Fast Five Quiz: Colorectal Cancer Practice Essentials

Elwyn C. Cabebe, MD

Disclosures

February 06, 2020

There is increased emphasis on screening practices, so colon cancer is now often detected before it starts to cause symptoms. In more advanced cases, common clinical presentations include iron-deficiency anemia, rectal bleeding, abdominal pain, change in bowel habits, and intestinal obstruction or perforation. Right-sided tumors are more likely to bleed and cause diarrhea, whereas left-sided tumors are usually detected later and may appear as bowel obstruction.

In patients younger than 50 years (an age group that is experiencing rising rates of colorectal cancer), a study that used data from England's Clinical Practice Research Datalink found that abdominal pain was the most common presenting symptom of colorectal cancer. Compared with other age groups, these younger patients had the lowest percentage of typical "red-flag" signs and symptoms (ie, rectal bleeding, anemia, change in bowel habits, diarrhea, abdominal mass). Instead, these patients were more likely to have presented to their primary care provider, in the year before diagnosis, with nonspecific symptoms.

Physical examination findings can be very nonspecific (eg, fatigue, weight loss) or normal early in the course of colon cancer. In more advanced cases, any of these findings may be present:

  • Abdominal tenderness

  • Macroscopic rectal bleeding

  • Palpable abdominal mass

  • Hepatomegaly

  • Ascites

Read more about the clinical presentation of colorectal cancer.

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