Long dwell time between the development of an adenomatous polyp and invasive carcinoma offers opportunity to intervene early in carcinogenesis. Screening and appropriate treatment of early stage cancer is more efficacious and cost-effective than using expensive techniques to treat advanced or recurrent cancer. A 45 year old woman presents to your office with rectal bleeding.
Flexible sigmoidoscopy reveals an adenomatous polyp in the rectosigmoid.
An abbreviated family history reveals that her mother died of colon cancer. Colonoscopy reveals 4 other adenomatous polyps scattered throughout the colon and a cancer in the ascending colon. Further family history reveals that her mother was diagnosed with colon cancer at age 67, a maternal aunt had endometrial cancer at age 45, and her maternal grandfather had rectal cancer diagnosed at age 54. Screening for endometrial and ovarian carcinoma are negative. The patient undergoes total abdominal colectomy and ileorectal anastomosis.