colorectal cancer Colorectal cancer hereditary sporadic Familial 1/12/2018
|
|
- Bonnie Carter
- 5 years ago
- Views:
Transcription
1 colorectal cancer Adenocarcinoma of the colon and rectum is the third most common site of new cancer cases and deaths in men (following prostate and lung or bronchus cancer) and women (following breast and lung or bronchus cancer) in the United States The risk of colorectal cancer increases with age, with more than 90% of new cases being diagnosed in patients older than 50 years Colorectal cancer hereditary sporadic Familial Hereditary colorectal cancer family history young age at onset the presence of other tumors Sporadic colorectal cancer absence of family history affects an older population isolated colon or rectal lesion 1
2 Genetic mutations associated with the cancer are limited to the tumor itself, unlike in hereditary disease, in which the specific mutation is present in all cells of the affected individual Colorectal Cancer Genetics Tumor Suppressor Genes Tumor suppressor genes produce proteins that inhibit tumor formation by regulating mitotic activity and providing inhibitory cell cycle control Tumor formation occurs when these inhibitory controls are deregulated by mutation Both alleles of the gene must be nonfunctional to initiate tumor formation 2
3 The APC gene is a tumor suppressor gene located on chromosome 5q21 A germline APC truncation mutation is responsible for the autosomal dominant inherited disease FAP Thirty percent of cases of FAP are de novo germline mutations, presenting without a family history of the disease FAP more than 100 adenomatous polyps present in the colon and rectum. These polyps often number in the thousands and are almost always manifested by the late second or early third decade of life Most patients with FAP die of colon cancer by their fifth decade of life in the absence of surgical intervention APC truncation mutations similar to those found in APC patients occur in 85% of sporadic colorectal cancers 3
4 extraintestinal manifestations osteomas of the mandible and skull desmoid tumors of the mesentery periampullary neoplasms Mismatch Repair Genes MMR genes are called caretaker genes because of their important role in policing the integrity of the genome and correcting DNA replication errors 3% of colorectal cancers in the United States are caused by HNPCC Mutations in MMR genes produce microsatellite instability Microsatellites are repetitive sequences of DNA that appear to be randomly distributed throughout the genome. Stability of these sequences is a good measure of the general integrity of the genome 4
5 Oncogenes Proto-oncogenes are genes that produce proteins that promote cellular growth and proliferation. Mutations in proto-oncogenes typically produce a gain of function and can be caused by mutation in only one of the two alleles Adenoma-Carcinoma Sequence The adenoma-carcinoma sequence is the process through which most colorectal carcinomas develop colorectal carcinomas evolve through a progression of benign polyps to invasive carcinoma Colorectal Polyps 5
6 A colorectal polyp is any mass projecting into the lumen of the bowel above the surface of the intestinal epithelium Polyps gross appearance pedunculated (with a stalk) sessile (flat, without a stalk) histologic appearance (a)tubular adenoma (with branched tubular glands) (b)villous adenoma (with long finger-like projections of the surface epithelium) (c)tubulovillous adenoma (with elements of both cellular patterns) degree of cellular atypia less atypia in tubular adenomas severe atypia or dysplasia (precancerous cellular change) found more often in villous adenomas 6
7 The incidence of invasive carcinoma being found in a polyp is dependent on the size and histologic type of the polyp there is less than a 5% incidence of carcinoma in an adenomatous polyp smaller than 1 cm in diameter, whereas there is a 50% chance that a villous adenoma larger than 2 cm in diameter will contain a cancer Adenomatous polyps should be considered precursors of cancer The treatment of an adenomatous or villous polyp is removal, usually by colonoscopy sessile (flat) polyps The presence of any polypoid lesion is an indication for a complete colonoscopy and polypectomy present technical problem because of the danger of perforation associated with the snare technique 7
8 sessile lesions that are large or have a central depression or cannot be "lifted" with saline may be perforation risks and should be surgically excised by segmental colectomy for complete removal and lymph node examination malignant polyp Invasive carcinoma describes the situation in which malignant cells have extended through the muscularis mucosae of the polyp, whether it is on a stalk or a sessile lesion If invasive carcinoma penetrates the muscularis mucosae, the risk for lymph node metastasis and local recurrence must be considered to determine whether a more extensive resection is required complete excision need for surgery no piecemeal lymphovascular invasion differentiation depth 8
9 There is a high risk for lymph node and distant metastases associated with sessile cancers in the rectum, and these lesions should be treated aggressively Familial Adenomatous Polyposis the gene responsible for the transmission of the disease, the APC gene The gene is expressed in 100% of patients with the mutation. Autosomal dominance results in expression in 50% of offspring There is a negative family history in 10% to 20% of affected individuals, who apparently acquire the syndrome as the result of a spontaneous germline mutation the common expression of the syndrome 9
10 invariable presence of multiple colonic polyps; frequent occurrence of gastric, duodenal, and periampullary polyps; and occasional association of extraintestinal manifestations, including epidermoid cysts, desmoid tumors in the abdomen, osteomas, and brain tumors gastric and duodenal polyps occur in approximately 50% of affected individuals duodenal polyps are adenomatous gastric polyps represent fundic gland hyperplasia, rather than adenomatous polyps, and have limited malignant potential in nature and should be considered premalignant. Patients with FAP have an increased risk for ampullary cancer all patients with the defective gene will develop cancer of the colon if left untreated age when things happen 10
11 The average age at discovery of a new patient with FAP is 29 years. The average age of a patient who is newly discovered to have colorectal cancer related to FAP is 39 years. Osteomas visible and palpable prominences in the skull, mandible, and tibia of individuals with FAP. They are almost always benign Radiographs of the maxilla and mandible may reveal bone cysts, supernumerary and impacted molars, or congenitally absent teeth Desmoid tumors can present in the retroperitoneum and abdominal wall of affected patients, usually after surgery these tumors seldom metastasize but are often locally invasive; direct invasion of the mesenteric vessels, ureters, or walls of the small intestine can result in death 11
12 surgical treatment Surgical treatment of patients with FAP is directed at removal of all affected colonic and rectal mucosa Restorative proctocolectomy with IPAA has become the most commonly recommended operation the IPAA is fashioned between the ileal pouch and dentate line of the anal canal IPAA is done for two diseases FAP UC Patients who undergo this procedure for FAP have a better functional result than patients similarly treated for ulcerative colitis 12
13 The incidence of inflammation in the ileal pouch (pouchitis) is much lower in patients with FAP than in patients with ulcerative colitis an alternative approach total abdominal colectomy with ileorectal anastomosis, If an FAP patient has relatively few polyps in the rectum, consideration may be given to this option certain advantages It is technically a simpler operation to perform, and the pelvic dissection is avoided This eliminates the potential complication of injury to the autonomic nerves that could result in impotence 13
14 sulindac and celecoxib have caused the regression of adenomatous polyps in some the disadvantages patients with FAP the rectum remains at high risk for the formation of new precancerous polyps proctoscopic examination is required every 6 to 12 months to detect and to destroy any new polyps, and there is a definite increased risk for cancer arising in the rectum with the passage of time genetic testing may help make the decision between restorative proctocolectomy with IPAA and abdominal colectomy with ileorectal anastomosis the risk for rectal cancer is almost three times higher in FAP patients with a mutation after codon 1250 than in patients with mutations before this codon. This may influence the decision to offer abdominal colectomy with ileorectal anastomosis to those whose mutation occurs proximal to codon 1250 if proctoscopic examination reveals no or few polyps in the rectum 14
15 what should you tell the patient who chooses total coloectomy Patients who choos abdominal colectomy with ileorectal anastomosis should Realize that the risk for development of rectal cancer is real (25% at 20 years after the operation) approximately one third of patients treated by abdominal colectomy and ileorectal anastomosis develop florid polyposis of the rectum that will require proctectomy (and ileostomy or IPAA) within 20 years Polyps of the stomach and duodenum The gastric polyps are usually hyperplastic and do not require surgical removal the duodenal and ampullary polyps are generally neoplastic and require attention 15
16 surveillance program is for upper GI surveillance every 2 years after the age of 30 years and endoscopic polypectomy, if possible, to remove all large adenomas from the duodenum If an ampullary cancer is discovered at an early stage, pancreatoduodenectomy is indicated The abdominal desmoid tumor an especially vexing and difficult extraintestinal manifestation of FAP After surgical procedures, dense fibrous tissue forms in the mesentery of the small intestine or within the abdominal wall in some patients with FAP If the mesentery is involved, the intestine can be tethered or invaded directly by the tumor 16
17 The locally invasive tumor can also encroach on the vascular supply to the intestine Small desmoid tumors confined to the abdominal wall are appropriately treated by resection the surgical treatment of mesenteric desmoids is dangerous and generally futile sporadic reports of regression of desmoid tumors after treatment with sulindac, tamoxifen, low-dose methotrexate, radiation, chemotherapy The initial treatment is usually with sulindac or tamoxifen 17
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY COLORECTAL POLYPS P Goldberg POLYP A polyp is a localised elevated lesion arising from a epithelial surface. If it has a stalk it is called a pedunculated polyp
More informationColonic Polyp. Najmeh Aletaha. MD
Colonic Polyp Najmeh Aletaha. MD 1 Polyps & classification 2 Colorectal cancer risk factors 3 Pathogenesis 4 Surveillance polyp of the colon refers to a protuberance into the lumen above the surrounding
More informationPathology reports, related operative reports and consult letters must be provided with a request for assessment.
Page 1 of 6 Polyposis Syndromes Inherited risk for colorectal cancer is associated with a number of polyposis syndromes (genes), some of which are well-defined and others are less common. Identification
More informationColorectal adenocarcinoma leading cancer in developed countries In US, annual deaths due to colorectal adenocarcinoma 57,000.
Colonic Neoplasia Remotti Colorectal adenocarcinoma leading cancer in developed countries In US, annual incidence of colorectal adenocarcinoma 150,000. In US, annual deaths due to colorectal adenocarcinoma
More informationFamilial Adenomatous Polyposis
Familial Adenomatous Polyposis 1 in 10,000 incidence 100 s to 1000 s of colonic adenomas by teens Cancer risk: colon, gastric, duodenum (periampulla), small bowel, pancreas, papillary thyroid, childhood
More informationB Base excision repair, in MUTYH-associated polyposis and colorectal cancer, BRAF testing, for hereditary colorectal cancer, 696
Index Note: Page numbers of article titles are in boldface type. A Adenomatous polyposis, familial. See Familial adenomatous polyposis. Anal anastomosis, ileal-pouch, proctocolectomy with, in FAP, 591
More informationColorectal Neoplasia. Dr. Smita Devani MBChB, MRCP. Consultant Physician and Gastroenterologist Aga Khan University Hospital, Nairobi
Colorectal Neoplasia Dr. Smita Devani MBChB, MRCP Consultant Physician and Gastroenterologist Aga Khan University Hospital, Nairobi Case History BT, 69yr male Caucasian History of rectal bleeding No change
More informationFamilial and Hereditary Colon Cancer
Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of
More informationBowel obstruction and tumors
Bowel obstruction and tumors Intestinal Obstruction Obstruction of the GI tract may occur at any level, but the small intestine is most often involved because of its relatively narrow lumen. Causes: Hernias
More informationNeoplastic Colon Polyps. Joyce Au SUNY Downstate Grand Rounds, October 18, 2012
Neoplastic Colon Polyps Joyce Au SUNY Downstate Grand Rounds, October 18, 2012 CASE 55M with Hepatitis C, COPD (FEV1=45%), s/p vasectomy, knee surgery Meds: albuterol, flunisolide, mometasone, tiotropium
More informationColon Cancer Screening & Surveillance. Amit Patel, MD PGY-4 GI Fellow
Colon Cancer Screening & Surveillance Amit Patel, MD PGY-4 GI Fellow Epidemiology CRC incidence and mortality rates vary markedly around the world. Globally, CRC is the third most commonly diagnosed cancer
More informationFor identification, support and follow up related to Familial Gastrointestinal Cancer conditions. South Island Cancer Nurses Network September 2013
For identification, support and follow up related to Familial Gastrointestinal Cancer conditions South Island Cancer Nurses Network September 2013 Who are we? Specialist multidisciplinary team: Nurse coordinators,
More informationFamilial and Hereditary Colon Cancer
Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of
More informationGeneral Surgery Grand Grounds
General Surgery Grand Grounds University of Colorado Health Sciences Center Case Presentation December 24, 2009 Adam Lackey, PGY-5 J.L. - 2111609 27 YO female with chief complaint of abdominal pain. PMHx:
More informationSurveying the Colon; Polyps and Advances in Polypectomy
Surveying the Colon; Polyps and Advances in Polypectomy Educational Objectives Identify classifications of polyps Describe several types of polyps Verbalize rationale for polypectomy Identify risk factors
More informationClassification of polyposis syndromes two major groups. Adenomatous polyposis syndromes. Hamartomatous polyposis syndromes
Hereditary polyposis syndromes Classification of polyposis syndromes two major groups adenomatous and non-adenomatous polyposis syndromes Adenomatous polyposis syndromes Familial adenomatous polyposis(fap)
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal surgery prior as factor in laparoscopic colorectal surgery, 554 555 Abscess(es) CRC presenting as, 539 540 Adenocarcinoma of
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationGENETIC MANAGEMENT OF A FAMILY HISTORY OF FAP or MUTYH ASSOCIATED POLYPOSIS. Family Health Clinical Genetics. Clinical Genetics department
GENETIC MANAGEMENT OF A FAMILY HISTORY OF FAP or MUTYH ASSOCIATED POLYPOSIS Full Title of Guideline: Author (include email and role): Division & Speciality: GUIDELINES FOR THE GENETIC MANAGEMENT OF A FAMILY
More informationCOLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University
COLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University 1. I am a surgeon; of course I have nothing to disclose.
More informationResident Seminar Aug 19 th, 2015 Colon: Neoplastic. Scott Rieder Dr. Colquhoun
Resident Seminar Aug 19 th, 2015 Colon: Neoplastic Scott Rieder Dr. Colquhoun Objectives Medical Expert: 1. The biologic basis of colon neoplasia 2. Colon cancer screening (guidelines and evidence) 3.
More informationWhat All of Us Should Know About Cancer and Genetics
What All of Us Should Know About Cancer and Genetics Beth A. Pletcher, MD, FAAP, FACMG Associate Professor of Pediatrics UMDNJ- New Jersey Medical School Disclosures I have no relevant financial relationships
More informationA superficial radiotherapy B single pass curettage C excision with 2 mm margins D excision with 5 mm margins E Mohs micrographic surgery.
1- A 63-year-old woman presents with a non-healing lesion on her right temple that has been present for over two years. On examination there is a 6 mm well defined lesion with central ulceration, telangiectasia
More informationRisk of Colorectal Cancer (CRC) Hereditary Syndromes in GI Cancer GENETIC MALPRACTICE
Identifying the Patient at Risk for an Inherited Syndrome Sapna Syngal, MD, MPH, FACG Director, Gastroenterology Director, Familial GI Program Dana-Farber/Brigham and Women s Cancer Center Associate Professor
More informationPatologia sistematica V Gastroenterologia Prof. Stefano Fiorucci. Colon polyps. Colorectal cancer
Patologia sistematica V Gastroenterologia Prof. Stefano Fiorucci Colon polyps Colorectal cancer Harrison s Principles of Internal Medicine 18 Ed. 2012 Colorectal cancer 70% Colorectal cancer CRC and colon
More information11/21/13 CEA: 1.7 WNL
Case Scenario 1 A 70 year-old white male presented to his primary care physician with a recent history of rectal bleeding. He was referred for imaging and a colonoscopy and was found to have adenocarcinoma.
More informationDevelopment of Carcinoma Pathways
The Construction of Genetic Pathway to Colorectal Cancer Moriah Wright, MD Clinical Fellow in Colorectal Surgery Creighton University School of Medicine Management of Colon and Diseases February 23, 2019
More informationYES NO UNKNOWN. Stage I: Rule-Out Dashboard ACTIONABILITY PENETRANCE SIGNIFICANCE/BURDEN OF DISEASE NEXT STEPS. YES ( 1 of above)
Stage I: Rule-Out Dashboard GENE/GENE PANEL: SMAD4, BMPR1A DISORDER: Juvenile Polyposis Syndrome HGNC ID: 6670, 1076 OMIM ID: 174900, 175050 ACTIONABILITY PENETRANCE 1. Is there a qualifying resource,
More informationFACT SHEET 49. What is meant by a family history of bowel cancer? What is bowel cancer? What causes bowel cancer?
Important points The most important factors that can influence an individual s chance of developing bowel cancer are getting older and having a family history of bowel cancer A family history of bowel
More informationHereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD
Hereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD Living Beyond Cancer A-Z January 12,2019 Hereditary CRC Syndromes Objectives are to discuss the : Most common Hereditary CRC syndromes
More information27
26 27 28 29 30 31 32 33 34 35 Diagnosis:? Diagnosis: Juvenile Polyposis with BMPR1A Mutation 36 Juvenile Polyposis Syndrome Rare Autosomal Dominant Disorder with Multiple Juvenile Polyps in GI Tract Juvenile
More informationwhat is the alternative mechanism of histogenesis? Aspects of the morphology of the adenomacarcinoma Morphology of the
Refer to: Morson B: Polyps and cancer of the large bowel. West J Med 125:93-99, Aug 1976 THE WESTERN Journal of Miedicine Polyps and Cancer of the Large Bowel BASIL MORSON, MD, London MORTALITY STATISTICS
More informationCancer Genomics 101. BCCCP 2015 Annual Meeting
Cancer Genomics 101 BCCCP 2015 Annual Meeting Objectives Identify red flags in a person s personal and family medical history that indicate a potential inherited susceptibility to cancer Develop a systematic
More informationImaging Evaluation of Polyps. CT Colonography: Sessile Adenoma. Polyps, DALMs & Megacolon Objectives
Polyps, DALMs & Megacolon: Pathology and Imaging of the Colon and Rectum Angela D. Levy and Leslie H. Sobin Washington, DC Drs. Levy and Sobin have indicated that they have no relationships which, in the
More informationColon Cancer Screening. Layth Al-Jashaami, MD GI Fellow, PGY 4
Colon Cancer Screening Layth Al-Jashaami, MD GI Fellow, PGY 4 -Colorectal cancer (CRC) is a common and lethal cancer. -It has the highest incidence among GI cancers in the US, estimated to be newly diagnosed
More informationAdenoma to Carcinoma Pathway
It is widely accepted that more than 95% of colorectal cancers arise from adenomatous polyps, which are generally defined as benign lesions with dysplastic epithelium that have variable potential for malignancy.
More informationRazvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationAlberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background... 3 Terms, Definitions
More informationAllinaHealthSystems 1
Overview Biology and Introduction to the Genetics of Cancer Denise Jones, MS, CGC Certified Genetic Counselor Virginia Piper Cancer Service Line I. Our understanding of cancer the historical perspective
More informationEARLY DETECTION OF COLORECTAL CANCER. Epidemiology of CRC
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationMr Chris Wakeman. General Surgeon University of Otago, Christchurch. 12:15-12:40 Management of Colorectal Cancer
Mr Chris Wakeman General Surgeon University of Otago, Christchurch 12:15-12:40 Management of Colorectal Cancer Bowel cancer Chris Wakeman Colorectal Surgeon Christchurch Sam Simon (Simpsons) Elizabeth
More informationMultistep nature of cancer development. Cancer genes
Multistep nature of cancer development Phenotypic progression loss of control over cell growth/death (neoplasm) invasiveness (carcinoma) distal spread (metastatic tumor) Genetic progression multiple genetic
More informationHereditary Gastric Cancer
Hereditary Gastric Cancer Dr Bastiaan de Boer Consultant Pathologist Department of Anatomical Pathology PathWest Laboratory Medicine, QE II Medical Centre Clinical Associate Professor School of Pathology
More informationHEREDITARY COLORECTAL CANCER AND POLYPOSIS SYNDROMES
gastrointestinal tract and abdomen HEREDITARY COLORECTAL CANCER AND POLYPOSIS SYNDROMES Jose G. Guillem, MD, MPH, FACS, and John B. Ammori, MD* The majority of cases of inherited colorectal cancer (CRC)
More informationReferences. GI Biopsies. What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD
What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD jcrawford1@nshs.edu Executive Director and Senior Vice President for Laboratory Services North
More informationA916: rectum: adenocarcinoma
General facts of colorectal cancer The colon has cecum, ascending, transverse, descending and sigmoid colon sections. Cancer can start in any of the r sections or in the rectum. The wall of each of these
More informationSerrated Polyps and a Classification of Colorectal Cancer
Serrated Polyps and a Classification of Colorectal Cancer Ian Chandler June 2011 Structure Serrated polyps and cancer Molecular biology The Jass classification The familiar but oversimplified Vogelsteingram
More informationColorectal Cancer Syndromes. Barbara Jung, MD AGAF Associate Professor and Chief University of Illinois at Chicago
Colorectal Cancer Syndromes Barbara Jung, MD AGAF Associate Professor and Chief University of Illinois at Chicago Outline Colon cancer General Genetics, Risk, Screening Specific Syndromes, when to suspect,
More informationThis is the portion of the intestine which lies between the small intestine and the outlet (Anus).
THE COLON This is the portion of the intestine which lies between the small intestine and the outlet (Anus). 3 4 5 This part is responsible for formation of stool. The large intestine (colon- coloured
More informationDavid P. Ryan, M.D. Clinical Director, MGH Cancer Center Chief, Hematology-Oncology, MGH
Colon Cancer 2015 David P. Ryan, M.D. Clinical Director, MGH Cancer Center Chief, Hematology-Oncology, MGH Colon Cancer Case presentation 72yo woman presented 1/03 abd discomfort and nausea Found to have
More informationPENETRANCE ACTIONABILITY SIGNIFICANCE/BURDEN OF DISEASE NEXT STEPS. YES ( 1 of above) YES (Proceed to Stage II)
Stage I: Binning Dashboard GENE/GENE PANEL: APC ACTIONABILITY 1. Is there a qualifying resource, such as a practice guideline or systematic review, for the genetic condition? 2. Does the practice guideline
More informationColorectal Cancer Prevention Quantity and Quality Count
Colorectal Cancer Prevention Quantity and Quality Count Ernesto Drelichman, MD Gastrointestinal Surgery & Endoscopy Providence Hospital Key Messages Colorectal cancer can be prevented Screening reduces
More informationAnaplastic A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells.
Oncology Terminology A Adenocarcinoma A cancerous tumor that arises in or resembles glandular tissue. Adjunct agent In cancer therapy, a drug or substance used in addition to the primary therapy. Adjuvant
More informationBowel obstruction and tumors
Bowel obstruction and tumors Intestinal Obstruction Obstruction of the GI tract may occur at any level, but the small intestine is most often involved because of its relatively narrow lumen. Causes: Hernias
More informationColon, or Colorectal, Cancer Information
Colon, or Colorectal, Cancer Information Definition Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Other types of cancer can affect
More informationColorectal Cancer Structured Pathology Reporting Proforma DD MM YYYY
Colorectal Cancer Structured Pathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Date of birth DD MM YYYY S1.02 Clinical details
More informationremoval of adenomatous polyps detects important effectively as follow-up colonoscopy after both constitute a low-risk Patients with 1 or 2
Supplementary Table 1. Study Characteristics Author, yr Design Winawer et al., 6 1993 National Polyp Study Jorgensen et al., 9 1995 Funen Adenoma Follow-up Study USA Multi-center, RCT for timing of surveillance
More informationLarge Colorectal Adenomas An Approach to Pathologic Evaluation
Anatomic Pathology / LARGE COLORECTAL ADENOMAS AND PATHOLOGIC EVALUATION Large Colorectal Adenomas An Approach to Pathologic Evaluation Elizabeth D. Euscher, MD, 1 Theodore H. Niemann, MD, 1 Joel G. Lucas,
More information6 semanas de embarazo. Tubulovillous adenoma with dysplasia icd 10. Inicio / Embarazo / 6 semanas de embarazo
Inicio / Embarazo / 6 semanas de embarazo 6 semanas de embarazo Tubulovillous adenoma with dysplasia icd 10 Free, official coding info for 2018 ICD-10-CM D13.2 - includes detailed rules, notes, synonyms,
More informationColon Screening in 2014 Offering Patients a Choice. Clark A Harrison MD The Nevada Colon Cancer Partnership
Colon Screening in 2014 Offering Patients a Choice Clark A Harrison MD The Nevada Colon Cancer Partnership Objectives 1. Understand the incidence and mortality rates for CRC in the US. 2. Understand risk
More informationSurgical Management of IBD. Val Jefford Grand Rounds October 14, 2003
Surgical Management of IBD Val Jefford Grand Rounds October 14, 2003 Introduction Important Features Clinical Presentation Evaluation Medical Treatment Surgical Treatment Cases Overview Introduction Two
More informationPDF // POSITIVE COLON CANCER RESULTS
01 March, 2018 PDF // POSITIVE COLON CANCER RESULTS Document Filetype: PDF 268.79 KB 0 PDF // POSITIVE COLON CANCER RESULTS This cohort study evaluates the association between time to colonoscopy after
More informationCOLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE
COLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE Guideline Authors: Todd S. Crocenzi, M.D.; Mark Whiteford, M.D.; Matthew Solhjem, M.D.; Carlo Bifulco, M.D.; Melissa Li, M.D.; Christopher Cai, M.D.;
More informationFAMILIAL ADENOMATOUS POLYPOSIS SBS11QHG-06 DANIEL KANTER PERIOD 6 #9
FAMILIAL ADENOMATOUS POLYPOSIS SBS11QHG-06 DANIEL KANTER PERIOD 6 #9 PHYSIOLOGY The colon plays one of the most important roles in the body, extracting salt and water from the wastes and eventually creating
More informationPeutz Jegher's Syndrome (Gastro-intestinal Polyposis) and Its Complications
Peutz Jegher's Syndrome (Gastro-intestinal Polyposis) and Its Complications Pages with reference to book, From 154 To 155 Zakiuddin G. Oonwala, Sina Aziz ( Department of Surgery, Dow Medical College and
More informationPolypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma
Polypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Date of birth
More informationAn Introduction to MUTYH Associated Polyposis (MAP)
An Introduction to MUTYH Associated Polyposis (MAP) 1 An Introduction to MUTYH Associated Polyposis(MAP) Contents What is MUTYH Associated Polyposis (MAP)? 2 What causes MUTYH Associated Polyposis (MAP)?
More informationEndoscopic techniques for surveillance and treatment of FAP
Endoscopic techniques for surveillance and treatment of FAP Evelien Dekker MD PhD Department of Gastroenterology & Hepatology Academic Medical Center Amsterdam The Netherlands FAP: endoscopic surveillance
More informationEmerging Interventions in Endoscopy. Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital
Emerging Interventions in Endoscopy Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital Colon Cancer Colon cancer is common. 1 in 20 people in the UK will develop the disease 19 000
More informationACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes
ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes Sapna Syngal, MD, MPH, FACG, 1,2,3 Randall E. Brand, MD, FACG, 4 James M. Church, MD, FACG, 5,6,7
More informationHyperplastische Polyps Innocent bystanders?
Hyperplastische Polyps Innocent bystanders?? K. Geboes P th l i h O tl dk d Pathologische Ontleedkunde, KULeuven Content Historical Classification Relation Hyperplastic polyps carcinoma The concept cept
More informationScreening & Surveillance Guidelines
Chapter 2 Screening & Surveillance Guidelines I. Eligibility Coloradans ages 50 and older (average risk) or under 50 at elevated risk for colon cancer (personal or family history) that meet the following
More informationThe Genetics of Familial Polyposis
The Genetics of Familial Polyposis Thursday, September 24 th 2015 Kara Semotiuk, MS, (C)CGC & Laura Winter, MSc, CGC Genetic Counsellors at the FGICR Familial Polyposis Familial Can run in the family related
More informationContent. Diagnostic approach and clinical management of Lynch Syndrome: guidelines. Terminology. Identification of Lynch Syndrome
of Lynch Syndrome: guidelines 17/03/2009 Content Terminology Lynch Syndrome Presumed Lynch Syndrome Familial Colorectal Cancer Identification of Lynch Syndrome Amsterdam II criteria Revised Bethesda Guidelines
More informationPrimary Care Approach to Genetic Cancer Syndromes
Primary Care Approach to Genetic Cancer Syndromes Jason M. Goldman, MD, FACP FAU School of Medicine Syndromes Hereditary Breast and Ovarian Cancer (HBOC) Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
More informationLOINC. Clinical information. RCPA code. Record if different to report header Operating surgeon name and contact details. Absent.
Complete as narrative or use the structured format below 55752-0 17.02.28593 Clinical information 22027-7 17.02.30001 Record if different to report header Operating surgeon name and contact details 52101004
More informationCancer statistics (US)
Disclosure I have no financial relationships to disclose Biology and Introduction to the Genetics of Cancer Vickie Matthias Hagen, MS, CGC Certified Genetic Counselor Virginia Piper Cancer Service Line
More informationLarge polyps: EMR, ESD, TEM and segmental resection. Terry Phang 2017 SON fall update
Large polyps: EMR, ESD, TEM and segmental resection Terry Phang 2017 SON fall update Key Points: Large polyps No RCT re: Recurrence, complications Piecemeal vs en bloc: EMR vs ESD Partial vs full-thickness:
More informationColon and Rectum. Protocol revision date: January 2005 Based on AJCC/UICC TNM, 6th edition
Colon and Rectum Protocol applies to all invasive carcinomas of the colon and rectum. Carcinoid tumors, lymphomas, sarcomas, and tumors of the vermiform appendix are excluded. Protocol revision date: January
More informationTumors of the Intestines. Malignant Lesion. Adenocarcinoma. sessile Serrated Adenomas
Tumors of the Intestines Non-Neoplastic Polyps Neoplastic Epithelial Polyps Other Tumors Hyperplastic, Hamartomatous, Juvenile, Peutz-Jeghers, Inflammatory abd Lymphoid Polyphs Benign Polyphs Malignant
More informationGastric Polyps. Bible class
Gastric Polyps Bible class 29.08.2018 Starting my training in gastroenterology, some decades ago, my first chief always told me that colonoscopy may seem technically more challenging but gastroscopy has
More informationSeventh Edition Staging 2017 Colorectum. Overview. This webinar is sponsored by. the Centers for Disease Control and Prevention.
Seventh Edition Staging 2017 Colorectum Donna M. Gress, RHIT, CTR Validating science. Improving patient care. No materials in this presentation may be repurposed in print or online without the express
More informationHST.161 Molecular Biology and Genetics in Modern Medicine Fall 2007
MIT OpenCourseWare http://ocw.mit.edu HST.161 Molecular Biology and Genetics in Modern Medicine Fall 2007 For information about citing these materials or our Terms of Use, visit: http://ocw.mit.edu/terms.
More informationSummary. Cezary ŁozińskiABDF, Witold KyclerABCDEF. Rep Pract Oncol Radiother, 2007; 12(4):
Rep Pract Oncol Radiother, 2007; 12(4): 201-206 Original Paper Received: 2006.12.19 Accepted: 2007.04.02 Published: 2007.08.31 Authors Contribution: A Study Design B Data Collection C Statistical Analysis
More information05/07/2018. Organisation. The English screening programme what is happening? Organisation. Bowel cancer screening in the UK is:
Organisation The English screening programme what is happening? Phil Quirke Lead Pathologist Bowel Cancer Screening PHE England Bowel Cancer Screening Pathology Committee Started 2006 with roll out 4 devolved
More informationHereditary Non Polyposis Colorectal Cancer(HNPCC) From clinic to genetics
From clinic to genetics Question 1) Clinical pattern of inheritance of the HNPCC-Syndrome? Question 1) Clinical pattern of inheritance of the HNPCC-Syndrome? Autosomal dominant Question 2) Incidence of
More informationArzu Ensari, MD, PhD Department of Pathology Ankara University Medical School
Precursors of Colorectal Carcinoma Arzu Ensari, MD, PhD Department of Pathology Ankara University Medical School Hyperplastic polyp Adenomatous polyp Colorectal carcinoma IBD-associated (1-2%) Sporadic
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Colorectal cancer: colonoscopic surveillance for prevention of colorectal cancer in patients with ulcerative colitis, Crohn
More informationQuiz. b. 4 High grade c. 9 Unknown
Quiz 1. 10/11/12 CT scan abdomen/pelvis: Metastatic liver disease with probable primary colon malignancy. 10/17/12 Colonoscopy with polypectomy: Adenocarcinoma of sigmoid colon measuring at least 6 mm
More informationNeoplasia 18 lecture 6. Dr Heyam Awad MD, FRCPath
Neoplasia 18 lecture 6 Dr Heyam Awad MD, FRCPath ILOS 1. understand the role of TGF beta, contact inhibition and APC in tumorigenesis. 2. implement the above knowledge in understanding histopathology reports.
More informationCOLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE
COLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE PROFESSOR OF SURGERY & DIRECTOR, PROFESSIONAL DEVELOPMENT CENTRE J I N N A H S I N D H M E D I C A L U N I V E R S I T Y faisal.siddiqui@jsmu.edu.pk
More informationNeoplasia part I. Dr. Mohsen Dashti. Clinical Medicine & Pathology nd Lecture
Neoplasia part I By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 2 nd Lecture Lecture outline Review of structure & function. Basic definitions. Classification of neoplasms. Morphologic features.
More informationCitation for published version (APA): Bartels, S. A. L. (2013). Laparoscopic colorectal surgery: beyond the short-term effects
UvA-DARE (Digital Academic Repository) Laparoscopic colorectal surgery: beyond the short-term effects Bartels, S.A.L. Link to publication Citation for published version (APA): Bartels, S. A. L. (2013).
More informationBIOLOGY OF CANCER. Definition: Cancer. Why is it Important to Understand the Biology of Cancer? Regulation of the Cell Cycle 2/13/2015
BIOLOGY OF CANCER Why is it Important to Understand the Biology of Cancer? Cynthia Smith, RN, BA, MSN, AOCN Oncology Clinical Nurse Specialist Harrison Medical Center Definition: Cancer Regulation of the
More informationBC CRC Update Malignant Polyp Who Needs Surgery
BC CRC Update Malignant Polyp Who Needs Surgery Anthony MacLean, MD, FRCSC, FACS, FASCRS Colorectal Surgeon Foothills Medical Centre Clinical Associate Professor of Surgery and Oncology University of Calgary
More informationGuidelines for Breast, Cervical and Colorectal Cancer Screening
Guidelines for Breast, Cervical and Colorectal Cancer Screening Your recommendation counts. Talk to your patients about screening for cancer. CancerCare Manitoba provides organized, population-based screening
More informationnumber Done by Corrected by Doctor مها شوماف
number 15 Done by Ali Yaghi Corrected by Waseem Alhaj Doctor مها شوماف 1 P a g e Epidemiology Epidemiology is the study of the incidence of a disease. It can give us information about the possible causes
More informationENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID
ENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID Manoop S. Bhutani, MD, FASGE, FACG, FACP, AGAF, Doctor Honoris Causa Professor of Medicine Eminent Scientist of the Year 2008, World
More informationCANCER. Inherited Cancer Syndromes. Affects 25% of US population. Kills 19% of US population (2nd largest killer after heart disease)
CANCER Affects 25% of US population Kills 19% of US population (2nd largest killer after heart disease) NOT one disease but 200-300 different defects Etiologic Factors In Cancer: Relative contributions
More informationDysplasia 4/19/2017. How do I practice Chromoendoscopy for Surveillance of Colitis? SCENIC: Polypoid Dysplasia in UC. Background
SCENIC: Polypoid in UC Definition How do I practice for Surveillance of Colitis? Themos Dassopoulos, M.D. Director, BSW Center for IBD Themistocles.Dassopoulos@BSWHealth.org Tel: 469-800-7189 Cell: 314-686-2623
More information