title: Proximalisation of colorectal carcinoma: a 10-year study in Italy.
abstract: BACKGROUND
  Proximalisation of colon carcinoma has been reported over the course of the last 60 years. Changes in site distribution are receiving increasing attention on account of their implications for screening programmes.
  
  
  OBJECTIVE
  A retrospective observational study to determine whether the site distribution of colorectal carcinoma in Italy has varied in the last years and whether changes have been influenced by age and sex.
  
  
  METHODS
  Findings of colonscopies conducted at Turin University from 1992 to 2001 were examined. Inclusion criteria were: outpatients, screening, presence of anaemia or gastrointestinal bleeding, weight loss, constipation or changes in evacuation frequency. Exclusion criteria were: uncompleted, surgical endoscopies or conducted for positive flexible sigmoidoscopy, with doubtful findings. Carcinomas and benign polyps were diagnosed histologically. Age, sex, date of examination, nature and location of lesions were recorded. Lesions were classed as carcinoma, and polyps <1 and >/=1 cm. Data were grouped into different year periods and compared with the chi square test. We compared 1992-1993 vs. 2000-2001 and 1992-1996 vs. 1997-2001.
  
  
  RESULTS
  Of the 8,132 colonoscopies performed, 7,342 were included in the study. Proximal carcinomas moved from 12.2% in 1992-1993 to 14.9% in 2000-2001 (P = 0.57), proximal polyps rose from 16.6% to 22.1% (P < 0.0001). Furthermore proximal carcinomas moved from 16.5% in 1992-1996 to 14.4% in 1997-2001 (P = 0.48); proximal polyps rose from 18.4% to 27.8% (P < 0.005). In the period 1996-2001 there was higher female prevalence (P = 0.0011) and older age (P = 0.0191).
  
  
  CONCLUSIONS
  We can suppose that proximalisation of carcinoma has not yet appeared in Italy.
authors: Department of Internal Medicine, Santa Croce General Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy. fenoglio.l@ospedale.cuneo.it
authors: Luigi
authors: L
authors: Fenoglio
authors: Paola
authors: P
authors: Cena
authors: Christian
authors: C
authors: Bracco
authors: Fulvio
authors: F
authors: Pomero
authors: Elena
authors: E
authors: Migliore
authors: Valentina
authors: V
authors: Benedetti
authors: Mario
authors: M
authors: Morino
authors: Paolo Cavallo
authors: PC
authors: Perin
mesh_terms: D000367:Age Factors; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007420:Intestine, Large / Q000473:pathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
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