TY - JOUR T1 - Challenges to diagnosing colorectal cancer during pregnancy JF - Canadian Family Physician JO - Can Fam Physician SP - 881 LP - 885 VL - 55 IS - 9 AU - Mohammad Yaghoobi AU - Gideon Koren AU - Irena Nulman Y1 - 2009/09/01 UR - http://www.cfp.ca/content/55/9/881.abstract N2 - 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. ER -