- Adenocarcinoma, typically develops within polyp over time
- No prior screening or screening > 10y ago
- Family history: one first
degree relative dx w/CRC or adenomatous polyp age < 60yo or two first degree relatives w/CRC (any age)
- Lynch Syndrome: autosomal dominant cancer syndrome; often age < 50, multiple family members w/CRC or GU, other GI, GYN cancers
- Familial Adenomatous Polyposis
- UC or colonic Crohn's
- Vague lower abdominal, pelvic and/or rectal area pain
- Persistent/progressive
- Change in bowel habits
- L sided→ obstructive sx
- May appreciate palpable mass on digital rectal exam if cancer is very distal
- Stool may appear mixed w/blood; often guaiac + if tested (i.e. + occult blood)
- Colonoscopy for dx
- Ct scan can show mets, sometimes colonic findings
- May have iron deficiency anemia (if persistent blood loss)