tissue arising from bowel wall and protruding into lumen 2. 50% of people have them 3. specific histological types - adenomas - may become malignant 4. most in rectum and sigmoid colon 5. most asx but rectal bleeding is common complaint 6. surgically removed 7. 2 annual inspections of entire colon with colonoscopy 8. if negative, then colonoscopy q2-3 yrs

Incidence
1. 2nd after lung CA 2. more after age 40 and peaks between 60-75 3. colon CA more in women; rectal CA more in men

Etiology
1. chronic UC 2. familial polyposis 3. low fiber, high fat, high refined CHO diet

Signs & Symptoms
1. early dx depends on routine examination ---stool occult blood 2. blood in the stool ---occult if in right colon; frank if in left ---rectal CA presents often as bleeding ---always R/O CA with rectal bleeding 3. grows slowly before it is large enough to produce sx 4. colicky abd pain if obstruction esp in left colon 5. alternating constipation and frequency of stools

Diagnosis
1. barium enema 2. 65% within reach of sigmoidoscope 3. total colonoscopy 4. biopsy 5. FOBT - fecal occult blood testing - 1 time is not definitive, have multiple samples

Treatment
1. surgery 2. chemotherapy if surgery not curative recommended: colonoscopy starting @ age 50 and every ten years

Studies: NSAID use tends to show a decrease in poyp formation Estrogen/progesterone seem to have a protective vegetables and fiber intake is protective against colorectal cancer