title: Changes in profile and colorectal cancer stage over 15 years in Puerto Rico.
abstract: BACKGROUND
  The stage of a malignant tumor defines how advanced the malignant process is at the time of diagnosis. In many clinical scenarios it is an indirect measurement of the efficacy of screening interventions used for early detection. We have evaluated changes in the tumor-node-metastasis (TNM) stage of colorectal cancer across a 15-year period.
  
  
  METHODS
  This was a retrospective study in which all patients who underwent colorectal cancer surgery at the HIMA San Pablo Medical Center in 1988-1990 (period 1) and 2002-2004 (period 2) had their pathological report examined. The TNM stage for all patients was examined by using standard criteria.
  
  
  RESULTS
  A total of 285 patients were evaluated: 108 in period 1 and 177 in period 2. The number of patients > 71 years of age who underwent colon surgery increased (33% vs 46%). An increase in patients with stage one colon cancer was observed in period 2 (30% vs 10%) with a corresponding decrease in stage 2 and 3 (59% vs 83%).
  
  
  CONCLUSIONS
  The pathologic and demographic profile of patients with colorectal cancer has changed over 15 years. Patients with colon cancer are younger and have an earlier stage of disease with a decrease in lymph node involvement. Patients with rectal cancer were older and more likely to be men.
authors.affiliation: Retrovirus Research Center, Internal Medicine Department, Universidad Central del Caribe, University Hospital Ramón Ruiz Arnau, Puerto Rico, USA.
authors.forename: Marinely
authors.initials: M
authors.lastname: Cruz-Amy
authors.forename: Juan
authors.initials: J
authors.lastname: Serrano
authors.forename: Ismael
authors.initials: I
authors.lastname: Labrador
authors.forename: David
authors.initials: D
authors.lastname: Hernandez
authors.forename: Diana M
authors.initials: DM
authors.lastname: Fernandez
authors.forename: Rafael
authors.initials: R
authors.lastname: Quintana
authors.forename: Robert F
authors.initials: RF
authors.lastname: Hunter-Mellado
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies