Waukesha Memorial Hospital

Waukesha Memorial Hospital

Am I at Increased Risk for Colorectal Cancer?

Anyone with a family history of colorectal cancer, polyps, ulcerative colitis, or a personal history of uterine, ovarian or breast cancer may be at increased risk. The following self-assessment can help you determine if you may be at increased risk of developing colorectal cancer.

Please check all that apply.
	Do you have rectal bleeding or have you seen blood in your stool?
	Have you noticed changes in your bowel habits, such as constipation, diarrhea or narrowing of the size of your stool?
	Do you have abdominal or rectal pain?
	Have you lost 10 pounds or more without dieting?
	Have you ever had colon or rectal cancer?
	Have you ever had colon or rectal polyps or growths?
	Have you ever been diagnosed with Crohn's Disease or ulcerative polyps?
	Has your mother, father, sister, brother or child ever had colon or rectal polyps?
	Has any blood relative had colon or rectal cancer?
	Has your mother, sisters or daughters had breast, ovarian or uterine cancer?
	Have you ever had breast, ovarian or uterine cancer?