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Gastroenterologists are often asked to perform colonoscopy in patients with metastatic cancer of unknown primary (MCUP) to search for a colonic primary site. Autopsy study findings suggest that the colon is the primary site in about 7% of cases and that more than half of lesions originate in the lung or pancreas. In about one quarter of cases, even autopsy cannot identify the primary cancer site.
To determine the yield of colonoscopy in identifying a primary colon cancer in patients with MCUP, researchers evaluated data from 160 patients who underwent colonoscopy for MCUP and did not have symptoms or signs suggestive of colon cancer. Among these patients, the site of the initial diagnosis was most frequently the liver (35%), followed by the …