title: Challenges to diagnosing colorectal cancer during pregnancy.
abstract: OBJECTIVE
  My patient is 13 weeks pregnant and has experienced rectal bleeding and vomiting. Should I send her for a colonoscopy to rule out colorectal malignancies or should I wait until after delivery?
  
  
  CONCLUSIONS
  The data on colorectal cancer in pregnancy are scarce; however, as the presenting features of colorectal cancer overlap with those of pregnancy itself, there is a risk of development of advanced disease, with poorer prognosis at diagnosis. Therefore, it is strongly recommended that this patient, who is in her second trimester, undergo at least a flexible sigmoidoscopy, which is presumed safe during pregnancy, with or without a liver ultrasound and carcinoembryonic antigen detection based on pretest probability according to her other risk factors.
authors.affiliation: Department of Medicine, University of Toronto, Ontario.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Yaghoobi
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.forename: Irena
authors.initials: I
authors.lastname: Nulman
mesh_terms: D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis*; D015203:Reproducibility of Results