title: [Change in location of colorectal cancer in Hungarian patients between 1993-2004].
abstract: The incidence of proximal tumours in Western countries has steadily increased while that of distal tumours has shown a corresponding decrease. Our aim was to investigate the prevalence, location and histology of colorectal cancers in the last twelve years in Hungarian patients.
  
  
  METHODS
  Clinical data of 1738 patients diagnosed with colorectal tumors (M/F: 940/798, mean age at diagnosis: 65.2 +/- 12.5 years) between 1st of January 1993 and 31st of December 2004 at the 1st Internal Medicine and 1st Surgery Department of Semmelweis University were enrolled. Pathology and clinical data were analysed retrospectively. The observed periods were the following 1993-1998 and 1999-2004.
  
  
  RESULTS
  1694 (97.5%) of the patients had adenocarcinoma (CRC), 15 anaplastic cancers, 9 carcinoid, 6 planocellular, 5 GIST, 3 leiomyoma and 2-2 melanoma, lymphoma and shigillocellular cancers were diagnosed. 75.7% (943/1246) of the CRCs were diagnosed at locally advanced stage (T3-T4), and 47.7% (521/1093) of CRC patients had lymph node metastasis at the time of diagnosis. 11.0% of the CRCs were diagnosed in <50 year-olds (<40 years: 2.5%, <30 years: 0.5%). The location of the CRC was distal in 1186 (rectum: 53.9%, sigmoid/descending: 46.1) and proximal in 508 cases. Synchronous cancers were detected in 12 patients (age: 68.8 +/- 11.6 years, gender: 11 male/1 female, location: rectum and transverse in 6, rectum and ascending/caecum in 5 patients). Age at diagnosis was not different according to gender (M/F: 64.8 +/- 12.0 years vs. 65.8 +/- 12.9 years), but it was lower in patients with rectal cancer compared to left or right sided cancers (64.1 years vs. left: 66.1 years, right: 66.0 years, p = 0.02). Rectal CRC was more common in males, while the proportion of proximal cancers was lower (rectum, M/F: 41.2% vs. 33.5%, proximal M/F: 26.8% vs. 33.8%, p = 0.003). The proportion of rectal cancers increased over the observed period (1993-1998: rectal: 31.6% vs. 1999-2004: 42.1%, p = 0.002).
  
  
  CONCLUSIONS
  In contrast to Western countries, the proportion of proximal CRC did not become higher in Hungary. Still more than two-third of the patients were diagnosed to have distal cancers. The proportion of male patients was higher in this subset of CRC. The high percentage of locally advanced and metastatic cancers supports the need for colorectal screening program in Hungary.
authors.affiliation: Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest. fuszpet@bel1.sote.hu
authors.forename: Péter
authors.initials: P
authors.lastname: Fuszek
authors.forename: Henrik Csaba
authors.initials: HC
authors.lastname: Horváth
authors.forename: Gábor
authors.initials: G
authors.lastname: Speer
authors.forename: János
authors.initials: J
authors.lastname: Papp
authors.forename: Petra
authors.initials: P
authors.lastname: Haller
authors.forename: Judit
authors.initials: J
authors.lastname: Halász
authors.forename: Balázs
authors.initials: B
authors.lastname: Járay
authors.forename: Eszter
authors.initials: E
authors.lastname: Székely
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Schaff
authors.forename: András
authors.initials: A
authors.lastname: Papp
authors.forename: Attila
authors.initials: A
authors.lastname: Bursics
authors.forename: László
authors.initials: L
authors.lastname: Harsányi
authors.forename: Péter
authors.initials: P
authors.lastname: Lukovich
authors.forename: Péter
authors.initials: P
authors.lastname: Kupcsulik
authors.forename: Erika
authors.initials: E
authors.lastname: Hitre
authors.forename: Péter László
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002276:Carcinoid Tumor / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D007889:Leiomyoma / Q000453:epidemiology / Q000473:pathology; D008223:Lymphoma / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution