Colorectal is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women.

1. COLORECTAL
CANCER

2. 95,520
Estimated new cases develop each year of colon
cancer
2http://pressroom.cancer.org/CRCstats2017

3. 39,910
Estimated new cases develop each year of rectal
cancer
3http://pressroom.cancer.org/CRCstats2017

4. 50, 260Annual Death rate despite regardless sex
4http://pressroom.cancer.org/CRCstats2017

5. Affects both gender
• 10% in both female and
male with the incidence
increasing significantly
in persona over age 50.
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The incidence rate is 50
times higher in people
over ages of 60 to 79
than those aged 40
years.
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The disease occur most
frequently countries like
North America, Eastern
and Western Europe, the
Scandinavian countries,
New Zealand, and
Australia.
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The incidence varies
among races, and
ethnicity. African
American, Indians,
Hawaiians, and
Mexicans have the
highest incidence
and mortality.
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9. ETIOLOGY
The cause of colorectal cancer is UNKNOWN
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10. 10
RISK FACTORS

11. HISTORY
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14. DIET
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16. GENETIC
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18. ENVIRONMENT
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20. COLON
DISEASES
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22. SCREENING
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23. Screening
ASYMPTOMATIC PERSON
Annual:
• DIGITAL RECTAL
EXAMINATION
• FECAL OCCULT BLOOD
TEST for person over age
50.
• PROCTOSIGMOIDOSCOP
Y should be done every 5
years.
• COLONOSCOPY every 10
years.
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• DOUBLE CONTRAST
BARIUM ENEMA should be
performed every 5-10 yrs and
complement a colonoscopy
exam
• SIGMOIDOSCOPY at lease
every 5 yrs

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28. INCREASED RISK
RISK CATEGORIES
▸ Single, small (<1cm)
adenoma
▸ Large (1+ cm)
adenoma, multiple
adenomas (with high
grade dysplasia, or
villous change)
▸ Personal hx or
curative intent
resection of colorectal
ca
▸ Either colorectal ca, or
adenomatous polyps
in any first degree
relatives at any age (if
not hereditary
syndrome)
AGE TO BEGIN
▸ 3-6yrs after the initial
polypectomy
▸ Within 3yrs after initial
polypectomy
▸ 40y/o, or 10 yrs before
the youngest case in
the immediate family
RECOMMENDATION
▸ Colonoscopy
▸ Colonoscopy
▸ Colonoscopy
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29. HIGH RISK
RISK CATEGORIES
▸ Family hx of familial
adenomatous polyps
(FAP)
▸ Family hx of
hereditary
nonpolyposis colon
cancer (HNPCC)
▸ Inflammatory bowel
disease Chronic
ulcerative colitis
▸ Crohn’s Disease
AGE TO BEGIN
▸ Puberty
▸ Age 21
▸ Cancer risk begins to
be significant 8yrs after
the onset of pancolitis,
or 12-15yrs after the
onset of left sided
colitis
RECOMMENDATION
▸ Early surveillance with
endoscopy, and
counseling to consider
genetic testing
▸ Colonoscopy and
counseling to consider
genetic testing
▸ Colonoscopy with
biopsies for dysplasia
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31. ▸ Barium Enema
▸ Colonoscopy
▸ CT/MR/PET scan
▸ Stool for occult blood
▸ Liver Scan
▸ Bone Scan
▸ CBC, AST (SGOT), LDH, ALP, BUN
▸ Carcinoembryonic Antigen (CEA)
▸ Rectal UTZ
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33. GENERAL
▸ Change in bowel habits
▸ Shape, color, size of stool
▸ Abdominal pain
▸ Anorexia
▸ flatulence
▸ Indigestion
▸ Alteration in constipation, or diarrhea
▸ Feeling of incomplete evacuation
(tenesmus)
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34. LATE SYMPTOMS
▸ Weight loss
▸ Fatigue
▸ Decline in general health
▸ Jaundice
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35. RIGHT-SIDED LESION
▸ Dull, vague, abdominal pain radiating to
the back
▸ Dark, red, or mahogany-red blood in
stool
▸ Weakness, anemia, malaise,
indigestion, weight loss, liquid stool
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36. LEFT-SIDED LESION
▸ Change in bowel habits—cramps
▸ Gas pains
▸ Decrease in caliber of stool
▸ Bright red bleeding
▸ Constipation
▸ Rectal pressure
▸ Incomplete evacuation of stool
▸ Abdominal pain
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37. TRANSVERESE COLON
▸ Palpable masses
▸ Obstruction
▸ Changes in bowel habits
▸ Bloody stool
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38. RECTAL
▸ Changes in bowel habits
▸ Bright-red bleeding
▸ Tenesmus
▸ Pain in the groin (labia, scrotum, legs,
or penis)
▸ Constipation
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43. PART 2
PATHOPHYSIOLOGY
Made by: Rosemarie Carpio
Reference: Oncology Nursing by Martha E. Langhorne
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