Epidemiology

- Colorectal cancers are the leading cancers all sexes. They bill for only 15 to 20 % of all cancers.

- Cancers of the colon balance for 60 % of colorectal cancers.
- The estimated incidence of colon cancer significance France is 34 000 dewy cases per date. Direction 20 caducity the incidence has greater by about 40 %.

- The colon cancer is heavier particularly the citizens over 50 oldness keep from a prognosis of 5 - go survival of onliest 55 % - The incidence of casualty from colon cancer control France is 18. 5 per 100 000 heads.
- The colon cancer is characterized by a slight mainly hold obscure a men ratio close to 1. 5.

Ordinary history of ailment: Subjects at risk 1 - Subject to rest risk These are the subjects becoming to the general riffraff, persons hold back no family history of colon cancer or other cancers encouraging. Predominance this tribe, the largest colon cancer is remarkable before 50 age with a rapid increase with age, the average age of diagnosis was 69.

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2 - High - Risk Subjects They are of different origins: The subjects with one or more first degree relatives are diagnosed with colorectal cancer Studies suggest that subjects with one or more first degree relatives diagnosed with colorectal cancer have a risk of this cancer doubled compared to the general population. It seems that the risk is especially increased as age of patient is low. The Consensus Conference recommended a colonoscopy screening among individuals whose parents were suffering from colorectal cancer before the age of 65. The discovery of polyps requires the resection and a review of control after 3 years or a period of 5 years is more than enough before the second check.

Individuals with a family history of colorectal adenoma The presence of colorectal adenomas is a risk factor for colorectal cancer. The relative risk of parents and siblings of carriers adenomas compared to that of the spouses is about 1.

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8. This risk is increased if the family of subjects with adenomas are less than 60 years. A study in Cote - d ' Or suggests that the risk of colorectal cancer is related to the size of the adenoma: it is not different from that of witnesses in the 1st degree relatives of subjects with adenomas less 1 cm in diameter, whereas it is multiplied by 2. 1 in the family of subjects with adenomas greater than 1 cm in diameter. Persons with a personal history of colorectal tumor The risk of colorectal cancer is high, multiplied by 3. 6 in patients with an adenoma or villous structures of more than one centimeter in diameter and multiplied by 6. 6 if these adenomas are multiple.

Subjects with inflammatory diseases of the colon Inflammatory diseases of the colon exposed to a high risk of colon cancer.
- Rectocolite ulcerative bleeding: the risk of colorectal cancer is much more important when pancolite in case of limited left colon. It is not increased significantly in cases of proctitis.

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- Crohn ' s Disease: Some studies suggest that the risk of colorectal cancer is higher if the Crohn ' s disease was diagnosed before age 30 and was originally extended.
Other groups at risk Women with ovarian cancer or the body of the uterus are at risk of colorectal cancer a bit higher than the general population. The risk of colorectal cancer is increased by only 2 among women with breast cancer when it is diagnosed before age 45 and has at least 10 years of evolution.

3 - at very high risk These subjects are a group with two genetically determined diseases: - Syndrome of hereditary colorectal cancer without polyps or Lynch syndrome: in this syndrome, the mutated genes belong to a family of genes involved in the mismatch repair of DNA.
- Familial adenomatous polyposis ( FAP ): less than 1 % of colorectal cancers are due to FAP. This disease is characterized by the development of hundreds of adenomatous polyps lining the intestinal mucosa.

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