Gastrointestinal Disease and Hepatology Clinical Evaluation and Management
Examination: Colorectal Cancer Epidemiology Risk Factors and Molecular
Pathogenesis Including APC Gene Mutation and Wnt Signaling Dysregulation,
Age and Genetic Risk Assessment with Lynch Syndrome and Familial
Adenomatous Polyposis Screening Considerations, Clinical Recognition of
Colorectal Cancer Symptoms Including Hematochezia Iron Deficiency Anemia
Weight Loss and Altered Bowel Habits, Diagnostic Colonoscopy with Biopsy and
Staging Imaging Using CT Chest Abdomen and Pelvis, Evidence Based Colorectal
Cancer Screening Strategies Including Colonoscopy Fecal Immunochemical
Testing and CT Colonography, Prognostic Survival Outcomes Based on Tumor
Invasion Lymph Node Involvement and Metastatic Disease, Diverticulosis
Pathophysiology and Diverticulitis Inflammatory Complications Associated with
Increased Intraluminal Colonic Pressure Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
Colon cancer - general information
•Cancer of Large Intestines or Rectum
•Risk of Colon Cancer increases with age
•Incidence and mortality have been decreasing
•Annually approx. 132,000 new cases are diagnosed
•CRC 25% higher in men than women
•CRC 20% higher in AA
•Begins in the lining of the bowel and can grow into the muscular layers
Colon cancer - pathophysiology
Originates in the epithelial cells in the lining of the large intestine or rectum => a mutation in the Wnt
signaling pathway => occurs in the intestinal crypt stem cell =>
Mutated APC gene "APC protein controls the levels of B-catenin" => decrease in APC => B catenin
increases => moves into the nucleus => binds to DNA => activates the transcription of genes that are
important for stem cell renewal and differentiation => high levels can cause colon cancer.
,Colon cancer risk factors
age (over 50)
environment (alcohol)
IBD
Genertics - Lynch syndrome, FAP
Colon cancer - signs and symptoms
Change in bowel habits
Hematochezia
Weight loss
Anemia/ iron deficiency
Abdominal pain
Colon cancer - diagnosis/management
Endoscopy - colonscopy with biopsy
CT chest/abdomen/pelvis
Surgery
Chemo/radiation therapy
Colon cancer screening
Three tier
Screening begins at age 50
AA begin testing at age 45
Individual with 1st degree relative with colon cancer diagnosed 60 or older screen like average risk
, First tier
Colonscopy every 10 years
Annual fecal immunochemical test
Second-tier
CT colonography every 5 years
FIT-fecal DNA every 3 years
Flexible sigmoioscopy every 5-10 years
Third-tier
Capsule colonoscopy - limited evidence
Colon cancer prognosis
•If the tumor does not invade the muscularis mucosa the 5 year survival rate is 100%
•If the tumor is in the submucosal layer or within the muscular layer the 5 year survival rate is 90%
•Invasive tumor without LN involvement the 5 year survival rate is 70%
•Regional LN involvement the 5 year survival rate is 40%
•Distant mets the 5 year survival rate is 5%
Diverticulosis
Common endoscopy finding found in the large intestine/these are pouches in the colon
Examination: Colorectal Cancer Epidemiology Risk Factors and Molecular
Pathogenesis Including APC Gene Mutation and Wnt Signaling Dysregulation,
Age and Genetic Risk Assessment with Lynch Syndrome and Familial
Adenomatous Polyposis Screening Considerations, Clinical Recognition of
Colorectal Cancer Symptoms Including Hematochezia Iron Deficiency Anemia
Weight Loss and Altered Bowel Habits, Diagnostic Colonoscopy with Biopsy and
Staging Imaging Using CT Chest Abdomen and Pelvis, Evidence Based Colorectal
Cancer Screening Strategies Including Colonoscopy Fecal Immunochemical
Testing and CT Colonography, Prognostic Survival Outcomes Based on Tumor
Invasion Lymph Node Involvement and Metastatic Disease, Diverticulosis
Pathophysiology and Diverticulitis Inflammatory Complications Associated with
Increased Intraluminal Colonic Pressure Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
Colon cancer - general information
•Cancer of Large Intestines or Rectum
•Risk of Colon Cancer increases with age
•Incidence and mortality have been decreasing
•Annually approx. 132,000 new cases are diagnosed
•CRC 25% higher in men than women
•CRC 20% higher in AA
•Begins in the lining of the bowel and can grow into the muscular layers
Colon cancer - pathophysiology
Originates in the epithelial cells in the lining of the large intestine or rectum => a mutation in the Wnt
signaling pathway => occurs in the intestinal crypt stem cell =>
Mutated APC gene "APC protein controls the levels of B-catenin" => decrease in APC => B catenin
increases => moves into the nucleus => binds to DNA => activates the transcription of genes that are
important for stem cell renewal and differentiation => high levels can cause colon cancer.
,Colon cancer risk factors
age (over 50)
environment (alcohol)
IBD
Genertics - Lynch syndrome, FAP
Colon cancer - signs and symptoms
Change in bowel habits
Hematochezia
Weight loss
Anemia/ iron deficiency
Abdominal pain
Colon cancer - diagnosis/management
Endoscopy - colonscopy with biopsy
CT chest/abdomen/pelvis
Surgery
Chemo/radiation therapy
Colon cancer screening
Three tier
Screening begins at age 50
AA begin testing at age 45
Individual with 1st degree relative with colon cancer diagnosed 60 or older screen like average risk
, First tier
Colonscopy every 10 years
Annual fecal immunochemical test
Second-tier
CT colonography every 5 years
FIT-fecal DNA every 3 years
Flexible sigmoioscopy every 5-10 years
Third-tier
Capsule colonoscopy - limited evidence
Colon cancer prognosis
•If the tumor does not invade the muscularis mucosa the 5 year survival rate is 100%
•If the tumor is in the submucosal layer or within the muscular layer the 5 year survival rate is 90%
•Invasive tumor without LN involvement the 5 year survival rate is 70%
•Regional LN involvement the 5 year survival rate is 40%
•Distant mets the 5 year survival rate is 5%
Diverticulosis
Common endoscopy finding found in the large intestine/these are pouches in the colon
