Hereditary nonpolyposis colorectal cancer history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]Ali Akram, M.B.B.S.[3]
Overview
The hallmark of hereditary nonpolyposis colorectal cancer is a first-degree relative with known MMR/EPCAM gene mutation. A positive family history of colorectal cancer and meeting Amsterdam I or II criteria or revised Bethesda guidelines is highly suggestive of hereditary nonpolyposis colorectal cancer. Some symptoms that are associated with colorectal cancer are change in bowel habits, hematochezia, and rectal pain.
History and Symptoms
History
Specific areas of focus when obtaining history, are outlined below:[1]
- Positive history of hereditary nonpolyposis colorectal cancer in a first degree family member
- At least two successive generations affected by hereditary nonpolyposis colorectal cancer (histologically confirmed)
- History of colorectal carcinoma and/or endometrial carcinoma or transitional cell carcinoma of the ureter
Common Symptoms
- Common symptoms include:
- Change in bowel habits:
- Change in frequency (constipation and/or diarrhea)
- Change in the quality of stool
- Change in consistency of stool
- Hematochezia or bleeding per rectum
- Mucus in stool
- Abdominal cramps or discomfort
- Melena (usually associated with upper gastrointestinal disease)
- Tenesmus (usually associated with rectal cancer)
- Diminished caliber of stool (usually associated with rectal cancer)
- Rectal pain (usually associated with rectal cancer)
- Nausea/vomiting
- Unexplained weight loss
- Unexplained loss of appetite
- Weakness
- Fatigue
- Metrorrhagia in premenopausal women
- Postmenopausal vaginal bleeding [2]
- Postcoital bleeding
- Change in bowel habits:
References
- ↑ Vasen HF, Watson P, Mecklin JP, Lynch HT. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology. 1999;116(6):1453-6.
- ↑ Kong A, Johnson N, Kitchener HC, Lawrie TA (2012). "Adjuvant radiotherapy for stage I endometrial cancer". Cochrane Database Syst Rev. 4: CD003916. doi:10.1002/14651858.CD003916.pub4. PMC 4164955. PMID 22513918.