Clase Dr. Sergio Buenaventura Cisneros - Cáncer colonorectal

Summary of Scientific Concepts and Discoveries on Colorectal Cancer

Definition and Prevalence: Colorectal Cancer is a malignant neoplasm originating from the mucosa of the colon or rectum. It is one of the most common malignancies globally, ranking third in incidence and mortality for both genders.

Epidemiology

• Increasing incidence attributed to factors like increased life expectancy, poor diet, smoking, obesity, and sedentary lifestyle.
• Majority of cases are sporadic, with a small percentage linked to genetic syndromes such as Lynch Syndrome and Familial Adenomatous Polyposis.

Risk Factors

• Non-modifiable Factors:
  • Age (most common between 65-67 years)
  • Gender (more common in males)
  • Family history of Colorectal Cancer or adenomatous polyps
  • Chronic inflammatory disorders (e.g., ulcerative colitis)
• Modifiable Factors:
  • Alcohol consumption
  • Smoking
  • Diet high in red and processed meats
  • Obesity

Pathology

The adenocarcinoma model explains the progression from normal mucosa to adenomatous polyps and invasive carcinoma, involving genetic changes (e.g., APC gene activation, alterations in p53).

Protective Factors

• Regular physical activity
• High intake of fruits and vegetables (over 200 grams/day)
• Adequate dietary fiber (10 grams/day)
• Calcium (400-800 mg/day)
• Certain medications (e.g., Aspirin, statins)

Genetic Syndromes

• Lynch Syndrome: Diagnosed using Amsterdam and Bethesda criteria, associated with a high risk of Colorectal Cancer.
• Familial Adenomatous Polyposis: Autosomal dominant disorder with mutations in the APC gene, characterized by numerous adenomas.

Diagnosis and Staging

• Gold standard for diagnosis: Colonoscopy (high sensitivity and specificity).
• Staging based on the TNM system (tumor size, lymph node involvement, metastasis).
• Imaging studies (CT, MRI) are used for staging and assessing metastasis.

Treatment

• Non-metastatic Stages (1-3): Surgical intervention is the cornerstone, often followed by adjuvant chemotherapy.
• Metastatic Stage (4): Systemic treatment with chemotherapy, targeted therapies, and immunotherapy; surgery may play a role in select cases.

Screening Recommendations

• Regular screening for individuals aged 50 and older, with options including fecal tests and Colonoscopy.
• Consideration of patient preferences and health status for screening decisions in older adults.

Featured Researchers/Sources

• Dr. Sergio Buenaventura Cisneros
• American Cancer Society guidelines (2018)