Common site :

Ascending colon - 15%

Transverse colon - 10%
Descending colon - 5%
Sigmoid - 20-25%
Rectum - 45-50%
splenic flexure
Common cancers : breast, lung, prostate, colorectal cancer
Commo in developed countries
Risk factors :
1. Age: Risk increases with age, peak incidence 70-80. Less than 5% occurs in
patients under 40
2. Gender: Women at slightly higher risk than men
2. Diet: low in fibre, high in fatty foods, red meat
3. Genetic: Familial Adenomatous Polyposis (FAP), Hereditary Non Polypoid Colonic
Cancer (HNPCC)
4. Other: ulcerative colitis, primary sclerosing cholangitis, excess bile salts
(carcinogenic), previous cholecystectomy
Staging TNM, Duke staging.
DUKE A: Confined to the bowel wall, i.e. below the muscularis mucosae
DUKE B: Extends through the bowel wall, i.e. beyond the muscularis mucosae
DUKE C: Involvement of regional lymph nodes
DUKE D: Distant metastases
C/F :
alternating bowel habit
PR bleeding, mucus
Tenesmus
abdominal pain
weight loss
iron deficiency anaemia
Common sites of metastasis - liver, bone and lung, brain
Most common histological subtype - Adenocarcinomas
Investigations: Colonoscopy, CT scan
Treatment: Surgery, Chemotherapy and Radiotherapy