Colon and Rectal Cancers PPT

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Objectives:
- Colon and rectal cancer statistics in Canada.
- Prevention and screening.
- Medical management of localized and advanced stage cancer.

Statistics:
- An estimated 153,000 new cases & 70,000 deaths from cancer will occur in 2006 in Canada1.
- An estimated 20,000 new cases & 8,500 deaths from colorectal cancer will occur in 2006 in Canada1.

Risk factors:
01.Sporadic (70%):
- Age: Risk increases significantly b/w ages of 40 and 50, & in each succeeding decade thereafter1.
- Lifetime incidence is about 5%.
Inflammatory bowel disease (Pancolitis ,5-15 fold increased risk )1
- Alcohol
- Diabetes mellitus
- Cigarette smoking.
02.inherited (5-10%):
(a) Germ line mutations.
Polyposis syndromes:
- Familial adenomatous polyposis.
- Less than 1% of CRC.
- Germ line mutations in APC gene on ch 5
Non Polyposis syndromes
- Hereditary nonpolyposis CRC.
- Autosomal dominant.
- More common than FAP1
03.familial (20-25%):
- Affected pts have family history, but pattern is different from inherited one.

Diagnosis:
* Presentation of metastatic disease:
- 15-20% of pts have metastatic disease on presentation.
- Common sites are LN, liver, lungs and peritoneum.

Diagnostic procedures:
- Colonoscopy.
- Double contrast barium enema


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