Gastroenterology Book

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Colorectal CancerAka: Colon Cancer

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  1. Epidemiology
    1. Accounts for 8.5% of all new cancer cases
    2. Colon Cancer related mortality in U.S. in 1998: 556,000
    3. Highest Incidence of Colon Cancer
      1. North America
      2. Western Europe
      3. Australia and New Zealand
      4. Japan
  2. Risk Factors
    1. See Colon Cancer Risk Factors
  3. Management: Non-resectable hepatic metastases
    1. Radiofrequency Ablation
      1. Small trials suggest prolonged survival or cure
      2. Wong (2001) Am J Surg 182:552
  4. Prevention
    1. See Colorectal Cancer Prevention
    2. See Colorectal Cancer Screening
  5. Course
    1. Recurrence risk
      1. Highest risk within first 5 years post-resection
  6. Protocol: Monitoring post-resection
    1. Clinical examination with CEA-125
      1. Initially repeat every 3 months for 2 years
      2. Later repeat every 6 months for up to 5 years
      3. Focus areas
        1. Ostomy problems or stool Incontinence
        2. Radiation proctitis
        3. Bowel adhesions
    2. Colonoscopy
      1. Perform at one year and 3 years post-resection
      2. Then, repeat every 5 years
    3. Ultrasound or CT Abdomen to evaluate liver
      1. Consider every 4-6 months for 3 years
      2. Surveillance per local guidelines
  7. References
    1. Sunga (2005) Am Fam Physician 71:699

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