colon-rectal cancer keith bradley, md national alliance of research associates programs narap
Post on 22-Dec-2015
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Colon-Rectal Cancer
• 2nd leading cause of cancer deaths in U.S.
• complex interactions between inherited susceptibility and environmental risk factors
Inherited Risk Factors
• age > 40
• personal hx of colon-rectal cancer
• Ulcerative colitis or Crohn’s disease
• family (parents or siblings) hx of
– colon-rectal cancer or – adenomas before age 60
• Familial polyposis
Acquired Risk Factors• diet
high in low in – saturated fat - calcium– protein - folate– calories– meat (both red and white)– alcohol
• sedentary lifestyle
• smoking cigarettes
Decreased Risk
• low-fat, high-fiber diet
• nonsteroidal anti-inflammatory drugs
• post menopausal female hormone use
• polyp removal
Colon-Rectal Cancer
• 2nd leading cause of cancer deaths in U.S.
• complex interactions between inherited susceptibility and environmental risk factors
• number of new cases and deaths due to colon-rectal cancer has been decreasing
Fecal Occult Blood Test
• special cards are coated with a stool sample and returned to the physician or lab
Fecal Occult Blood Test
• special cards are coated with a stool sample and returned to the physician or lab
• fecal occult blood test
performed every 1 or 2 years
in people between the ages of 50-80 years decreases deaths due to colorectal cancer by 20 – 40%
Flexible Sigmoidoscopy• a thin, lighted tube (sigmoidoscope)
into rectum and only the descending colon• most often done
– in a doctor’s office or clinic– by a family practitioner (FP) or general internist
• patient remembers the procedure • polyps or other abnormal tissue
removed and biopsied• combined with FOBT every 3 years
Colonoscopy
• a thin, lighted tube (colonoscope)
into rectum and through the entire colon• most often done
– in a hospital or specialized setting– by a gastroenterologist (but possibly a FP)
• under conscious sedation• polyps or other abnormal tissue
removed and biopsied
Polyps
• adenomas = precursors for vast majority of colorectal cancer
• most of these adenomas are polypoid
Colon-Rectal Cancer Screening
Fewer than 50% over age 50 get screened
In a survey,
respondents who had never had a colonoscopy
said they would rather give up three months of life
than have the test.
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