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13 - Colon and rectum

Published online by Cambridge University Press:  23 December 2009

By
Richard Adams ,
Timothy Maughan  and
Tom Crosby
Edited by
Louise Hanna ,
Tom Crosby  and
Fergus Macbeth
Richard Adams
Affiliation:
Senior Lecturer, Clinical Oncology, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Timothy Maughan
Affiliation:
Professor of Cancer Studies, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Tom Crosby
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Cardiff
Louise Hanna
Affiliation:
Velindre Hospital, Cardiff
Tom Crosby
Affiliation:
Velindre Hospital, Cardiff
Fergus Macbeth
Affiliation:
Velindre Hospital, Cardiff
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Summary

Introduction

Colorectal cancer (CRC) is second in incidence in Europe only to lung cancer, and it causes around 204,000 deaths each year. The aetiology of CRC is still unclear, but the eight- to ten-fold higher incidence in the developed world compared to that in the developing world suggests environmental causes. Around 15 to 20% of CRCs are of familial origin.

Screening is currently being adopted in the UK with the roll-out of a programme of faecal occult blood (FOB) testing, followed by colonoscopy if FOB testing is positive. Many other countries are also considering such a programme.

Surgery is the only curative treatment and total mesorectal excision (TME) is now well established as the best way of managing rectal carcinoma. But the last 10 years have also seen a rapid increase in the use of preoperative radiotherapy, of neoadjuvant and adjuvant chemotherapy, and of new agents for advanced disease, with small but incremental improvements in outcome.

Targeted therapy such as epithelial growth factor receptor (EGFR) inhibitors and vascular endothelial growth factor inhibitors have been tested in patients with advanced CRC, but the role of these therapies in routine management has not yet been established.

Types of colorectal tumours

The range of tumours that affect the colon and rectum is shown in Table 13.1.

Incidence and epidemiology

The annual incidence of CRC is 54 per 100,000 in the UK, and 35,000 new cases are reported per year (CRUK; http://info.cancerresearchuk.org, accessed September 2006).

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Practical Clinical Oncology , pp. 159 - 173
Publisher: Cambridge University Press
Print publication year: 2008

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  • Colon and rectum
    • By Richard Adams, Senior Lecturer, Clinical Oncology, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Timothy Maughan, Professor of Cancer Studies, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Tom Crosby, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Cardiff
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.014
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  • Colon and rectum
    • By Richard Adams, Senior Lecturer, Clinical Oncology, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Timothy Maughan, Professor of Cancer Studies, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Tom Crosby, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Cardiff
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.014
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Colon and rectum
    • By Richard Adams, Senior Lecturer, Clinical Oncology, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Timothy Maughan, Professor of Cancer Studies, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Tom Crosby, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Cardiff
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.014
Available formats
×