Topics: Cancer, Colorectal cancer, Oncology Pages: 14 (4758 words) Published: April 4, 2013
Colorectal cancer
From Wikipedia, the free encyclopedia
Colorectal cancer|
Classification and external resources|

Diagram of the lower gastrointestinal tract|
ICD-10| C18-C20/C21|
ICD-9| 153.0-154.1|
ICD-O:| M8140/3 (95% of cases)|
OMIM| 114500|
DiseasesDB| 2975|
MedlinePlus| 000262|
eMedicine| med/413 med/1994ped/3037|
Colorectal cancer, commonly known as bowel cancer, is a cancer from uncontrolled cell growth in the colon or rectum (parts of the large intestine), or in the appendix. Symptoms typically include rectal bleeding and anemia which are sometimes associated with weight loss and changes in bowel habits. Most colorectal cancer occurs due to lifestyle and increasing age with only a minority of cases associated with underlying genetic disorders. It typically starts in the lining of the bowel and if left untreated, can grow into the muscle layers underneath, and then through the bowel wall. Screening is effective at decreasing the chance of dying from colorectal cancer and is recommended starting at the age of 50 and continuing until a person is 75 years old. Localized bowel cancer is usually diagnosed through sigmoidoscopy or colonoscopy. Cancers that are confined within the wall of the colon are often curable with surgery while cancer that has spread widely around the body is usually not curable and management then focuses on extending the person's life via chemotherapy and improving quality of life. Colorectal cancer is the fourth most commonly diagnosed cancer in the world, but it is more common in developed countries.[1] Around 60% of cases were diagnosed in the developed world.[1] It is estimated that worldwide, in 2008, 1.23 million new cases of colorectal cancer were clinically diagnosed, and that it killed 608,000 people.[1] Contents  [hide]  * 1 Signs and symptoms * 2 Cause * 2.1 Inflammatory bowel disease * 2.2 Genetics * 3 Pathogenesis * 4 Diagnosis * 4.1 Pathology * 5 Prevention * 5.1 Lifestyle * 5.2 Medication * 5.3 Screening * 6 Management * 6.1 Surgery * 6.2 Chemotherapy * 6.3 Radiation * 6.4 Palliative care * 7 Prognosis * 7.1 Follow-up * 8 Epidemiology * 9 Society and culture * 9.1 Notable cases * 10 Research * 11 References * 12 External links| -------------------------------------------------

[edit]Signs and symptoms
The symptoms and signs of colorectal cancer depend on the location of tumor in the bowel, and whether it has spread elsewhere in the body (metastasis). The classic warning signs include: worsening constipation, blood in the stool, weight loss, fever, loss of appetite, and nausea or vomiting in someone over 50 years old.[2] While rectal bleeding or anemia are high-risk features in those over the age of 50,[3] other commonly described symptoms including weight loss and change in bowel habit are typically only concerning if associated with bleeding.[3][4] -------------------------------------------------

Greater than 75-95% of colon cancer occurs in people with little or no genetic risk.[5][6] While some risk factors such as older age and male gender cannot be changed many can.[6] A high fat,alcohol or red meat intake are risk factors for colorectal cancer as is obesity, smoking and a lack of physical exercise.[5] The risk for alcohol appears to increase at greater than one drink per day.[7] [edit]Inflammatory bowel disease

People with inflammatory bowel disease (ulcerative colitis and Crohn's disease) are at increased risk of colon cancer.[8] The risk is greater the longer a person has had the disease,[9] and the worse the severity of inflammation.[10] In these high risk groups both prevention with aspirin and regular colonoscopies are recommended.[9] People with inflammatory bowel disease account for less than 2% of colon cancer cases yearly.[10] In those with Crohn's disease 2% get colorectal...

References: 5. ^ a b Watson, AJ; Collins, PD (2011). "Colon cancer: a civilization disorder.". Digestive diseases (Basel, Switzerland) 29 (2): 222–8. DOI:10.1159/000323926.PMID 21734388.
6. ^ a b c d e f g h i j k l m n o p q r Cunningham, D; Atkin, W, Lenz, HJ, Lynch, HT, Minsky, B, Nordlinger, B, Starling, N (2010-03-20). "Colorectal cancer.". Lancet 375 (9719): 1030–47.DOI:10.1016/S0140-6736(10)60353-4. PMID 20304247.
9. ^ a b Xie, J; Itzkowitz, SH (2008-01-21). "Cancer in inflammatory bowel disease.". World journal of gastroenterology : WJG 14 (3): 378–89. PMC 2679126.PMID 18200660.
11. ^ Juhn, E; Khachemoune, A (2010). "Gardner syndrome: skin manifestations, differential diagnosis and management.". American journal of clinical dermatology 11(2): 117–22. DOI:10.2165/11311180-000000000-00000.PMID 20141232.
12. ^ Half, E; Bercovich, D, Rozen, P (2009-10-12). "Familial adenomatous polyposis.". Orphanet journal of rare diseases 4: 22. DOI:10.1186/1750-1172-4-22.PMC 2772987. PMID 19822006.
13. ^ Ionov Y, Peinado MA, Malkhosyan S, Shibata D, Perucho M (1993). "Ubiquitous somatic mutations in simple repeated sequences reveal a new mechanism for colonic carcinogenesis". Nature 363 (6429): 558–61.DOI:10.1038/363558a0. PMID 8505985.
14. ^ Srikumar Chakravarthi, Baba Krishnan, Malathy Madhavan (1999). "Apoptosis and expression of p53 in colorectal neoplasms". Indian J Med Res 86 (7): 95–102.
15. ^ a b c d Markowitz SD, Bertagnolli MM (December 2009)."Molecular Origins of Cancer: Molecular Basis of Colorectal Cancer". N. Engl. J. Med. 361 (25): 2449–60.DOI:10.1056/NEJMra0804588. PMC 2843693.PMID 20018966.
16. ^ Mehlen P, Fearon ER (August 2004). "Role of the dependence receptor DCC in colorectal cancer pathogenesis". J. Clin. Oncol. 22 (16): 3420–8.DOI:10.1200/JCO.2004.02.019. PMID 15310786.
17. ^ Vogelstein, B.; Kinzler, K. W. (2004). "Cancer genes and the pathways they control". Nature Medicine 10 (8): 789–799.DOI:10.1038/nm1087. PMID 15286780. edit
23. ^ Agency for Healthcare Research and Quality (2010/2011)."Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer". United States Department of Health & Human Services.
26. ^ Yin, L; Grandi, N, Raum, E, Haug, U, Arndt, V, Brenner, H (2011 Jul-Aug). "Meta-analysis: Serum vitamin D and colorectal adenoma risk.". Preventive medicine 53 (1-2): 10–6. DOI:10.1016/j.ypmed.2011.05.013. PMID 21672549.
27. ^ "Screening for Colorectal Cancer". U.S. Preventive Services Task Force. 2008.
28. ^ "Screening for Colorectal Cancer". U.S. Preventive Services Task Force. 2008.
29. ^ a b He, J; Efron, JE (2011). "Screening for colorectal cancer.". Advances in surgery 45: 31–44. PMID 21954677.
32. ^ none (2010 Oct). "Chemotherapy of metastatic colorectal cancer.". Prescrire Int. 19 (109): 219–224.PMID 21180382.
34. ^ Wasserberg N, Kaufman HS (December 2007). "Palliation of colorectal cancer". Surg Oncol 16 (4): 299–310.DOI:10.1016/j.suronc.2007.08.008. PMID 17913495.
35. ^ Amersi F, Stamos MJ, Ko CY (July 2004). "Palliative care for colorectal cancer". Surg. Oncol. Clin. N. Am. 13 (3): 467–77. DOI:10.1016/j.soc.2004.03.002. PMID 15236729.
36. ^ Box 3-1, Page 107 in: Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7153-6.
39. ^ a b NCCN Clinical Practice Guidelines in Oncology - Colon Cancer (version 1, 2008: September 19, 2007).
41. ^ Jeffery M, Hickey BE, Hider PN (2002). Jeffery, Mark. ed."Follow-up strategies for patients treated for non-metastatic colorectal cancer". Cochrane Database Syst Rev (1): CD002200. DOI:10.1002/14651858.CD002200.PMID 11869629. CD002200.
44. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved Nov. 11, 2009.
45. ^ a b Merika, E; Saif, MW, Katz, A, Syrigos, K, Morse, M (2010 Sep-Oct). "Review. Colon cancer vaccines: an update.". In vivo (Athens, Greece) 24 (5): 607–28. PMID 20952724.
46. ^ Jemal, A; Bray, F, Center, MM, Ferlay, J, Ward, E, Forman, D (2011-02-04). "Global cancer statistics". CA: a cancer journal for clinicians 61 (2): 69–90. DOI:10.3322/caac.20107.PMID 21296855.
47. ^ WHO (February 2010). "Cancer". World Health Organization. Retrieved 2011-01-05.
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