1. DIAGNOSTIC DE CANCERS DE L’OESOPHAGE ET DE L’ESTOMAC Dr Denis LI KAM WA Gastro enterologue

2. FACTEURS DE RISQUE 1.1.AGE ET SEXE 1.2.PRIVATION 1.3. TABAC 1.4.ALCOOL 1.5. BMI 1.6.DIET 1.7.GENETIC 1.8.PREDISPOSITIONS 1.9.HP

3. SYMPTOMES 1.DYSPEPSIES 2.REFLUX GASTRO OESOPHAGIEN 3. SIGNES D’ALARMES

4. DELAIS AU DIAGNOSTIC 1.DUREE DES SYMPTOMES 2.DELAI DES PATIENTS 3.DELAI DES MEDECINS 4.LISTE D’ATTENTE A L’HOPITAL

5. DIAGNOSTIC 1. PLACE DE TRANSIT OESOGASTRODUODENAL 2.GASTROSCOPIE 3.CHROMOENDOSCOPIE

6. HISTOLOGIE BIOPSIES ENDOSCOPIQUES HISTOPATH

7. STAGING CLASSIFICATION TNM: TECHNIQUES: CT SCAN ECHOENDOSCOPIE LAPAROSCOPIE IRM BRONCHOSCOPIE,POSITRONS?

8. CANCERS COLO RECTAL FREQUENCE:

9. FACTEURS PREDISPOSANTS 95% SONT SPORADIQUES AGE: A PARTIR DE 50 ANS ADENOMES:TAILLE,VILLEUSE,DYSPLA SIE FAMILIAL: 5% LESIONS INFLAMMATOIRES CHRONIQUES:RCH,CROHN

10. DEPISTAGE SANG OCCULTE COLOSCOPIE SIGMOIDOSCOPIE COLOSCOPIE VIRTUEL: CT SCAN,IRM

11. DIAGNOSTIC:SYMPTOMES TRES LONGTEMPS ASYMPTOMATIQUES ANEMIE FERRIPRIVE MELAENAS,RECTORRAGIES, ALTERATION DU TRANSIT ALTERATION DE L’ETAT GENERAL T ABDOMINAL,FOIE METASTATIQUE COMPLICATION:OCCLUSION, PERFORATION

12. EXPLORATIONS COMPLEMENTAIRES ECHOENDOSCOPIE SCANNER,OU IRM RECHERCHE DE METASTASES:CT SCAN THORACO ABDOMINO PELVIENNES,RX PULMONAIRE, ECHO ABDO

13. Gastro-intestinal Malignanacies in Mauritius New Cases Diagnosed during period 2001 - 2005 Cancer Site MaleFemale Oesophagus 80 44 Stomach 187 109 Small Intestine 11 18 Colon 171 164 Rectum 169 120 Anus 12 11 Liver & Intra-hepatic bile ducts5757 Gall bladder, etc3069 Pancreas1231 Digestive Organs729623 By comparison: Female Breast01348 Uterine Cervix0477 All Sites28123935 Source: National Cancer Registry of Mauritius

14. Case study A 47 year old male with HBP comes to clinic for routine check. His father had CA colon at 56, his parental grand mother died of cancer, but he is not sure of what type at 49, but it is not colon,female organ cancer? He is afraid of prostate cancer.

15. At what age to do systematic screening for colon? 40 years 45 years 50 years 55 years 60 years

16. Which is commonly accepted modifiable risk factor with increased risk of colorectal cancer A) alcohol consumption B) obesity C) physical inactivity D) all

17. Screening decrease incidence of colonic cancer True or false What type of screening ; Virtual colonoscopy? Coloscopy? Sigmoidoscopy? Fob?

18. What factor indicate that screening for colorectal cancer may be necessary? A) 1 st degree relative with diagnosis of colon cancer before 60. B) history of HBP C) possibility of grand mother with endometrial cancer D) both A and C

19. Which major risk should be noted when evaluating a patient for early colorectal cancer screening? A) family history breast cancer B) chronic inflammatory bowel disease C) onset of early menses in females D) none of the above

20. SUMMARY A) colorectal cancer is 2 nd leading cause of cancer mortality B) can be reduced by screening C) most patients with colorectal cancer have no known risk factors D) occult gi bleeding is intermittent so once a patient is +,no need for repeat E) stool testing at home