Colon cancer during pregnancy

Colon cancer in pregnancy is a distinct entity from colon cancer in the general population. Pregnancy affects the clinical presentation, evaluation, therapy, and prognosis of the colon cancer. Pregnant patients typically present with advanced colon cancer that is, unfortunately, usually the result of delayed diagnosis. Patients frequently postpone self-referral because of confusion of symptoms from cancer, such as rectal bleeding or constipation, with symptoms of a normal pregnancy. Physicians may delay diagnostic tests because of potential fetal risks and because of inattention to the potential significance of symptoms given the relative rarity of colon cancer in this young population. Diagnostic delays often lead to the tragic demise of a young woman from a potentially curable disease and of an otherwise viable fetus. Arguably, colon cancer should be diagnosed expeditiously during pregnancy because of frequent obstetric office visits. This article reviews this uncommon, but not rare, entity with a focus on the special and unique features of colon cancer in pregnancy to facilitate earlier diagnosis, to optimize the therapy, and to improve the maternal and fetal outcomes.