## 1 Introduction  
Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide, with over 1.8 million new cases per year, of which approximately 500,000 new cases are in Europe [1]. CRC can be hereditary in 3% of patients, with an onset at younger ages [2; 3]. The increasing incidence of CRC emphasized the studying of quality of life (QoL) in patients undergoing oncological and surgical therapies. The health deterioration due to cancer along with the consequences regarding psychological, physical or social functioning changes, all of them influencing the QoL [4]. Several studies highlighted the impact on QoL of CRC protocols in patients, immediately after chemoradiation and in the long run [5]. The QoL for cancer patients is associated with a greater number of factors [6], such as: socio-demographic characteristics; health-related factors; factors related to cancer and surgical procedures; lifestyle [7]; other factors [8; 9]. The stage and location of CRC at the time of diagnosis is important in quantifying QoL, as they determine the symptoms, treatments and duration of therapy [10]. The stage I patients showed a positive progressive tendency in the QoL score. The stage IV patients had a negative score. In contrast, an initial decrease in QoL score, followed by better scores, was achieved by those with stage II and III, maybe because of a better perception of QoL after diagnosing CRC [11]. In patients with CRC undergoing surgery and colostomy, such procedures could lead to physical, psychological and social consequences on QoL. Studies showed an immediate decrease in QoL scores after surgical interventions, and a gradual recovery after 3 months. The presence of colostomy can lead to decreased QoL physical scores but also to emotional and social functioning scores as compared to those in patients with resection and anastomosis, but not all authors registered a significant difference [12]. Various studies worldwide investigated the role of chemotherapy and its associated symptoms influencing QoL in patients diagnosed and treated for CRC [13]. In Romania, the risk of developing cancer before the age of 75 is 23.1%, of which 28.0% in men and 19.1% in women. The risk of dying from a form of cancer is 14.0%, of which 19.1% in men and 9.8% in women. Colorectal cancer is the second most common cancer that affects the Romanian population (21,387,000 inhabitants), for both men and women. The number of new CRC cases reported in 2012 was 10,256 (13% of all cancers), of which 5760 were men (13.3% of all cancers in men) and 4496 were women (12.6% of all cancers in women). In 2012 the number of deaths due to CRC was 5675 people, of which 3229 were men and 2446 were women. The 5-year prevalence was 24,170 cases of CRC, of which 13,654 were men and 10,516 were women [10]. Of all the neoplastic sites, CRC is one of the most common familial cancers. People with Lynch syndrome are prone to various types of cancer, with a predilection for colonic and endometrial damage. Lynch syndrome accounts for 2-4% of all cases of CRC. Affected individuals may develop colonic adenomas with a higher frequency than the general population. The lifetime risk of developing a CRC is estimated at 50% [14]. Recent studies have shown that path_MLH1 and path_MSH2 carriers have a lifetime risk of CRC of approximately 50% and this incidence could not be decreased by surveillance colonoscopy. According to The Prospective Lynch Syndrome Database (PLSD), there was no risk of cancer in path_PMS2 carriers before the age of 40, and in older carriers, no other tumor associations were observed, excepting endometrial and prostate cancer [15]  
In Lynch syndrome, malignant colonic polyps appear at an early age and have a more proximal location compared to those in sporadic CRC neoplasms. Histologically, these polyps are often poorly differentiated, mucinous and have a significant lymphocytic infiltrate.