Proximalisation of colorectal carcinoma: a 10-year study in Italy.
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.
Fenoglio
Luigi
L
Department of Internal Medicine, Santa Croce General Hospital, Via Michele Coppino 26, 12100 Cuneo, Italy. fenoglio.l@ospedale.cuneo.it
Cena
Paola
P
Bracco
Christian
C
Pomero
Fulvio
F
Migliore
Elena
E
Benedetti
Valentina
V
Morino
Mario
M
Perin
Paolo Cavallo
PC
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
Radiology. 1985 Apr;155(1):35-8
3975415
World J Surg. 1989 May-Jun;13(3):321-4; discussion 324-5
2662631
Am J Gastroenterol. 1999 Jan;94(1):41-6
9934729
N Engl J Med. 1990 Dec 13;323(24):1664-72
2172820
Cancer. 1986 Aug 15;58(4):997-1000
3719563
Dis Colon Rectum. 1990 Mar;33(3):190-4
2311461
Cancer. 1984 Dec 15;54(12):3065-9
6498782
Int J Cancer. 2005 Feb 20;113(5):829-34
15499619
Ann Intern Med. 1990 Nov 15;113(10):779-88
2240880
Am Surg. 1983 Feb;49(2):62-5
6824242
Cancer. 1997 Jul 15;80(2):193-7
9217029
Cancer. 1996 Oct 15;78(8):1666-70
8859178
Gastroenterology. 1997 Feb;112(2):594-642
9024315
Cancer. 1999 Jun 15;85(12):2519-25
10375097
Br J Cancer. 1984 Dec;50(6):825-9
6498080
Dis Colon Rectum. 1981 Mar-Apr;24(2):93-5
7215082
Lancet. 1989 Sep 23;2(8665):725-7
2570969
Arch Surg. 1993 May;128(5):505-9
8489383
Cancer. 1997 Feb 1;79(3):441-7
9028352
Am J Gastroenterol. 1982 Feb;77(2):63-6
7072682
J Surg Oncol. 2004 Dec 15;88(4):261-6
15565587
Cancer. 1998 Nov 1;83(9):2040-2
9806665
Dis Colon Rectum. 1983 Aug;26(8):522-4
6872779
Cancer. 1993 Jun 15;71(12):3819-26
8508350
Lancet. 1989 Aug 12;2(8659):353-6
2569552
Br J Surg. 1998 Feb;85(2):246-8
9501827
Dis Colon Rectum. 1983 Oct;26(10):658-60
6884156