Colon Cancer Awareness Quiz

Colon Cancer Symptoms and Screening

• Common symptoms of colon cancer include blood in the stool, stomach pain, and changes in bowel movements, such as size and frequency.
• Individuals without risk factors should begin colon cancer screening at age 50, continuing until age 75.
• For symptomatic individuals or those at risk, screening is recommended before the age of 50.

Polyps and Screening Recommendations

• Most colorectal cancers (CRCs) arise from adenomatous or serrated polyps due to sporadic mutations or DNA mismatch repair failures.
• The U.S. Preventive Services Task Force (USPSTF) endorses CRC screening for average-risk adults between ages 50 and 75.

Stool-Based Screening Methods

• Stool-based screening options include the guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and multitargeted stool DNA test (FIT-DNA).
• Office-based gFOBT is not recommended for CRC screening.
• FIT is more sensitive than gFOBT and requires no dietary restrictions, needing only one stool sample yearly.
• Both FIT and FIT-DNA have low sensitivity in detecting adenomatous and serrated polyps of 1 cm or larger.

Direct Visualization Tests

• Direct visualization testing, such as colonoscopy, computed tomographic colonography (CTC), and flexible sigmoidoscopy, can identify polyps before they develop into CRC.
• Polyethylene glycol is used for complete bowel preparation before colonoscopy.
• Colonoscopy is recommended every 10 years for average-risk individuals with normal findings.
• CTC screening is advised every 5 years.
• Flexible sigmoidoscopy also requires bowel preparation but does not necessitate sedation, with screening recommended every 5 years.

Medication and Lifestyle Factors

• Aspirin usage may decrease CRC incidence by 40%, but its routine use in average-risk populations is discouraged due to the risk of gastrointestinal bleeding and hemorrhagic stroke.
• Aspirin is most effective for preventing cancers in the proximal colon.
• NSAIDs and COX-2 inhibitors can lower the risk of CRC and adenomatous polyps.
• Smoking is associated with an increased risk of CRC and adenomatous polyps.
• Reducing body mass index (BMI) may decrease CRC risk.

Dietary Factors and Supplements

• Increased fiber intake has been found not to lower the risk of CRC or adenomatous polyp recurrence according to two Cochrane reviews.
• Higher red meat consumption is linked to an elevated risk of CRC.
• Calcium supplementation is associated with a reduced risk of adenomatous polyps and CRC based on observational studies.
• No supportive evidence exists for folic acid supplementation decreasing adenomatous polyp risk.
• Hormone therapy shows no significant association with the risk of developing serrated polyps.
• Some observational data suggest statin use may lower the risk of advanced adenomatous polyps, but randomized controlled trial (RCT) data are lacking.
• No evidence supports that Vitamin D supplementation decreases CRC risk.

Colon Cancer Symptoms and Screening

• Common symptoms include blood in the stool, stomach pain, and changes in bowel movements, such as stool size.
• Routine screening for colon cancer is recommended starting at age 50 until age 75 for average-risk individuals.
• Individuals with symptoms or at risk should be screened before age 50.

Polyps and Causes

• Most colorectal cancers (CRCs) arise from adenomatous or serrated polyps due to sporadic mutations or DNA mismatch repair issues.

Stool-Based Screening Methods

• Stool-based screening options include:
  • Guaiac-based fecal occult blood test (gFOBT)
  • Fecal immunochemical test (FIT)
  • Multitargeted stool DNA test (FIT-DNA)
• gFOBT is not recommended for CRC screening in office settings.
• FIT is more sensitive than gFOBT and does not require dietary restrictions; it only needs a single stool sample.
• FIT testing should be performed yearly, but both FIT and FIT-DNA tests show poor sensitivity for detecting large adenomatous and serrated polyps (≥1 cm).

Direct Visualization Tests

• Tests like colonoscopy, computed tomographic colonography (CTC or virtual colonoscopy), and flexible sigmoidoscopy can identify adenomatous and serrated polyps before they progress to CRC.
• Polyethylene glycol is used for complete bowel preparation prior to colonoscopy.
• Colonoscopy is recommended every 10 years for average-risk individuals if normal findings and adequate bowel preparation are observed.
• CTC screening is recommended every 5 years.
• Flexible sigmoidoscopy requires bowel preparation but does not require sedation, with screenings recommended every five years.

Risk Factors and Preventative Measures

• Aspirin can reduce CRC incidence by approximately 40%, but guidelines advise against its use in average-risk populations due to bleeding risks.
• Aspirin is more effective for colorectal cancers in the proximal colon.
• NSAIDs and COX-2 inhibitors may lower the risk of CRC and adenomatous polyps.
• Smoking is associated with an increased risk of CRC and adenomatous polyps.
• Reducing body mass index (BMI) decreases CRC risk.
• Increased consumption of red meat raises CRC risk.
• Calcium supplementation is linked to a reduced risk of adenomatous polyps and CRC in observational studies.
• Evidence does not support folic acid supplementation for reducing adenomatous polyp risk.
• Hormone therapy exhibits no significant association with the risk of serrated polyps.
• Some observational data indicate statin use may lower the risk of advanced adenomatous polyps, but randomized controlled trial data is lacking.
• No evidence suggests Vitamin D supplementation decreases CRC risk.