Colon cancer, also referred to as large bowel or colorectal cancer, is an atypical pediatric cancer 1. Tumors are typically found on the right side of the colon for a child, which too often than not results in milder symptoms. Cure rates are higher for children if initially diagnosed during the early stages of the disease. Therefore, family history and symptom awareness, as well as regular screenings are prudent measures to take with children predisposed to colorectal cancer 1.

Atypical and Aggressive

Western countries see about 300,000 to 1.5 million children diagnosed with colorectal cancer 1. Colorectal cancer is highly treatable if caught early, however, early detection in children versus adults with this condition is exceptionally difficult to do 1. Not all screening tests used in adult diagnosis are feasible with children. Colorectal cancer tumors have aggressive growth behavior in children as compared to adults, worsening prognosis when compiled with delayed diagnosis and treatment 1. Predisposed genetic factors relate to most of these colorectal tumor growths in children 1. Therefore, doctors who increase surveillance to these children may improve overall prognosis.

Family History

Since the occurrence for children diagnosed with this disease is unlikely, doctors rarely suspect it. However, researchers suggest doctors should be more vigilant with children who have rectal bleeding or a family history of cancers (cancer family syndrome), such as breast, endometrial, ovarian or prostate cancer. Furthermore, Kravarusic et al. notes that children with a genetic predisposition for developing "adenomatous polyposis, juvenile polyposis syndrome, and Peutz-Jeghers syndrome" have susceptibility for colorectal cancer, therefore, requires increased medical supervision from their doctors 1. While many polyps are benign, they can be a precursor to cancer.

Symptoms

Colorectal cancer can grow for years and remain asymptomatic, making detection extremely difficult during the early stages if relying on symptoms alone 1. When a child becomes symptomatic, various symptoms may be present. Some symptoms experienced are: constipation; abnormally thin stools, with the narrowness of a pencil (caused by a colon or rectal obstruction); lower abdominal cramps; bloody stools (hematochezia); unexplainable weight loss; nausea and vomiting; gas and bloating and constant fatigue.

Screening

Since symptoms do tend to be asymptomatic, researchers suggest doctors perform routine screenings for children predisposed to colorectal cancer as a way to increase overall prognosis 1. Stools may be tested, or a barium enema, colonoscopy, sigmoidoscopy or virtual colonoscopy may be performed. Regardless of any test, a laboratory analysis of tissue ultimately determines whether or not there is cancer. Therefore, a biopsy of cells, fluid or tissue in the colon needs to be taken and examined to determine whether cancer is present.

Avoid Delayed Diagnosis

Missed and delayed colorectal diagnoses are amongst some of the most common malpractice suits 1. Therefore, parents should get a copy of the screening and make sure the necessary appointments are scheduled. If time sensitive appointments cannot be scheduled soon enough with the doctor, make an appointment with another doctor. Differences in recommendations between the first and second doctor require an explanation. Most importantly, listen to your intuition and get a second opinion from other doctors if that is what your gut tells you.