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Chapter 20. Colorectal

Risk factors associated with colorectal cancer include which one of the following?

A. Irritable bowel syndrome

B. Low intake of dietary fiber

C. Low intake of red meat

D. Chronic aspirin therapy

Answer: B. Inflammatory bowel disease is associated with an increased risk of colorectal cancer, but there is no association with irritable bowel syndrome. Other factors associated with increased risk are a low intake of dietary fiber and a high intake of red meat. Risk has been shown to be reduced by regular ingestion of aspirin.

Surgery for liver metastases from colorectal cancer is:

A. Associated with a 10% mortality

B. Contraindicated if more than 1 lesion is present

C. Associated with 16% to 40% 5-year survival

D. Usually followed with consolidation radiotherapy

Answer: C. Surgery for liver metastases from colorectal cancer is associated with a 2% mortality, can be performed if more than 1 lesion is present, and is associated with 16% to 40% 5-year survival. Radiotherapy is not used for liver metastases, as the toxicity to normal liver tissue would be too severe.

What is bevacizumab?

A. A monoclonal antibody that targets vascular endothelial growth factor (VEGF)

B. A monoclonal antibody that targets EGFR

C. A drug that has no proven survival benefit in the metastatic setting

D. A standard treatment for metastatic colorectal cancer in the UK

Answer: A. Bevacizumab is a monoclonal antibody that targets VEGF. It has been shown to improve survival in the metastatic setting when used in combination with chemotherapy.

Which statement about ulcerative colitis with malignancy is true?

A. It has a better prognosis

B. It is related to disease activity

C. It is related to the duration of ulcerative colitis

D. Malignancy is greater in anorectal ulcerative colitis

Answer: C. Carcinoma of the colon afflicts patients with ulcerative colitis 7 to 30 times more frequently than it does the general population. The risk of colon cancer in ulcerative colitis is related to 2 factors: (1) duration of the colitis ...

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