A) The aim of the bowel cancer screening program is to detect and treat colorectal cancer (CRC) at an
early stage, often before symptoms manifest, in order to improve prognosis and reduce mortality
(also less patients).
B) One reason it is increasingly important to focus on cancer prevention is the rising incidence of
cancer globally, which places a significant burden on healthcare systems and societies Cheaper to
prevent than to cure.
C) One changeable risk factor for colorectal cancer is diet, particularly a diet high in processed meat.
But also physical activity. A non-changeable risk factor is age, as the risk of colorectal cancer increases
with age.
D) Human observational studies, such as cohort studies and case-control studies, are needed to
provide convincing evidence that a lifestyle factor increases the risk of developing cancer.
E) Carcinogens are divided into two major groups: Group 1 (carcinogenic to humans) and Group 2
(probably carcinogenic to humans). Nitrosamines, found in processed meat, belong to Group 1.
Genotoxic and non-genotoxic (one affects the DNA and the other doesn’t). nitrosamines belong to
genotoxic.
F) Signs of dysplasia include abnormal cellular changes, such as altered cell size, shape, and
organization, which may indicate the presence of precancerous or cancerous lesions. More mitosis.
More dense nucleus. Nuclei appear (dots).
G) TNM staging describes the extent of cancer based on the size and extent (distribution) of the
primary tumor (T), involvement of regional lymph nodes (N), and presence of distant metastases (M).
It is used to guide treatment decisions and estimate prognosis.
Colon cancer metastases: cancer cells end up in liver and in the lungs.
H) Surgery is a local treatment, and in this case, the goal is curative, aiming to remove the cancerous
tissue and achieve a cure.
I) Information on invasion is relevant because it helps determine the extent of the cancer and
influences treatment decisions.
J) To test whether the MSH6 mutation is a germline variant, genetic testing of the patient's normal
(non-tumor) cells, usually obtained from a blood sample, is needed.
K) If there is a germline variant, the daughter of this man would have an increased risk of developing
colorectal cancer, and screening and preventive measures should be considered. 50% chance that
daughter has defect.
L) Measures to reduce cancer risk in Lynch syndrome patients include regular surveillance, such as
colonoscopies, and considering risk-reducing surgeries. For endometrial cancer, regular gynecological
surveillance and, if needed, hysterectomy may be recommended. For ovarian cancer: ultrasound is
used.
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