2018 Volume 33 Issue 1 Pages 69-75
A 64-year-old woman had been positive for fecal occult blood for three consecutive years in occupational health check-ups, but this was not followed up. She developed orthostatic dizziness and pain upon defecation, but did not consult a physician. Thereafter, she was diagnosed with anemia and consulted a doctor who diagnosed advanced rectal cancer and early colon cancer. Pretreatment examination also revealed gallbladder cancer. She developed ileus due to bowel preparation for endoscopic therapy to be performed for early colon cancer and required construction of an artificial anus. The colon and gallbladder cancers were treated endoscopically and surgically, respectively. Chemotherapy is currently being administered for the rectal cancer.
Although rates of colorectal cancer have recently increased, rates for secondary testing following colorectal cancer screening are generally low, and they are lower for occupational health check-ups than for local health check-ups. Education on colorectal cancer would lead to enhanced awareness of the need for examination and it would be important to combine this with appropriate encouragement to undergo it.
Rates of multiple primary cancers have been tending to increase together with the aging of the population and advances in diagnostic imaging. Although multiple primary cancers of the colon and gallbladder are rare, there is a visible increasing trend. In cancer screening, it is important to confirm whether cancer predilection and multiple factors are present or not through history taking, physical and other examinations. Knowledge of multiple primary cancers is required even for medical staff engaged in general health check-ups.
