Article

Changes in profile and colorectal cancer stage over 15 years in Puerto Rico.

Retrovirus Research Center, Internal Medicine Department, Universidad Central del Caribe, University Hospital Ramón Ruiz Arnau, Puerto Rico, USA.
Ethnicity & disease (Impact Factor: 0.92). 01/2008; 18(2 Suppl 2):S2-128-31.
Source: PubMed

ABSTRACT The stage of a malignant tumor defines how advanced the malignant process is at the time of diagnosis. In many clinical scenarios it is an indirect measurement of the efficacy of screening interventions used for early detection. We have evaluated changes in the tumor-node-metastasis (TNM) stage of colorectal cancer across a 15-year period.
This was a retrospective study in which all patients who underwent colorectal cancer surgery at the HIMA San Pablo Medical Center in 1988-1990 (period 1) and 2002-2004 (period 2) had their pathological report examined. The TNM stage for all patients was examined by using standard criteria.
A total of 285 patients were evaluated: 108 in period 1 and 177 in period 2. The number of patients > 71 years of age who underwent colon surgery increased (33% vs 46%). An increase in patients with stage one colon cancer was observed in period 2 (30% vs 10%) with a corresponding decrease in stage 2 and 3 (59% vs 83%).
The pathologic and demographic profile of patients with colorectal cancer has changed over 15 years. Patients with colon cancer are younger and have an earlier stage of disease with a decrease in lymph node involvement. Patients with rectal cancer were older and more likely to be men.

Download full-text

Full-text

Available from: Diana M Fernández, Apr 28, 2015
0 Followers
 · 
87 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cancers of the rectum can be divided into A B and C cases according to the extent of spread. A cases are those in which the growth is limited to the wall of the rectum: B cases those in which there is extrarectal spread but no lymphatic metastases; C cases those in which metastases are present in the regional lymph nodes. A striking difference is found in the operative mortality rate and in the survival period after operation in these three groups. There is reason to believe that in A cases the disease is completely eradicated by rectal excision and the excellent results of operative treatment confirms the opinion previously expressed that lymphatic metastases are not found until a rectal carcinoma has spread by direct continuity to the extrarectal tissues. A good prognosis is justified also in B cases, though slightly less favourable than in A. The results of surgical treatment in C cases are very disappointing. The scope and limitations of histological grading by Broders' method are discussed and the conclusions reached that grading of a tumour is also of value for prognosis, though not when applied to fragments removed for diagnosis.
    Diseases of the Colon & Rectum 10/1980; 23(8):605-611. DOI:10.1007/BF02989012 · 3.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Screening for colorectal cancer reduces mortality in individuals aged 50 years or older. A number of screening tests, including fecal occult blood tests, sigmoidoscopy, double-contrast barium enema, and colonoscopy, are recommended by professional organizations for colorectal cancer screening, yet the rates of colorectal cancer screening remain low. Questions regarding the quality of evidence for each screening test, whether screening for individuals at higher risk should be modified, the availability of the tests, and cost-effectiveness are addressed. Many potential barriers to colorectal cancer screening exist for the patient and the physician. Strategies to increase compliance for colorectal cancer screening are proposed.
    JAMA The Journal of the American Medical Association 04/2003; 289(10):1297-302. · 30.39 Impact Factor
  • New England Journal of Medicine 06/2002; 346(21):1672-4. · 54.42 Impact Factor
Show more