title: Trend of incidence, subsite distribution and staging of colorectal neoplasms in the 15-year experience of a specialised cancer registry.
abstract: BACKGROUND
  Two-thirds of colorectal malignancies are localised in the left colon and rectum. Recent studies suggest a trend towards an increase of right-sided tumours which might have important implications for screening and surveillance. A colorectal cancer registry was set up in Modena, northern Italy, with the purpose of examining incidence, subsite distribution and staging of colorectal malignancies over a 15-year period.
  
  
  METHODS
  From 1984 to 1998, 2517 tumours in 2462 patients were detected and staged with the tumour node metastasis (TNM) system. The 'right colon' was considered from caecum to splenic flexure; the 'left colon' included descending and sigmoid colon; and the 'rectum' included rectosigmoid junction, ampulla and anus.
  
  
  RESULTS
  Cancer incidence showed an overall increase. Considering the various subsites, an increase of 33.7% in all colonic segments was shown whereas rectal tumours tended to decline. TNM staging showed a gradual increase of localised lesions (41.2% in 1984 versus 53.3% in 1998), with a proportional reduction of advanced tumours.
  
  
  CONCLUSIONS
  Our study indicates an increase of tumour incidence in all colonic segments more than a shift to the right colon. TNM staging tended to improve with an appreciable increase of localised lesions. These findings could be consequent to a more extensive use of colonoscopy.
authors.affiliation: Dipartimento di Medicine e Specialità Mediche, Medicina I, Università di Modena e Reggio Emilia, Modena, Italy. deleon@unimo.it
authors.forename: M
authors.initials: M
authors.lastname: Ponz de Leon
authors.forename: M
authors.initials: M
authors.lastname: Marino
authors.forename: P
authors.initials: P
authors.lastname: Benatti
authors.forename: G
authors.initials: G
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Menigatti
authors.forename: M
authors.initials: M
authors.lastname: Pedroni
authors.forename: C
authors.initials: C
authors.lastname: Di Gregorio
authors.forename: L
authors.initials: L
authors.lastname: Losi
authors.forename: F
authors.initials: F
authors.lastname: Borghi
authors.forename: A
authors.initials: A
authors.lastname: Scarselli
authors.forename: G
authors.initials: G
authors.lastname: Ponti
authors.forename: B
authors.initials: B
authors.lastname: Roncari
authors.forename: G
authors.initials: G
authors.lastname: Zangardi
authors.forename: G
authors.initials: G
authors.lastname: Abbati
authors.forename: E
authors.initials: E
authors.lastname: Ascari
authors.forename: L
authors.initials: L
authors.lastname: Roncucci
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007420:Intestine, Large / Q000473:pathology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries