title: Association of symptoms of colon cancer patients with tumor location and TNM tumor stage.
abstract: OBJECTIVE
  Colon cancer is the second most common cause of cancer death in Iceland and accounts for 8% of malignancies. We related information on symptoms of colon cancer patients with information on tumor location and pTNM-stage.
  
  
  METHODS
  The study is retrospective and population-based. Information on all patients diagnosed with colon cancer in Iceland in 1995-2004 was obtained. Information on symptoms of patients and blood hemoglobin was collected from patients' files. The pathological parameters were derived from a previously performed study.
  
  
  RESULTS
  A total of 768 patients (422 males, 346 females) participated in this study. Median age was 73 years. Nearly 60% had anemia at the time of diagnosis, 53% had visible blood in stools, and 65% had changes in bowel habits. Around 84% had visible blood in stools and/or anemia. Of those with right-sided tumors, 75% had anemia and were more likely to be diagnosed incidentally (40%) than those with left-sided tumors (20%). Left-sided tumors were associated with blood in stools (68% compared to 41%, p < 0.05) and changes in bowel habits (74% compared to 57%, p < 0.05). Multivariate analysis indicated that blood in stools was strongly associated with a lower TNM-stage (OR = 0.75, p < 0.05). Anemia was strongly associated with a higher TNM-stage (OR = 1.84, p < 0.05).
  
  
  CONCLUSIONS
  Right-sided tumors were associated with anemia and incidental diagnosis; left-sided tumors were associated with visible blood in stools and changes in bowel habits. Visible blood in stools was significantly associated with lower TNM-stage, whereas abdominal pain, general and acute symptoms were associated with higher TNM-stage.
authors.affiliation: Faculty of Medicine, University of Iceland, Iceland.
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Alexiusdottir
authors.forename: Pall Helgi
authors.initials: PH
authors.lastname: Möller
authors.forename: Petur
authors.initials: P
authors.lastname: Snaebjornsson
authors.forename: Larus
authors.initials: L
authors.lastname: Jonasson
authors.forename: Elinborg J
authors.initials: EJ
authors.lastname: Olafsdottir
authors.forename: Einar Stefan
authors.initials: ES
authors.lastname: Björnsson
authors.forename: Laufey
authors.initials: L
authors.lastname: Tryggvadottir
authors.forename: Jon G
authors.initials: JG
authors.lastname: Jonasson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D000740:Anemia / Q000209:etiology*; D016009:Chi-Square Distribution; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology*; D003672:Defecation; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006454:Hemoglobins; D006801:Humans; D007055:Iceland; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins