With almost 100,000 new cases estimated to occur in the United States in 2017 (with equal gender predilection), colon carcinoma is among the most commonly diagnosed malignant diseases in the Western World [1] [2]. The incidence rate seems to be highest among the elderly individuals (between 60-70 years of age), and several risk factors have been established, most important being physical inactivity, obesity and increased body weight, cigarette smoking, overt alcohol consumption and certain dietary habits, such as excessive intake of animal fats and reduced fiber in nutrition [3] [4] [5]. Countries belonging to the developed world (Canada, Denmark, Sweden, the United States, and several other) report the highest prevalence rates [3] [4] [5] The clinical presentation of colon carcinoma is usually nonspecific and up to several months may pass before the diagnosis is even suspected [6] [7]. One of the reasons is the insidious and nonspecific onset of gastrointestinal complaints such as abdominal pain, fatigue, weakness, and changes in bowel habits (both constipation and diarrhea) [4] [5] [8]. This is typical for right-sided colonic cancers, whereas left-sided carcinomas of the colon more frequently produce symptoms that are highly suggestive of a neoplastic process in the large intestine - rectal bleeding and anemia [4] [9]. In addition, cramping, anorexia, and abdominal discomfort may be reported [4] [8]. As anemia becomes more severe and clearly stems from iron depletion due to continuous bleeding, cardiac manifestations (angina pectoris and palpitations) can appear, in which case immediate suspicion toward colon carcinoma, especially in elderly men and women, should be mounted [4] [5].

• Fatigue

  The secondary outcomes will be: physical measurements, QoL, level of physical activity, executive functions, fatigue, body composition, blood test, energy expenditure. [clinicaltrials.gov]

  One of the reasons is the insidious and nonspecific onset of gastrointestinal complaints such as abdominal pain, fatigue, weakness, and changes in bowel habits (both constipation and diarrhea). [symptoma.com]

  Common side effects include: hair loss nausea fatigue vomiting Combination therapies often mix multiple types of chemotherapy or combine chemotherapy with other treatments. [medicalnewstoday.com]

  As you’ve probably noticed, fatigue, chills and nausea can indicate the presence of numerous different conditions, including the flu. [marcianolegal.com]

• Inguinal Hernia

  Primary colon carcinoma within an inguinal hernia sac is very rare and most reported cases were found at emergency open surgery for an incarcerated hernia. [ncbi.nlm.nih.gov]

  Home OSTMED-DR Colon carcinoma discovered in an adolescent during inguinal hernia repair To link to this object, paste this link in email, IM or document To embed this object, paste this HTML in website Small Medium Large Extra Large Full-size Full-size [ostemed-dr.contentdm.oclc.org]

• Constipation

  The presenting symptoms varied and included abdominal pain, nausea, vomiting, diarrhea, constipation, and hematochezia, with symptom duration ranging from a few days to 4 months. No patient had a predisposing disease or syndrome. [ncbi.nlm.nih.gov]

  Constipation : When bowel movements are infrequent or difficult. [m.webmd.com]

  People may experience some chronic pain and anemia along with intermittent constipation. [livestrong.com]

  Intermittent (Alternating) Constipation and Diarrhea: It's not uncommon for colon cancer to result in symptoms of alternating diarrhea and constipation. This may occur when there is a partial obstruction in the bowel due to a tumor. [coloncancer.about.com]

  Diets that are low in fiber, like those in the developed world, often lead to constipation. Constipation in turn leads to increased pressure in the intestines, along with straining during bowel movements. [marcianolegal.com]

• Abdominal Pain

  On the 7th day after admission, her temperature was 38.8°C, she had increased white blood cell count (24 610 cells/mm(3)), and suffered persistent severe abdominal pain. [ncbi.nlm.nih.gov]

  The clinical presentation, comprised of abdominal pain, nausea, vomiting, anemia and weight loss is frequently insidious, thus the diagnosis is delayed in the majority of patients. [symptoma.com]

• Rectal Bleeding

  A 69-year-old man presented with rectal bleeding. Colonoscopy revealed a rectal tumor, whereas biopsy specimens revealed a poorly differentiated carcinoma. During the preoperative evaluation, pancytopenia was detected. [ncbi.nlm.nih.gov]

  One of these complications is rectal bleeding, also called diverticular bleeding. Diverticular bleeding occurs when there is chronic (long-term) injury to the small blood vessels near the diverticula. The other complication is diverticulitis. [my.clevelandclinic.org]

  Rectal bleeding may be coming from around the anus, commonly haemorrhoids (piles) or a fissure. Polyps, rather than cancer, may produce rectal bleeding or iron deficiency anaemia. [netdoctor.co.uk]

  This is typical for right-sided colonic cancers, whereas left-sided carcinomas of the colon more frequently produce symptoms that are highly suggestive of a neoplastic process in the large intestine - rectal bleeding and anemia. [symptoma.com]

• Nausea

  The presenting symptoms varied and included abdominal pain, nausea, vomiting, diarrhea, constipation, and hematochezia, with symptom duration ranging from a few days to 4 months. No patient had a predisposing disease or syndrome. [ncbi.nlm.nih.gov]

  Nausea and/or Vomiting: When nausea and vomiting are symptoms of colon cancer, it's usually because a tumor is causing a bowel obstruction, usually in the proximal colon (meaning the end closer to the small intestines). [coloncancer.about.com]

  The clinical presentation, comprised of abdominal pain, nausea, vomiting, anemia and weight loss is frequently insidious, thus the diagnosis is delayed in the majority of patients. [symptoma.com]

  Case Report A 35-year-old male presented with a 3-month history of intermittent abdominal pain, weight loss, dyspepsia, intermittent fever, and nausea. No history of bloody diarrhea. [jdrntruhs.org]

• Hematochezia

  The presenting symptoms varied and included abdominal pain, nausea, vomiting, diarrhea, constipation, and hematochezia, with symptom duration ranging from a few days to 4 months. No patient had a predisposing disease or syndrome. [ncbi.nlm.nih.gov]

  A 68 year-old woman visited our hospital because of constipation and hematochezia. Colonoscopy revealed an invasive fungating mass with a narrowing of lumen and severe ulceration at the sigmoid colon. [kci.go.kr]

  This patient also reported mild intermittent hematochezia (about 10–12 episodes) for a month and gave a pertinent history of colon cancer in his mother at the age of 50. [karger.com]

  Diverticular bleeding manifests as painless hematochezia. Because the bleeding vessel is an arteriole, the amount of blood loss is usually moderate to severe. [merckmanuals.com]

• Subcutaneous Nodule

  Physical examination revealed two subcutaneous nodules on the glans penis. Biopsy of the nodules showed that penile metastasis of sigmoid colon carcinoma. [ncbi.nlm.nih.gov]

• Swelling of the Scrotum

  A 67-year-old man with a 2-year history of swelling of the scrotum and a breast lump was referred to us for surgical treatment of an irreducible left inguinal hernia and a right breast tumor. Blood examination results showed severe anemia. [ncbi.nlm.nih.gov]

Early recognition of colon carcinoma is favored, especially if we know that 5-year survival rates range between 40%-60%, depending on the stage [1] [6] [7] [8]. In fact, the degree of tumor invasion and infiltration of adjacent lymph nodes or distant organs are the two predictors of mortality in this patient population, suggesting that advanced stages of the disease carry a poorer prognosis undoubtedly [4]. In all patients with non-specific gastrointestinal (GI) complaints, a thoroughly obtained patient history and a meticulous physical examination can provide sufficient clues to investigate colon carcinoma as a potential cause, especially among the elderly. A complete blood count (CBC) and basic biochemical workup will often identify sideropenic anemia, in which case a fecal occult blood test must be performed. If the test is positive, imaging studies should be employed. Several studies have been listed in the literature as possible modalities for visualization of the tumor, including barium enema and computed tomographic colonography (CTC), but optical colonoscopy (OC) remains the cornerstone in diagnosing colon carcinoma [1] [10]. Moreover, fluorodeoxyglucose positron emission tomography (FDG-PET), magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI), ultrasonography, computed tomography (CT) as well as contrast-enhanced MRI have also been mentioned as valuable procedures in determining the stage of the tumor [1] [4]. A definite diagnosis, however, is made after a biopsy sample is obtained during colonoscopy for microscopic evaluation, and the tumor is classified according to the degree of local (but also distant) tissue invasion by the TNM classification [4] [5]:

• Stage I - Tumor invasion of the mucosa or submucosa (T1 and T2, respectively), without nodal (N0) or metastatic spread (M0).
• Stage II - Proliferation either into the muscularis propria (T3) or the adjacent organs and the peritoneum (T4) with N0 and M0 (also known as stages IIA and IIB).
• Stage III - In the setting of tumor infiltration into 1-3 lymph nodes (N1) and the mucosa/submucosa (T1/T2), the tumor is classified as stage IIIA. In the setting of deeper local invasion (T3/T4), the stage IIIB is reached, and if four or more lymph nodes are infiltrated by the tumor (N2), regardless of the local tissue invasion, colon carcinoma has reached stage IIIC.
• Stage IV - The presence of distant metastases denotes the most advanced stage of the tumor, carrying a very poor prognosis.

• Fusarium

  Abstract Zearalenone (ZEN) and Aflatoxin B1 (AFB1) are fungal secondary metabolites produced by Fusarium and Aspergillus genera, respectively. These mycotoxins are found world-wide as corn and wheat contaminants. [ncbi.nlm.nih.gov]

• Clostridium Perfringens

  The Clostridium perfringens enterotoxin (CPE) is a pore-forming toxin with selective cytotoxicity. The transmembrane tight junction proteins claudin-3 and -4 are known high affinity CPE receptors. [ncbi.nlm.nih.gov]

Novel treatment strategies such as immunotherapy are being evaluated to further improve the outcomes of colorectal cancer patients. [ncbi.nlm.nih.gov]

Treatment Surgical removal of the tumor is the only radical treatment. This is followed by 6 months of adjuvant chemotherapy for patients with CRC stage III and high-risk stage II. [www2.keelpno.gr]

KEYWORDS: Colon carcinoma; Metastasis; Prognosis; Transglutaminase 2; mRNA [ncbi.nlm.nih.gov]

Stage IV - The presence of distant metastases denotes the most advanced stage of the tumor, carrying a very poor prognosis. [symptoma.com]

Metastases from the urinary tract are CK7+/CK20+/ Prognosis Too few cases have been reported to assess prognosis. References 1 Sakamoto K, Watanabe M, De La Cruz C, et al. Primary invasive micropapillary carcinoma of the colon. [e-immunohistochemistry.info]

The etiology is usually considered as traumatic. Carcinoma of the splenic angle is consistently one of the rarest of colon carcinomata, that of the descending colon alone being more rare. [pubs.rsna.org]

This prompted us to report these two cases and review the possibility of an etiological relationship between the two pathological conditions. [saudijgastro.com]

The etiology of colonic diverticulosis is multifactorial and not entirely known. [merckmanuals.com]

Abstract Epidemiology and evidence have demonstrated that colon carcinoma is one of the most common gastrointestinal tumors in the clinic. [ncbi.nlm.nih.gov]

Information about the Study Design: International epidemiological observational non-interventional study Study population: Patients with pancreas or colorectal carcinoma undergoing surgery Number of patients: 100 participants First patient in: April 2019 [centogene.com]

Sciences Research Biennial Book Clinical Trials About Clinical Trials ECRU About Clinical Trials & Epidemiological Sciences Clinical Trials Office Biostatistics and Epidemiology Unit SingHealth Research Education & Training Back to Home Overview Professional [nccs.com.sg]

Found ( 762 ) clinical trials Phase Phase Biofilm Epidemiology and Mechanisms in Colon Cancer This research is being done to learn more about why people get colon cancer. [centerwatch.com]

The aim of this review is to examine the epidemiology of colonic diverticulosis and the incidence of complications, namely acute diverticulitis and diverticular hemorrhage. [karger.com]

CONCLUSION: Strong differential expression of DCC in OA compared with normal chondrocytes hints of a possible role of DCC in the pathophysiology of OA. [mendeley.com]

Review article: The pathophysiology and medical management of diverticulosis and diverticular disease of the colon. Alimentary Pharmacology and Therapeutics. 2015;42:664. Pemberton JH, et al. [mayoclinic.org]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. National Cancer Institute website. [nlm.nih.gov]

Although constipation, fecal incontinence and several other associated benign conditions increase in frequency with aging, a paucity of information exists regarding the normal aging effect on gastrointestinal pathophysiology Tumor is an abnormal growth [colorectal-cancer.imedpub.com]

Abstract Oxymatrine (OMT), one of the main active components of extracts from the dry roots of Sophora flavescens, has been reported to possess many pharmacological properties including cancer-preventive and anti-cancer effects. [ncbi.nlm.nih.gov]

Neugut says, if you're taking aspirin to prevent coronary artery disease, you could get a bonus in colon-cancer prevention. [health.com]

Finding and removing polyps can prevent colorectal cancer. Explore the links on this page to learn more about colorectal cancer prevention, screening, treatment, statistics, research, clinical trials, and more. [cancer.gov]

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2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.
3. Haggar FA, Boushey RP. Colorectal Cancer Epidemiology: Incidence, Mortality, Survival, and Risk Factors. Clinics in Colon and Rectal Surgery. 2009;22(4):191-197.
4. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2016.
5. Aster, JC, Abbas, AK, Robbins, SL, Kumar, V. Robbins basic pathology. Ninth edition. Philadelphia, PA: Elsevier Saunders; 2013.
6. Vega P, Valentín F, Cubiella J. Colorectal cancer diagnosis: Pitfalls and opportunities. World J Gastrointest Oncol. 2015;7(12):422-433.
7. Halligan S, Wooldrage K, Dadswell E, et al. Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR):a multicentre randomised trial. Lancet. 2013;381:1185–1193.
8. Smith D, Ballal M, Hodder R, Soin G, Selvachandran S, Cade D. Symptomatic Presentation of Early Colorectal Cancer. Ann R Coll Surg Engl. 2006;88(2):185-190.
9. Fletcher RH. The diagnosis of colorectal cancer in patients with symptoms: finding a needle in a haystack. BMC Medicine. 2009;7:18.
10. Esteva M, Leiva A, Ramos M, et al. Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer. BMC Cancer. 2013;13:87.