Subsite distribution of colorectal carcinoma and implications for screening; a retrospective audit of 1771 cases.
OBJECTIVE
Recent epidemiologic studies mentioned a shift from left to right in colorectal cancer. We searched our hospital database to try to give an insight into the patient characteristics and also optimize the screening programs in our country.


METHODS
A total of 1771 colorectal cancer patients were identified and analyzed. Patients' gender, age, operation dates, tumor localization, resectability and T stage of the lesions, were recorded and comparisons were made. Second step of the study consisted of a questionnaire including 6 questions that were asked to 278 physicians to document current physician attitudes and practices regarding colorectal cancer screening, and to formulate appropriate interventions.


RESULTS
Most of our patients were older than 51 in our study and a higher percentage of cases had sigmoid and rectal cancer (67%). The chronological trends in anatomic subsite distribution of colorectal cancer showed that by changing years when left colon cancer percentage was increasing, rectum cancer percentage was decreasing. There was no age-dependent variation in the topographical distribution of colorectal cancer by changing years. Also there was no relation between sex differences and subsite distribution when the whole group was taken into consideration. Specialist physicians had a poor understanding of colorectal cancer screening and lacked the responsibility of the screening programs.


CONCLUSIONS
Data presented in this article do not support a progressive left to right shift in the distribution of colorectal carcinoma. Screening with fecal occult blood testing and sigmoidoscopy seems appropriate. Physician education may be an important step in screening before public awareness.
Erkek
Bulent
B
Department of Surgery, Ankara University School of Medicine, Ankara, Turkey.
Ozkan
Namik
N
Bayar
Sancar
S
Genc
Volkan
V
Ekrem
Unal
U
Kuzu
Ayhan
A
Aribal
Dikmen
D
D000328:Adult; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D009780:Occult Blood; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D012812:Sigmoidoscopy; D014421:Turkey / Q000453:epidemiology