Two Onc Docs Localized Colon Cancer 2025 UPDATE
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Mar 3, 2025 Discover the latest on early-stage colorectal cancer, including the updated screening guidelines recommending checks starting at age 45. Learn about crucial testing and staging processes, particularly the importance of Lynch syndrome screening. Explore advancements in neoadjuvant immunotherapy for high-risk stage 2 tumors and the implications of recent clinical trials on treatment choices. Delve into key findings from the IDEA trial, comparing the effectiveness of three-month versus six-month chemotherapy, and understand the role of genetic testing in management.
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Begin Screening At 45
- Start colorectal cancer screening at age 45 using FIT, colonoscopy, CT colonography, or flexible sigmoidoscopy.
- Use colonoscopy to remove polyps and reduce colorectal cancer mortality.
Familial Versus Hereditary CRC
- About 20% of colorectal cancers are familial while 2–5% are Lynch syndrome and <1% are FAP.
- Lynch involves MMR gene mutations and FAP arises from APC mutations.
Always Test For Lynch
- Test every colorectal cancer patient for Lynch syndrome with IHC or MSI testing.
- If MLH1/PMS2 loss is present, check BRAF V600E to identify sporadic cases.