Colorectal Tumours

• Colorectal tumours can be benign (e.g., polyps) or malignant (e.g., colorectal carcinoma).
• The colon and rectum are common sites for cancer development, often from precursor adenomatous polyps.

• Age: Incidence increases over 50.
• Family history of colorectal cancer or polyps.
• Hereditary conditions: Familial adenomatous polyposis (FAP), Lynch syndrome.
• Inflammatory bowel diseases: Ulcerative colitis, Crohn’s disease.
• Diet: High in red/processed meat, low in fibre.

• Adenomas: Precancerous polyps. Can be tubular, tubulovillous, or villous.
• Colorectal Carcinoma: Most are adenocarcinomas (~95%).

• Change in bowel habits: Diarrhoea, constipation.
• Rectal bleeding or melaena.
• Abdominal pain.
• Unintended weight loss and fatigue.
• Iron-deficiency anaemia.
• Palpable abdominal mass or rectal mass.

• Colonoscopy with biopsy: Gold standard.
• Flexible sigmoidoscopy.
• Faecal occult blood test (FOBT): Screening.
• CT colonography
• CT TAP (Thorax, Abdomen and Pelvis) to assess for metastatic spread

Investigations should be undertaken and then referral to a colorectal multi-disciplinary team (MDT)

Treatment options include:

• Surgery: Primary treatment for localised tumours.
• Chemotherapy: Adjuvant or for metastatic disease.
• Radiotherapy: Particularly for rectal tumours.
• Endoscopic removal for early, small tumours or polyps.

• Depends on the stage at diagnosis and the presence of metastasis.
• Regular monitoring and follow-up colonoscopies are essential.

• Regular screening, especially in those over 50 or with risk factors.
• Dietary modifications: Increase fibre intake, reduce red/processed meat.