Colorectal Cancer Mr Eoghan Condon, MD,FRCSI. Consultant Colorectal Surgeon Mid Western Regional Hospital Limerick.

incidence Second most commonly diagnosed cancer in men and women in ireland 1900 cases per year Ave 8 per week diagnosed in the Mid western hospital group . Six surgeries per week.

Causes No definite link to any virus food or drink Diseases Crohns and Ulcerative colitis significant links Genetics Familial polyposis coli, Microsatellite instability.

Survival 5 year survival in ireland for colorectal cancer is 50% 5 year survival in the USA is 75% Why ? Early detection. Every body is screened in the US at 50

Ireland Screening 2012 12 million 55-74 Based on immunohsitocemical screening 12 centres, Ennis new endoscopy suite has applied to centre. Expected to increase survival

Polyps 10-15% population 10yrs before cancers Adenomas >1 cm increases risk

Family history and risk of colorectal cancer

liver

Symptoms that define high risk and low risk patients

Urgent referral Over 50 years of age Rectal bleeding persistently without anal symptoms Change of bowel habit to looser stools and/or increased frequency of defaecation, without bleeding, persisting for > 6 weeks

Urgent referral All ages Definite palpable abdominal/ rectal mass Rectal bleeding with a change in bowel habit to looser stools and/or increased frequency persistent for > 6 weeks Iron deficiency anaemia without an obvious cause

Treatment options – are based on staging! Surgery Radiotherapy chemotherapy

On the occasion of Dr. George Crile, Sr On the occasion of Dr. George Crile, Sr.’s twenty-five thousandth thyroidectomy (June 3, 1936), thirteen people crowded around the patient - some without masks or gowns. Barney is the fourth from left; his father is across from him. Third from right is the Chief’s longtime secretary, Amy Rowland.

Thank you