Colon Cancer Presentation

Screening for CRC before it becomes clinically apparent has been shown to reduce cancer related mortality. The success of screening programs is one of the reasons cited for the decline in mortality rates from CRCs over the past 20 years. Screening is generally recommended to begin at the age of 50 years, unless risk factors including family history are present. Recommended screening options include colonoscopy every 5 to 10 years, flexible sigmoidoscopy every 5 years, and/or annual fecal occult blood testing (FOBT).

Despite these recommendations, only about onethird of Americans have routine fecal occult blood testing and even fewer comply with endoscopic screening (Quinn, 2003).With increased patient and physician awareness, however, screening compliance for CRC has been on the rise in recent years.Yet even today, the majority of patients with colon cancer come to medical attention through symptomatic presentation rather than from screening (Smith et al, 2001) There is a separate chapter on colon cancer screening.

The most common presenting symptoms are abdominal pain, blood per rectum, anemia, constipation, diarrhea, or change in stool character. In contrast to rectal cancer, colon cancer rarely presents with anal pain, tenesmus, or incontinence. The location of the tumor within the colon often dictates the type of symptoms experienced. Rightsided tumors tend to present with anemia or the constitutional symptoms produced by such. Obstruction from right-sided tumors are more commonly in the region of the ileocecal valve. Left-sided tumors are more likely to present with obstruction, largely due to the narrow bowel caliber, circumferential lesions, and firmer stool consistency. Evident blood in the stool and a change in stool caliber are also more commonly seen with distal colon cancer.

Colonic cleansing will help in avoiding colorectal cancer.