Colorectal cancer secondary prevention: Difference between revisions
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===Familial Colorectal Cancer Syndromes=== | ===Familial Colorectal Cancer Syndromes=== | ||
*Surgical resection followed by a colonoscopy yearly for most polyposis syndromes | *Surgical resection followed by a colonoscopy yearly for most polyposis syndromes<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref> | ||
:*Criteria for surveilling patients and categorizing them as polyposis patients include | :*Criteria for surveilling patients and categorizing them as polyposis patients include the following<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref>: | ||
::*The presence of multiple polyps in the colon | ::*The presence of multiple polyps in the colon | ||
::*Young age at onset of colorectal cancer, particularly age less than 50 years | ::*Young age at onset of colorectal cancer, particularly age less than 50 years | ||
::*A strong family history suggesting a familial syndrome | ::*A strong family history suggesting a familial syndrome | ||
::*Evidence for a syndrome based on genetic testing | ::*Evidence for a syndrome based on genetic testing | ||
*Chemoprevention has been used as an adjunct to colonoscopy in some FAP patients, such as | *Chemoprevention has been used as an adjunct to colonoscopy in some FAP patients, such as the following: | ||
:*Cyclooxygenase (COX) inhibitors<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref> | |||
:*Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs)<ref name="pmid21144578">{{cite journal| author=Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW| title=Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. | journal=Lancet | year= 2011 | volume= 377 | issue= 9759 | pages= 31-41 | pmid=21144578 | doi=10.1016/S0140-6736(10)62110-1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21144578 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21403065 Review in: Ann Intern Med. 2011 Mar 15;154(6):JC3-2] [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21555322 Review in: Evid Based Nurs. 2011 Jul;14(3):71] </ref> | |||
:*Postmenopausal hormone therapy (both combined estrogen plus progestin and unopposed estrogen) - not recommended for chemoprevention of colon cancer in women because of the associated long-term risks of therapy<ref name="pmid21365647">{{cite journal| author=Lin KJ, Cheung WY, Lai JY, Giovannucci EL| title=The effect of estrogen vs. combined estrogen-progestogen therapy on the risk of colorectal cancer. | journal=Int J Cancer | year= 2012 | volume= 130 | issue= 2 | pages= 419-30 | pmid=21365647 | doi=10.1002/ijc.26026 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21365647 }} </ref> | |||
===Sporadic Colorectal Cancer Syndromes=== | ===Sporadic Colorectal Cancer Syndromes=== | ||
*An individual may develop sporadic colorectal cancer for the following reasons: | *An individual may develop sporadic colorectal cancer for the following reasons<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref>: | ||
:*The patient has an unrecognized familial syndrome | :*The patient has an unrecognized familial syndrome | ||
:*The residual tumor may be present after resection | :*The residual tumor may be present after resection | ||
:*The patient has strong risk factors | :*The patient has strong risk factors | ||
:*The patient has genetic risk factors that do not fit into a familial syndrome | :*The patient has genetic risk factors that do not fit into a familial syndrome | ||
*After diagnosis, a colonoscopy should be performed to rule out synchronous tumors and polyps | *After diagnosis, a colonoscopy should be performed to rule out synchronous tumors and polyps along with a primary tumor resection<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref> | ||
*Within 1 year after the primary tumor resection, another colonoscopy should take place<ref name="Carethers2010">{{cite journal|last1=Carethers|first1=John M.|title=Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?|journal=Current Colorectal Cancer Reports|volume=6|issue=1|year=2010|pages=24–29|issn=1556-3790|doi=10.1007/s11888-009-0038-1}}</ref> | |||
*Within 1 year after the primary tumor resection, another colonoscopy should take place | |||
:*If this examination is negative for lesions, the next colonoscopy generally may be performed after 3 years | :*If this examination is negative for lesions, the next colonoscopy generally may be performed after 3 years | ||
:*If that colonoscopy is negative, then secondary prevention by colonoscopy may be extended to every 5 years | :*If that colonoscopy is negative, then secondary prevention by colonoscopy may be extended to every 5 years | ||
Revision as of 15:50, 15 July 2015
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To view the secondary prevention of familial adenomatous polyposis (FAP), click here
To view the secondary prevention of hereditary nonpolyposis colorectal cancer (HNPCC), click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
Overview
Secondary prevention of colorectal cancer, as opposed to primary prevention, indicates that a person has already had the disease and there are steps being taken to prevent cancer recurrence, usually as metachronous tumors. This involves annual surveillance with colonoscopy after surgical removal an possibly an adjunct after the initial operation. The timing for secondary prevention is critical to prevent recurrent advanced disease[1].
Colorectal Cancer Secondary Prevention
Familial Colorectal Cancer Syndromes
- Surgical resection followed by a colonoscopy yearly for most polyposis syndromes[1]
- Criteria for surveilling patients and categorizing them as polyposis patients include the following[1]:
- The presence of multiple polyps in the colon
- Young age at onset of colorectal cancer, particularly age less than 50 years
- A strong family history suggesting a familial syndrome
- Evidence for a syndrome based on genetic testing
- Chemoprevention has been used as an adjunct to colonoscopy in some FAP patients, such as the following:
- Cyclooxygenase (COX) inhibitors[1]
Sporadic Colorectal Cancer Syndromes
- An individual may develop sporadic colorectal cancer for the following reasons[1]:
- The patient has an unrecognized familial syndrome
- The residual tumor may be present after resection
- The patient has strong risk factors
- The patient has genetic risk factors that do not fit into a familial syndrome
- After diagnosis, a colonoscopy should be performed to rule out synchronous tumors and polyps along with a primary tumor resection[1]
- Within 1 year after the primary tumor resection, another colonoscopy should take place[1]
- If this examination is negative for lesions, the next colonoscopy generally may be performed after 3 years
- If that colonoscopy is negative, then secondary prevention by colonoscopy may be extended to every 5 years
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Carethers, John M. (2010). "Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer?". Current Colorectal Cancer Reports. 6 (1): 24–29. doi:10.1007/s11888-009-0038-1. ISSN 1556-3790.
- ↑ Rothwell PM, Fowkes FG, Belch JF, Ogawa H, Warlow CP, Meade TW (2011). "Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials". Lancet. 377 (9759): 31–41. doi:10.1016/S0140-6736(10)62110-1. PMID 21144578. Review in: Ann Intern Med. 2011 Mar 15;154(6):JC3-2 Review in: Evid Based Nurs. 2011 Jul;14(3):71
- ↑ Lin KJ, Cheung WY, Lai JY, Giovannucci EL (2012). "The effect of estrogen vs. combined estrogen-progestogen therapy on the risk of colorectal cancer". Int J Cancer. 130 (2): 419–30. doi:10.1002/ijc.26026. PMID 21365647.