COLORECTAL

CANCER
 95,520
Estimated new cases develop each year of colon
cancer

http://pressroom.cancer.org/CRCstats2017 2
 39,910
Estimated new cases develop each year of rectal
cancer

http://pressroom.cancer.org/CRCstats2017 3
 50, 260
Annual Death rate despite regardless sex

http://pressroom.cancer.org/CRCstats2017 4
Affects both gender
• 10% in both female and
male with the incidence
increasing significantly
in persona over age 50.

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The incidence rate is 50
times higher in people
over ages of 60 to 79 Place your screenshot here

than those aged 40

years.

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The disease occur most
frequently countries like
North America, Eastern
and Western Europe, the Place your screenshot here

Scandinavian countries,
New Zealand, and
Australia.

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The incidence varies
among races, and Place your screenshot here

ethnicity. African
American, Indians,
Hawaiians, and
Mexicans have the
highest incidence
and mortality.

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ANATOMY
 ETIOLOGY

The cause of colorectal cancer is UNKNOWN

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RISK FACTORS

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HISTORY

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DIET

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GENETIC

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ENVIRONMENT

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 COLON
DISEASES

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SCREENING

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 Screening

ASYMPTOMATIC PERSON
Annual:
• DIGITAL RECTAL • DOUBLE CONTRAST
EXAMINATION BARIUM ENEMA should be
performed every 5-10 yrs and
• FECAL OCCULT BLOOD
complement a colonoscopy
TEST for person over age
exam
50.
• SIGMOIDOSCOPY at lease
every 5 yrs
• PROCTOSIGMOIDOSCOP
Y should be done every 5
years.
• COLONOSCOPY every 10
years.

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 INCREASED RISK

RISK CATEGORIES AGE TO BEGIN RECOMMENDATION

▸ Single, small (<1cm) ▸ 3-6yrs after the initial ▸ Colonoscopy
adenoma polypectomy

▸ Large (1+ cm) ▸ Within 3yrs after initial ▸ Colonoscopy

adenoma, multiple polypectomy
adenomas (with high
grade dysplasia, or
villous change)
▸ Personal hx or
curative intent
resection of colorectal
ca
▸ 40y/o, or 10 yrs before
the youngest case in ▸ Colonoscopy
▸ Either colorectal ca, or the immediate family
adenomatous polyps
in any first degree
relatives at any age (if
not hereditary
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syndrome)
 HIGH RISK

RISK CATEGORIES AGE TO BEGIN RECOMMENDATION

▸ Family hx of familial ▸ Puberty ▸ Early surveillance with
adenomatous polyps endoscopy, and
(FAP) counseling to consider
genetic testing
▸ Family hx of
hereditary ▸ Age 21
nonpolyposis colon ▸ Colonoscopy and
cancer (HNPCC) counseling to consider
genetic testing

▸ Inflammatory bowel ▸ Cancer risk begins to ▸ Colonoscopy with

disease Chronic be significant 8yrs after biopsies for dysplasia
ulcerative colitis the onset of pancolitis,
▸ Crohn’s Disease or 12-15yrs after the
onset of left sided
colitis

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▸ Barium Enema
▸ Colonoscopy
▸ CT/MR/PET scan
▸ Stool for occult blood
▸ Liver Scan
▸ Bone Scan
▸ CBC, AST (SGOT), LDH, ALP, BUN
▸ Carcinoembryonic Antigen (CEA)
▸ Rectal UTZ
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 GENERAL

▸ Change in bowel habits

▸ Shape, color, size of stool
▸ Abdominal pain
▸ Anorexia
▸ flatulence
▸ Indigestion
▸ Alteration in constipation, or diarrhea
▸ Feeling of incomplete evacuation
(tenesmus)
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 LATE SYMPTOMS

▸ Weight loss
▸ Fatigue
▸ Decline in general health
▸ Jaundice

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 RIGHT-SIDED LESION

▸ Dull, vague, abdominal pain radiating to

the back
▸ Dark, red, or mahogany-red blood in
stool
▸ Weakness, anemia, malaise,
indigestion, weight loss, liquid stool

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 LEFT-SIDED LESION

▸ Change in bowel habits—cramps

▸ Gas pains
▸ Decrease in caliber of stool
▸ Bright red bleeding
▸ Constipation
▸ Rectal pressure
▸ Incomplete evacuation of stool
▸ Abdominal pain

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 TRANSVERESE COLON

▸ Palpable masses
▸ Obstruction
▸ Changes in bowel habits
▸ Bloody stool

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 RECTAL

▸ Changes in bowel habits

▸ Bright-red bleeding
▸ Tenesmus
▸ Pain in the groin (labia, scrotum, legs,
or penis)
▸ Constipation

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