Colorectal cancer

Location and appearance of two example colorectal tumors
Longitudinally opened freshly resected colon segment showing a cancer and four polyps. Plus a schematic diagram indicating a likely field defect (a region of tissue that precedes and predisposes to the development of cancer) in this colon segment. The diagram indicates sub-clones and sub-sub-clones that were precursors to the tumors.
Colon cancer with extensive metastases to the liver
Relative incidence of various histopathological types of colorectal cancer. The vast majority of colorectal cancers are adenocarcinomas.
Micrograph of colorectal adenocarcinoma, showing "dirty necrosis".
A diagram of a local resection of early stage colon cancer
A diagram of local surgery for rectal cancer
Colon and rectum cancer deaths per million persons in 2012

Development of cancer from the colon or rectum (parts of the large intestine).

- Colorectal cancer
Location and appearance of two example colorectal tumors

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Micrograph of pseudomembranous colitis, an indication for colectomy. H&E stain.

Colectomy

Bowel resection of the large bowel (colon).

Bowel resection of the large bowel (colon).

Micrograph of pseudomembranous colitis, an indication for colectomy. H&E stain.

Colon cancer

Micrograph showing tumor-infiltrating lymphocytes (in a colorectal cancer), a finding associated with MSI-H tumours, as may be seen in Lynch syndrome. H&E stain.

Hereditary nonpolyposis colorectal cancer

Micrograph showing tumor-infiltrating lymphocytes (in a colorectal cancer), a finding associated with MSI-H tumours, as may be seen in Lynch syndrome. H&E stain.
HNPCC is inherited in an autosomal dominant fashion.

Hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome is an autosomal dominant genetic condition that is associated with a high risk of colon cancer as well as other cancers including endometrial cancer (second most common), ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin.

CT scan of a liver with cholangiocarcinoma

Liver cancer

Cancer that starts in the liver.

Cancer that starts in the liver.

CT scan of a liver with cholangiocarcinoma
Liver tumor types by relative incidence in adults in the United States (liver cancers in dark red color).
This electron micrograph shows hepatitis B virus "Dane particles", or virions.
High magnification micrograph of a liver with cirrhosis. Trichrome stain. The most common cause of cirrhosis in the Western world is alcohol use disorder – the cause of cirrhosis in this case.
Left lobe liver tumor in a 50-year-old male, operated in King Saud Medical Complex, Riyadh, Saudi Arabia
A surgeon performing photodynamic therapy
Deaths from liver cancer per million persons in 2012

Frequently, the site of origin is the gastrointestinal tract, since the liver is close to many of these metabolically active, blood-rich organs near to blood vessels and lymph nodes (such as pancreatic cancer, stomach cancer, colon cancer and carcinoid tumors mainly of the appendix), but also from breast cancer, ovarian cancer, lung cancer, renal cancer, prostate cancer.

Surface model of a KRASG12C protein, showing a GDP molecule (orange) in its high-affinity binding site and the covalent inhibitor sotorasib (aqua) occupying an adjacent "cryptic" binding pocket. Sotorasib forms an irreversible bond with a cysteine residue and disrupts function of the mutated protein. From.

KRAS

Gene that provides instructions for making a protein called K-Ras, a part of the RAS/MAPK pathway.

Gene that provides instructions for making a protein called K-Ras, a part of the RAS/MAPK pathway.

Surface model of a KRASG12C protein, showing a GDP molecule (orange) in its high-affinity binding site and the covalent inhibitor sotorasib (aqua) occupying an adjacent "cryptic" binding pocket. Sotorasib forms an irreversible bond with a cysteine residue and disrupts function of the mutated protein. From.

The transforming protein that results is implicated in various malignancies, including lung adenocarcinoma, mucinous adenoma, ductal carcinoma of the pancreas and colorectal cancer.

A person preparing for breast cancer screening by mammography

Cancer screening

Cancer screening aims to detect cancer before symptoms appear.

Cancer screening aims to detect cancer before symptoms appear.

A person preparing for breast cancer screening by mammography
Microscope image of the cervical gland showing an area of high grade epithelial dysplasia.
A bowel polyp that can be identified by sigmoidoscopy. Some polyps will develop into cancers if not removed.

The likelihood of cancer being present: Screening is not normally useful for rare cancers. It is rarely done for young people, since cancer is largely a disease found in people over the age of 50. Countries often focus their screening recommendations on the major forms of treatable cancer found in their population. For example, the United States recommends universal screening for colon cancer, which is common in the US, but not for stomach cancer, which is less common; by contrast, Japan recommends screening for stomach cancer, but not colon cancer, which is rarer in Japan. Screening recommendations depend on the individual's risk, with high-risk people receiving earlier and more frequent screening than low-risk people.

Cholecalciferol (D3)

Vitamin D

Group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects.

Group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects.

Cholecalciferol (D3)
Calcium regulation in the human body. The role of active vitamin D (1,25-dihydroxyvitamin D, calcitriol) is shown in orange.
Global vitamin D serum levels among adults (nmol/L).
The photochemistry of vitamin D biosynthesis in animal and fungi
Thermal isomerization of previtaminD3 to vitamin D3
In the epidermal strata of the skin, vitamin D production is greatest in the stratum basale (colored red in the illustration) and stratum spinosum (colored light brown).
Liver hydroxylation of cholecalciferol to calcifediol
Kidney hydroxylation of calcifediol to calcitriol

Meta-analyses of observational studies have found reduced risk of cancer incidence related to vitamin D intake and 25(OH)D levels, particularly for colorectal cancer, although the strength of the associations was classified as weak.

Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas).

Constipation

Bowel dysfunction that makes bowel movements infrequent or hard to pass.

Bowel dysfunction that makes bowel movements infrequent or hard to pass.

Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas).
Bristol stool chart
Significant constipation in the plain X-ray of an 8-year-old
19th century satirical cartoon of a monkey rejecting an old style clyster for a new design, filled with marshmallow and opium

Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease.

Thinly sliced raw beef is red.

Red meat

Commonly red when raw and a dark color after it is cooked, in contrast to white meat, which is pale in color before and after cooking.

Commonly red when raw and a dark color after it is cooked, in contrast to white meat, which is pale in color before and after cooking.

Thinly sliced raw beef is red.
Roast beef is a darker color after being cooked.
Cooked duck with potatoes, showing the red color of the meat
Meat with a dark exterior, common in high temperature cooking

Overall, diets high in red and processed meats are associated with an increased risk of diabetes, cardiovascular disease, cancer (particularly colorectal cancer), and all-cause mortality.

Celecoxib

COX-2 inhibitor and nonsteroidal anti-inflammatory drug .

COX-2 inhibitor and nonsteroidal anti-inflammatory drug .

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The use of celecoxib to reduce the risk of colorectal cancer has been investigated, but neither celecoxib nor any other drug is indicated for this use.

Micrograph of an adenocarcinoma showing mucin-containing vacuoles. Pap test

Adenocarcinoma

Type of cancerous tumor that can occur in several parts of the body.

Type of cancerous tumor that can occur in several parts of the body.

Micrograph of an adenocarcinoma showing mucin-containing vacuoles. Pap test
Many seborrheic keratoses on back of person with Leser–Trélat sign due to colon cancer
Gross appearance of an opened colectomy specimen containing two adenomatous polyps (the brownish oval tumors above the labels, attached to the normal beige lining by a stalk) and one invasive colorectal carcinoma (the crater-like, reddish, irregularly-shaped tumor located above the label)
Histopathologic image of colonic carcinoid stained by hematoxylin and eosin
Pie chart showing incidence of adenocarcinoma of the lung (shown in yellow) as compared to other lung cancer types, with fractions of non-smokers versus smokers shown for each type

The vast majority of colorectal cancers are adenocarcinomas.