Patient Report
GS is a 66-year-old African American woman presents for a first time colonoscopy. She stated that she has had a “change in the way that her stools look” however denies seeing visible blood. GS stated that she typically has one bowel movement daily.   GS stated that she does not “think” that she has any family members with colon cancer but there have been family members that have had breast and cancer in the “intestines”.   GS stated that she has had a ten pound unintentional weight loss in the last six months.   GS reported that she has high blood pressure and takes lisinopril 20mg a day, and is a type 2 diabetic, on oral hypoglycemic.   Has not undergone any age appropriate, recommended health screenings because she “did not have any insurance until last month”.   GS is post-menopausal and is not on any hormonal therapy.  
Social History
GS is married with 4 adult children.   Mother died at 42 of unknown cancer and father died of Myocardial Infraction at the age of 36.   GS has seven living siblings and four dead siblings. Three of her four brothers died of violence, one sister died of ovarian cancer.   She had one sister (deceased) with questionable colon cancer.   GS denies recreational drug use and states that she does drink socially about twice a month and does not have routine exercise regime.
Physical Examination
GS is an African American female who appears to be younger than her stated age. Her weight is 180 pounds and she is approximately 5 feet 6 inches.   Her blood pressure is 148/87, pulse is 82, and pulse ox is 97%.   Physical examination did not reveal any abnormalities outside of the stated findings.  
Laboratory Findings
It is critical to review the laboratory findings when evaluating for colon cancer.
  * Complete blood count (CBC):
  * Liver enzymes:
  * Tumor markers:
  * CarcinoEmbryonic Antigen (CEA):
  *   Epidermal Growth Factor Receptor (EGFR)
  * KRAS gene mutation
GS pre- procedure lab work up showed...