Immediately after the anus the neoplasia is seen. Many factors increase the risk for rectal cancer, including the following: High-fat, low-fiber diet Age greater than 50 years Personal history of colorectal adenoma or carcinoma (3-fold greater risk) First-degree relative with colorectal cancer (3-fold greater risk) Familial polyposis coli, Gardner syndrome, and Turcot syndrome (in which all patients without a colectomy develop colorectal carcinoma) Juvenile polyposis syndrome, Peutz-Jeghers syndrome, and Muir syndrome (risk increased slightly) Hereditary nonpolyposis colorectal cancer (as many as 50% of patients are affected) Inflammatory bowel disease. Ulcerative colitis (risk is 30% after 25 y) Crohn disease (4- to 10-fold risk)
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