define those patients who will benefit from neoadjuvant therapy. This might continue to consist of
chemoradiotherapy with a 5-fluorouracil backbone
or may progress to exclude radiation for selected
patients in the future based on the results of currently accruing studies. Surgical resection is the
mainstay of therapy and should include attention to the CRM. Adjuvant therapy remains the
established standard, although its utility is being
evaluated in several ongoing trials. Finally, intense
surveillance is appropriate for rectal cancer survivors, and particular attention should be paid to the
unique set of psychosocial issues that arise from
1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA
Cancer J Clin 2015;65:5–29.
2. Siegel R, Ward E, Brawley O, Jemal A. The impact of eliminating socioeconomic and racial disparities on premature
cancer deaths. CA Cancer J Clin 2011;61:212–36.
3. Jemal A, Simard EP, Dorell C, et al. Annual report to the
nation on the status of cancer, 1975–2009, featuring the
burden and trends in human papillomavirus (HPV)–
associated cancers and HPV vaccination coverage levels. J Natl
Cancer Inst 20136;105:175–201.
4. Jemal A, Bray F, Center MM, et al. Global cancer statistics.
CA Cancer J Clin 2011;61:69–90.
5. Doubeni CA, Laiyemo AO, Major JM, et al. Socioeconomic status and the risk of colorectal cancer. Cancer
6. Klabunde CN, Cronin KA, Breen N, et al. Trends in
colorectal cancer test use among vulnerable populations
in the United States. Cancer Epidemiol Biomarkers Prev
7. Cokkinides VE, Chao A, Smith RA, Vernon SW, Thun MJ.
Correlates of underutilization of colorectal cancer screen-
ing among US adults, age 50 years and older. Prev Med
8. Koushik A, Hunter DJ, Spiegelman D, et al. Fruits, veg-
etables, and colon cancer risk in a pooled analysis of 14
cohort studies. J Natl Cancer Inst 2007;99:1471–83.
9. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014.
CA Cancer J Clin 2014;64:9–29.
10. Lindor NM, Petersen GM, Hadley DW, et al. Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review. JAMA
11. Galiatsatos P, Foulkes WD. Familial adenomatous polyposis. Am J Gastroenterol 2006;101:385–98.
12. Lubbe SJ, Di Bernardo MC, Chandler IP, Houlston RS.
Clinical implications of the colorectal cancer risk associated with MUTYH mutation. J Clin Oncol 2009;27:3975–80.
13. Eaden J, Abrams K, Mayberry J. The risk of colorectal cancer
in ulcerative colitis: a meta-analysis. Gut 2001;48:526–35.
14. Gillen C, Andrews H, Prior P, Allan R. Crohn’s disease and
colorectal cancer. Gut 1994;35:651–5.
15. Nottage K, McFarlane J, Krasin MJ, et al. Secondary
colorectal carcinoma after childhood cancer. J Clin Oncol
16. Rothwell PM, Wilson M, Elwin CE, et al. Long-term effect
of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet
17. Rodríguez LAG, Huerta-Alvarez C. Reduced risk of colorectal cancer among long-term users of aspirin and nonaspi-rin nonsteroidal antiinflammatory drugs. Epidemiology
18. Burn J, Gerdes AM, Macrae F, et al. Long-term effect of
aspirin on cancer risk in carriers of hereditary colorectal
cancer: an analysis from the CAPP2 randomised controlled trial. Lancet 2012;378:2081–7.
19. Cuzick J, Otto F, Baron JA, et al. Aspirin and non-steroidal
anti-inflammatory drugs for cancer prevention: an international consensus statement. Lancet Oncol 2009;10:501–7.
20. Edge SB, Byrd DR, Compton CC, et al, eds. AJCC Cancer
Staging Manual. 7th ed. New York: Springer; 2010.
21. Kang H, O’Connell JB, Leonardi MJ, et al. Rare tumors of
the colon and rectum: a national review. Int J Colorectal Dis
22. Compton CC, Fielding LP, Burgart LJ, et al. Prognostic factors in colorectal cancer. Arch Pathol Lab Med
23. Locker GY, Hamilton S, Harris J, et al. ASCO 2006 update
of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol 2006;24:5313–27.
24. Mulder SA, Kranse R, Damhuis RA, et al. Prevalence
and prognosis of synchronous colorectal cancer: a Dutch
population-based study. Cancer Epidemiol 2011;35:442–7.
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