title: [Clinical predictors of staging in colorectal cancer].
abstract: OBJECTIVE
  We undertook this study to determine the relationship between clinical symptoms as predictors for staging colorectal cancer (CRC).
  
  
  METHODS
  We performed a cross-sectional study from January 2000 to January 2005 at the "Hospital Civil Fray Antonio Alcalde." All patients with histological diagnosis of CRC were included. Variables analyzed were gender, age, clinical manifestations and location of the tumor, as well as degree of differentiation and time of evolution.
  
  
  RESULTS
  We studied 108 patients with CRC. There were 52 female patients (48.1%) and 56 male patients (51.9%). Twenty five patients were <40 years old (23.15%). Most tumors were well to mildly differentiated adenocarcinomas (88.9%). We observed 37% of proximal tumors with a median evolution time of 11.45 months. Distal tumors were observed in 68 patients with a median evolution time of 9.19 months (p = 0.20). Hemoglobin levels were lower in proximal carcinomas (p = 0.02). Advanced tumors (stages III and IV) corresponded to 82.4% of the cases. The three most common symptoms were rectal bleeding, change in bowel habits and nonspecific abdominal pain. All showed low sensitivity but moderately high specificity (rectal bleeding 89%, change in bowel habits 68%). Combinations of these last two symptoms to predict advanced stage were 55 and 68%.
  
  
  CONCLUSIONS
  The majority of the patients were diagnosed with advanced stages of well-to-mildly differentiated adenocarcinomas. Symptom evaluation as predictors for staging showed a low sensitivity and a moderately high specificity due to a late diagnosis of advanced tumors. We attributed our results to a referral bias, the absence of screening programs and lack of clinical judgment to diagnose CRC at earlier stages.
authors.affiliation: Servicio de Cirugía General, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco.
authors.forename: Félix Omar
authors.initials: FO
authors.lastname: Márquez-Villalobos
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ambriz-González
authors.forename: Hilda Vanesa
authors.initials: HV
authors.lastname: Romo-Sandoval
authors.forename: Gabriela Abigail
authors.initials: GA
authors.lastname: Velázquez-Ramírez
authors.forename: Andrea Socorro
authors.initials: AS
authors.lastname: Alvarez-Villaseñor
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D013997:Time Factors; D055815:Young Adult