Skip to main content
SpringerLink
Log in

Colon Polyps, Colonoscopy, and Colorectal Cancer in Pregnancy

  • Chapter
  • First Online:
Colon Polyps and Colorectal Cancer

  • 1291 Accesses

Abstract

Endoscopic evaluation is the main examination in the diagnosis of premalignant and malignant lesions of the gastrointestinal tract. Early diagnosis and treatment are possible by routine screening of people who have risk factors. It is diagnosed in advanced stages during pregnancy because of the pregnancy-associated symptoms masking CRC symptoms. CRC is more common in older ages. Due to the increasing maternal age in recent years, the risk of encountering CRC in pregnancy increases accordingly. Colonoscopy is an essential procedure in diagnosis. The risk and convenience of the procedure are different according to the week of pregnancy. Since the organogenesis of the fetus continues in the first trimester, anesthetic medications increase the risk of abortion with possible teratogenic effects.

Because of the growing uterus in the third trimester, the difficulty of the procedure, the risk of preterm labor due to mechanical pressure, and trauma of the uterus are increased. Endoscopic evaluation is inevitable in cases such as gastrointestinal bleeding, obstruction, and incarceration that will put the life of the mother at risk. If minimally invasive procedures cannot be postponed after delivery, the most reliable time, in this case, is the second trimester. Pregnant women who have endoscopy should be followed carefully. When GIS malignancy is detected during pregnancy, the management is decided according to the gestational week, histological type of malignancy, and the extent of the disease. The prognosis of CRC arising during pregnancy is poor. Early diagnosis is vital. For this purpose, risk groups should be followed closely with effective screening programs. The most effective screening is the colonoscopy. With the use of artificial intelligence in colonoscopy, benign and malignant differentiation of lesions will be made more accurately, and human errors will be minimized.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ryerson AB, Eheman CR, Altekruse SF, Ward JW, Jemal A, Sherman RL, et al. Annual report to the nation on the status of cancer, 1975–2012, featuring the increasing incidence of liver cancer. Cancer. 2016;122(9):1312–37.

    Article  Google Scholar 

  2. Liu P-H, Wu K, Ng K, Zauber AG, Nguyen LH, Song M, et al. Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncol. 2019;5(1):37–44.

    Article  Google Scholar 

  3. Yaghoobi M, Koren G, Nulman I. Challenges to diagnosing colorectal cancer during pregnancy. Can Fam Physician. 2009;55(9):881–5.

    Google Scholar 

  4. Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994–2008: a population-based linkage study. BJOG. 2012;119(13):1572–82.

    Article  CAS  Google Scholar 

  5. Lu Y, Oddsberg J, Martling A, Lagergren J. Reproductive history and risk of colorectal adenocarcinoma. Epidemiology. 2014;25(4):595–604.

    Article  Google Scholar 

  6. Tawadros PS, Paquette IM, Hanly AM, Mellgren AF, Rothenberger DA, Madoff RD. Adenocarcinoma of the rectum in patients under age 40 is increasing: impact of signet-ring cell histology. Dis Colon Rectum. 2015;58(5):474–8.

    Article  Google Scholar 

  7. Aytac E, Ozuner G, Isik O, Gorgun E, Stocchi L. Management of colorectal neoplasia during pregnancy and in the postpartum period. World J Gastrointest Oncol. 2016;8(7):550–4.

    Article  Google Scholar 

  8. Matthews TJ, Hamilton BE. Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009;21:1–8.

    Google Scholar 

  9. Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW, American College of Gastroenterology. ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol. 2015;110(2):223–62.

    Article  Google Scholar 

  10. Ma H, Brosens LAA, Offerhaus GJA, Giardiello FM, de Leng WWJ, Montgomery EA. Pathology and genetics of hereditary colorectal cancer. Pathology. 2018;50(1):49–59.

    Article  CAS  Google Scholar 

  11. Cohn DE, Ramaswamy B, Christian B, Bixel K. Malignancy and pregnancy. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, editors. Creasy and Resnik’s maternal-fetal medicine: principles and practice. 8th ed. Philadelphia: Elsevier Saunders; 2019. p. 1007–24.

    Google Scholar 

  12. Dahling MT, Xing G, Cress R, Danielsen B, Smith LH. Pregnancy associated colon and rectal cancer: perinatal and cancer outcomes. J Matern Fetal Neonatal Med. 2009;22(3):204–11.

    Article  Google Scholar 

  13. Kraljević M, Hoffmann H, Knipprath A, von Holzen U. Obstructing adenocarcinoma of the descending colon in a 31-year-old pregnant woman. Int J Surg Case Rep. 2014;5(12):958–60.

    Article  Google Scholar 

  14. Zhivotovskiy AS, Kutikhin AG, Azanov AZ, Yuzhalin AE, Magarill YA, Brusina EB. Colorectal cancer risk factors among the population of South-East Siberia: a case-control study. Asian Pac J Cancer Prev. 2012;13(10):5183–8.

    Article  Google Scholar 

  15. Yang L, Hu S, Tan J, Zhang X, Yuan W, Wang Q, et al. Pregnancy-specific glycoprotein 9 (PSG9), a driver for colorectal cancer, enhances angiogenesis via activation of SMAD4. Oncotarget. 2016;7(38):61562–74.

    Article  Google Scholar 

  16. Bernstein MA, Madoff RD, Caushaj PF. Colon and rectal cancer in pregnancy. Dis Colon Rectum. 1993;36(2):172–8.

    Article  CAS  Google Scholar 

  17. Munteanu O, Voicu D, Voiculescu DI, Negreanu L, Georgescu TA, Sajin M, et al. Colon cancer in pregnancy: a diagnostic and therapeutic challenge. Romanian J Morphol Embryol. 2019;60(1):307–17.

    Google Scholar 

  18. Longo SA, Moore RC, Canzoneri BJ, Robichaux A. Gastrointestinal conditions during pregnancy. Clin Colon Rectal Surg. 2010;23(2):80–9.

    Article  Google Scholar 

  19. Dhull AK, Gogia P, Atri R, Dhankhar R, Kaushal V, Singh S, et al. Exploring signet-ring cells in pregnant female. J Gastrointest Oncol. 2015;6(2):E10–5.

    Google Scholar 

  20. De Lima A, Galjarta B, Wisse PH, Bramer WM, van der Woude CJ. Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? A systematic review. BMC Gastroenterol. 2015;15:15.

    Article  Google Scholar 

  21. Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, et al. ASGE Standard of Practice Committee. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012;76(1):18–2.

    Article  Google Scholar 

  22. Friedel D, Stavropoulos S, Iqbal S, Cappell MS. Gastrointestinal endoscopy in the pregnant woman. World J Gastrointest Endosc. 2014;6(5):156–67.

    Article  Google Scholar 

  23. ACOG Committee Opinion No. 775: Nonobstetric surgery during pregnancy. Obstet Gynecol. 2019;133(4):e285–6.

    Google Scholar 

  24. Savas N. Gastrointestinal endoscopy in pregnancy. World J Gastroenterol. 2014;20(41):15241–52.

    Article  Google Scholar 

  25. Ludvigsson JF, Lebwohl B, Ekbom A, Kiran RP, Green PH, Höijer J, et al. Outcomes of pregnancies for women undergoing endoscopy while they were pregnant: a nationwide cohort study. Gastroenterology. 2017;152(3):554–63.

    Article  Google Scholar 

  26. Walsh C, Fazio VW. Cancer of the colon, rectum, and anus during pregnancy: the surgeon’s perspective. Gastroenterol Clin N Am. 1998;27:257–67.

    Article  CAS  Google Scholar 

  27. Mason MH, Kovalcik PJ. Ovarian metastases from colon carcinoma. J Surg Oncol. 1981;17(1):33–8.

    Article  Google Scholar 

  28. Pitluk H, Poticha SM. Carcinoma of the colon and rectum in patients less than 40 years of age. Surg Gynecol Obstet. 1983;157(4):335–7.

    CAS  Google Scholar 

  29. Silverstein J, Kidder W, Fisher SJ, Hope TA, Maisel S, Ng D, et al. Hormone receptor expression of colorectal cancer diagnosed during the peri-partum period. Endocr Connect. 2019; https://doi.org/10.1530/EC-19-0063.

  30. Sommers GM, Kao MS. Using chemotherapeutic agents during pregnancy. Contemp Obstet Gynecol. 1987;30:45–8.

    Google Scholar 

  31. Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, et al. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol. 2010;28:683–9.

    Article  Google Scholar 

  32. Basta P, Bak A, Roszkowski K. Cancer treatment in pregnant women. Contemp Oncol. 2015;19:354–60.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Health Science University, Izmir, Turkey

    Ibrahim Uyar

Authors
  1. Ibrahim Uyar
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgery, Izmir Tepecik Training and Research Hospital, Konak, Izmir, Turkey

    Omer Engin

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Uyar, I. (2021). Colon Polyps, Colonoscopy, and Colorectal Cancer in Pregnancy. In: Engin, O. (eds) Colon Polyps and Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-57273-0_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-57273-0_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-57272-3

  • Online ISBN: 978-3-030-57273-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation