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Cancers of the gastrointestinal tract 

Cancers of the gastrointestinal tract
Chapter:
Cancers of the gastrointestinal tract
Author(s):

Peter L. Labib

, J.A. Bridgewater

, and Stephen P. Pereira

DOI:
10.1093/med/9780198746690.003.0311
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date: 05 March 2021

Cancers of the gastrointestinal tract are one of the most rewarding interfaces in translational medicine, leading to greater understanding of the genetic mechanisms leading to cancer and the development of novel targeted therapies. Diagnosis of gastrointestinal tract cancers is usually made or suspected at endoscopy and confirmed by biopsy. Oesophageal cancer is a common cancer, usually of squamous cell histology, that is particularly prevalent in East Asia and Southeast Africa. Typical presentation is with dysphagia. Overall survival at 5 years is 15%. Usually adenocarcinoma, stomach cancer is particularly prevalent in East Asia, Eastern Europe, and Western South America. Predisposing factors include Helicobacter pylori infection, low socioeconomic status, tobacco smoking, heavy alcohol use, and diet. Dysphagia, early satiety, and anaemia are common presenting features, with weight loss being an indication of advanced disease. Overall survival at 5 years is 18.9%. Colorectal cancer is the third most common cancer in men and second most common in women worldwide, and is predisposed to by a Western diet. Most cases arise by transformation of an adenoma to a carcinoma by sequential inherited and acquired mutations. Typical presentations of left-sided tumours are alteration in bowel habit, obstruction, or overt bleeding, whereas right-sided tumours often present with iron-deficiency anaemia. Overall survival at 5 years is now almost 60%.

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