Colorectal Cancer

Epidemiology

In the UK, nearly 34,900 people are diagnosed with colorectal cancer each year. Excluding non melanoma skin cancer, this makes colorectal cancer the second commonest cancer affecting women and the third most common cancer of men.[1]

Pathology

Most colorectal cancers arise from adenomatous polyps[2] which have been found in 33% of patients aged 65-75 years old.[3]

Risk Factors

Age is a powerful risk factor for the development of both polyps and colorectal cancer[4] and our ageing population means that colorectal cancer prevention and management will be increasingly important in the 21st Century.

Prevention and Surveillance

A key part of the prevention strategy (in surveillance) as well diagnosis and initial management of polyps is colonoscopy which may result in polypectomy if appropriate.

Management

[This section has presumably 'strayed in' from an article on gastroduodenal ulcers!] [Epinephrine injection has been compared with haemoclip placement in the context of bleeding gastroduodenal ulcers with comparable rates of initial haemostasis (96%), however, the recurrent bleeding rate and length of stay tended to be lower for the haemoclip group. Active bleeders can be injected with epinephrine followed by thermal therapy for visible vessels.]

References

1. Rankin, G., Indications, contraindications and complications of colonoscopy. Gastrointestinal Endoscopy, ed. e. Sivak M. 1987, Philadelphia: WB Saunders. 873-8.

2. Zuckerman GR, P.C., Acute lower intestinal bleeding. Part I: clinical presentation and diagnosis. Gastrointest Endosc 1998. 48: p. 606-17.

3. T., H., Evaluation of endoscopic haemostasis using an improved clipping apparatus. Surgical Endoscopy, 1988. 2: p. 13-17.

4. Binmoeller KF, T.F., Soehendra N., Endoscopic hemoclip treatment for gastrointestinal bleeding. Endoscopy, 1993. 25: p. 167-70. --Admin 15:50, 2 September 2006 (EDT)