North Texas GME Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

Document Type


Publication Date



colorectal cancer, colon cancer, medication adherence


Digestive System Diseases | Internal Medicine | Medicine and Health Sciences | Neoplasms


BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer mortality and third leading cause of incidence worldwide; accounting for one in ten cancer cases and deaths. Thirty-three percent of people between the age of 50 and 75 are not up to date on screening for colon cancer. Depending on the stage of CRC at the time of presentation, the range of chief complaints that bring patients to seek care for this single etiology is diverse, therefore, a thorough work-up is essential for diagnosis. CASE PRESENTATION: A 55-year-old patient presents to the hospital three times over the course of 18 months, each time with a different chief complaint. The patient is worked-up and the etiology of his complaints is found to be CRC each time. His acute complaints are addressed at each hospital visit and he is given instructions to follow-up in the outpatient setting for further treatment. The patient is non-compliant in the outpatient setting. Thus, with each new hospital visit, the cancer has progressed further, with multiple organ systems becoming involved and demonstrating the diversity of chief complaints which can occur throughout the course of uninterrupted or under-treated colon cancer. LESSONS LEARNED: While the detection of CRC falls under the purview of gastroenterologists through regular screening options, it may also be detected through the involvement of adjacent and metastatically involved organ systems. A thorough history, physical exam, and work-up should be performed by all clinicians to aid in the early detection of CRC in order to improve time-to-diagnosis and outcomes.

Original Publisher

HCA Healthcare Graduate Medical Education

Colon Cancer Symptom Progression in a Non-Adherent Patient: A Case Report



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