Colorectal Carcinoma

Colorectal cancer is the third most common cause of cancer in men and women, and it affects 5% of the population in the United States and other Western countries. Approximately 106,000 new cases of colon cancer, 40,570 new cases of rectal cancer, and 57,000 deaths (10% of all cancer deaths) were expected to occur in 2004 in the United States.248 Most patients (70%) diagnosed with colorectal cancer undergo surgery with curative intent, and the overall survival of 5 years is less than 60%.

The recurrence rate is close to 40% within the 5 years following surgery, with up to 80% of the recurrence appearing in the first 2 years. The most common sites of recurrence are in the liver (20%), in the original local site (12.5%), and in the lungs (8%). Only 20% of patients are amenable to a second surgery with curative intent, and long-term survival is expected in only 30% of these.249,250

The diagnosis of colorectal carcinoma is based on colonoscopy and biopsy. Most follow-up strategies include carcinoembryonic antigen (CEA) testing and liver imaging. The use of frequent colonoscopy is still being investigated.

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