1. Colorectal Cancer.. Let’s Talk About It
Lauren Dansereau MS RN ANP
Health Educator, Western New England College Health Services

2. Colorectal Cancer

3. Colorectal Cancer

4. Colorectal Cancer

5. Colorectal Cancer

6. Colorectal Cancer

7. Colorectal Cancer

8. Colorectal Cancer

9. Colorectal Cancer

10. Colorectal Cancer

11. Colorectal Cancer

12. Colorectal Cancer

13. Colorectal Cancer

14. Colorectal Cancer
Are You At High High Risk?

15. Colorectal Cancer
Are You At High High Risk?

16. Colorectal Cancer Risk Factors

17. Colorectal Cancer Risk Factors

18. Colorectal Cancer Risk Factors

19. Colorectal Cancer Risk Factors

20. Colorectal Cancer Risk Factors

21. Colorectal Cancer Risk Factors

22. Colorectal Cancer

23. Colorectal Cancer

24. Symptoms

25. Symptoms
Early, usually has no
symptoms
More advanced disease:
rectal bleeding, blood in
stool, change in bowel
habits, lower abdominal
cramping, anemia, weight
loss

26. Colon Polyps
Hyperplastic-
noncancerous
Adenomatous-
90% precancerous

28. Progression of A Polyp to Carcinoma

29. Colon Cancer Stages

30. Colon Cancer Stages

31. Benefits of Colorectal Screening

32. Benefits of Colorectal Screening
Cancer Prevention-
removal of
precancerous polyps
prevents cancer
Increased Survival- early
detection increases chances of
long term survival.

33. Colorectal Cancer Tests

34. Colorectal Cancer Tests
Yearly Fecal occult
blood test

35. Colorectal Cancer Tests
Yearly Fecal occult
blood test
Yearly Fecal
immunochemical test

36. Colorectal Cancer Tests
Yearly Fecal occult
blood test
Yearly Fecal
immunochemical test
Stool DNA test (interval
uncertain)

37. Colorectal Cancer Tests
Flexible CT Colonography
Sigmoidoscopy every (virtual colonoscopy)
5 yrs OR every 5yrs
Colonoscopy every 10
yrs OR
Double Barium
contrast Enema every
5 yrs OR

38. Colonoscopy
A procedure to
visualize the lining of
the colon and rectum.
Used to detect
inflamed tissue
ulcerations and
abnormal growths.

39. Colonoscope
Thin flexible scope
which is dial controlled
and maneuverable with
fiberoptic video camera.
It also blows air to inflate
the colon, irrigates with
water, suctions, inserts
instruments for removal,
biopsies, cauterization of
polyps skin tissue.

40. Colon Preps
WHICH ONE TO CHOOSE ???.....

42. 2008 New Screening Tests Available

43. Stool DNA Test
Rationale behind:
Detects blood in the stool – which is
intermittent and non-specific
Colon cells are shed continuously
Polyps and cancer cells contain abnormal
DNA
Stool DNA tests look for abnormal DNA from
cells that are passed in the stool*
Drawbacks:
Misses some adenomas
Still in testing phase
Cost ($300-400)
Not covered by all insurance

44. CT
Colonography

45. CTC Image Optical Colonoscopy

46. CT
Colonography New Sources of Risk
Colorectal cancer prevention largely focuses
on finding polyps, but flatter, less visible lesions
that are not polyps are also cancer risks.
Limitations:
Polyp
Requires full bowel prep (which most
patients find
Elevated
to be the most distressing element of lesion
colonoscopy)
Colonoscopy is required if abnormalities Flat
detected, lesion
sometimes necessitating a second bowel
prep Depressed
lesion
Steep learning curve for radiologists
Limited availability to high quality exams in The New York Times: Illustrations by JAMA
many parts of the country
Most insurers do not currently cover CTC as
a screening modality
Can miss flat, smaller lesions

47. What is Best For You?

48. What is Best For You?
Discuss with your Health Care Provider.

49. What is Best For You?
Discuss with your Health Care Provider.
Unless high risk or symptoms age 50
colonoscopy or discuss other screening
methods.

50. What is Best For You?
Discuss with your Health Care Provider.
Unless high risk or symptoms age 50
colonoscopy or discuss other screening
methods.
Early detection is key! Colon cancer is
preventable.