title: The changing distribution of colorectal cancer in Barbados: 1985-2004.
abstract: OBJECTIVE
  Recent reports have suggested a shift to the right in older female patients of colon cancer. This is believed to be representative of more accessible national endoscopic screening programs.
  
  
  METHODS
  We report the demographic shift in colorectal cancer based on an analysis of resection specimens during four five-year time periods from 1985 to 2004 at the University Hospital, Barbados. Differences in population-based colorectal cancer incidence, age, gender, site, stage, and presentation (emergency vs. elective) are analyzed.
  
  
  RESULTS
  A total of 1,014 specimens obtained from 993 patients were analyzed, showing a progressive population-based increase in colorectal cancer in Barbados during this 20-year time period. There was an increase in right-sided tumors (P < 0.0001) without a concomitant decline in left-sided tumors. There was a significant increase in Dukes A cancers (P < 0.0001) without gender predilection. During the time period, there was a significant reduction in right-sided tumors presenting as emergencies (P < 0.005) without an effect of stage or gender.
  
  
  CONCLUSIONS
  There has been a steady increase in both right-sided and left-sided colonic cancers without gender predilection. The increase in early-stage tumors and reduction in emergency presentations during the latter part of the study suggests value in instituting a formal national colonoscopic screening program to assess its prospective effect on these parameters.
authors.affiliation: Department of Surgery, School of Clinical Medicine and Research, The University of the West Indies, Queen Elizabeth Hospital Barbados, St Michael, Barbados. apzbar@yahoo.com
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Zbar
authors.forename: Michael
authors.initials: M
authors.lastname: Inniss
authors.forename: Patsy R
authors.initials: PR
authors.lastname: Prussia
authors.forename: Radhakanth
authors.initials: R
authors.lastname: Shenoy
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001460:Barbados / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D017678:Sex Distribution