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Colorectal Cancer: Risk Prevention and Diagnosis Dr Cyril Evbuomwan Colorectal Cancer • It is cancer of the large bowel and rectum • It is the third most common cancer in men • It is the second most common cancer in women • It is the fourth most common cause of death from cancer globally • 1.4m new cases and 700,000 death annually Colorectal Cancer: Occurrence and risk factors • Incidence increases with age peak around 70yrs of age • Male sex • Red meat and process meat consumption • Overweight • Alcohol • Smoking • Family history • Medical conditions: polyp, Diabetes, IBD( inflammation of bowel) Colorectal Cancer: Presentation • Abdominal Pain • Change in bowel Habit: constipation, diarrhoea, increased frequency • Bleeding per rectum • Anaemia with evidence of iron deficiency(present in 10%) • Weight loss • Signs of bowel obstruction • Abdominal mass Colorectal Cancer: Investigations • Colonoscopy and biopsies • Scan: CT colonography • X-ray: Barium Enema • FOB • Some blood test Colorectal Cancer: Prevention • Adequate diet: Increased fibres like cereal, grain, • Milk and cheese, calcium • Aspirin • Increased exercise Bowel Cancer: Screening Programme(FOBT) • England and Wales • Invited every 2yrs from 60-74 • SCOTLAND • FROM 50-74YRS Bowel Cancer: Screening Programme • Benefits • Lowers risk of bowel cancer • Can pick cancer at very early stage and improves outcome of treatment • Can identify conditions which can lead to cancer in future Bowel cancer: Screening Programme • Risks • Cancer not bleeding can be missed • Blood from non cancer cause can lead to false positive result • Cancer can develop in the 2yrs between screenin Bowel Cancer screening: High Risk Persons • Usually by colonoscopy and start early • Those with genetic conditions that increase risk of bowel Cancer • Strong family History • Certain bowel conditions: Crohns Ulcerative Colitis • Certain conditions like Acromegaly