Browse
Topics & Collections
Search for a specific
disease or term
—  or  —
Learn more about ACP Smart Medicine

Dynamed

X
This content was provided by DynaMed (dynamed.ebscohost.com). For more information click here.
Last Updated: 7/17/2013  

Colorectal Cancer

Screening
  • Screen all average risk adults age 50 to 75 for colorectal cancer and adenomatous polyps using:

    • Annual fecal occult blood testing or fecal immunochemical testing

    • Flexible sigmoidoscopy every 5 years

    • Annual fecal occult blood testing and flexible sigmoidoscopy every 5 years

    • Colonoscopy every 10 years

  • Begin screening at age 40 in black patients and in others with a strong familial risk of colorectal cancer or adenomatous polyps.

  • Perform repeat screening with colonoscopy after removal of an adenomatous polyp after 3 years in patients with higher risk lesions, and after 5 to 10 years in those with lower risk lesions.

Diagnosis
  • Perform a complete colonoscopy in all patients in whom colorectal cancer is suspected.

  • Obtain colonoscopy in asymptomatic men and asymptomatic postmenopausal women with iron deficiency anemia.

  • Consider an inherited colorectal cancer syndrome whenever a diagnosis is made.

Therapy
  • Perform preoperative testing including CEA and metastatic work-up in patients with colorectal cancer and stage disease using the TNM system.

  • Perform surgery in patients with colorectal cancer to stage, definitively cure when possible, and palliate when cure is not possible.

  • Treat with radiation therapy in addition to surgery (and in some patients, chemotherapy) for all rectal cancers beyond stage I and for some metastatic lesions.

  • Treat with adjuvant chemotherapy in patients with stage III colon and rectal cancer and in stage II patients at high risk for recurrence.

  • Treat patients with stage IV (metastatic) colon and rectal cancer with chemotherapy.

DOI: 10.7326/d182
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Randall W. Burt, MD consultant for Myriad Genetics, received honoraria from Myriad Genetics. Richard Wheeler, MD received honorarium from ImClone, Sanofi-Aventis. David A. Johnson, MD, FACG, FASGE, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Related Content
Annals of Internal Medicine