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Can Fam Physician
Vol. 55, No. 9, September 2009, pp.881 - 885
Copyright © 2009 by The College of Family Physicians of Canada
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Motherisk Update

Challenges to diagnosing colorectal cancer during pregnancy

Mohammad Yaghoobi, MD MSc, Gideon Koren, MD FRCPC FACMT and Irena Nulman, MD FRCPC
QUESTION My patient is 13 weeks pregnant and has experienced rectal bleeding and vomiting. Should I send her for a colonoscopy to rule out colorectal malignancies or should I wait until after delivery?

ANSWER The data on colorectal cancer in pregnancy are scarce; however, as the presenting features of colorectal cancer overlap with those of pregnancy itself, there is a risk of development of advanced disease, with poorer prognosis at diagnosis. Therefore, it is strongly recommended that this patient, who is in her second trimester, undergo at least a flexible sigmoidoscopy, which is presumed safe during pregnancy, with or without a liver ultrasound and carcinoembryonic antigen detection based on pretest probability according to her other risk factors.






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