Colorectal cancer in Jamaica - Poster abstract

ABSTRACT

OBJECTIVE: This review was designed as a pilot study to collect data on colorectal cancer surgery which would provide the basis for conducting formal prospective data collection on the patterns of this disease and its clinical presentation. DESIGN AND METHOD: A comprehensive audit of all patients with a diagnosis of colorectal carcinoma was undertaken over a 2 year period (January 1996 to December 1997). RESULTS: A total of seventy-nine patients were studied. There were 47 females and 32 males. The median age was 64.5 years (range 19 to 91 years). The predominant presenting symptoms were abdominal pain in 44 patients (55.7 percent), change in bowel habit in 38 patients (48.1 percent) and rectal bleeding in 37 patients (46.8 percent). The presence of an abdominal mass in 18 patients was the most frequently detected sign. Rectal examination detected the presence of a mass in 14 (17.7 percent) patients. Forty-seven percent of patients present with anaemia. The most common location was the right colon in 21 patients (26.5 percent) followed by sigmoid colon in 15 (18.9 percent) and rectum in 14 (17.7 percent). Left and transverse colon accounted for 7 and 5 cases, respectively. Resection with restorative anastomosis was the most common procedure for primary disease with colostomy being performed infrequently (in 3 cases). Seventeen patients presented with advanced disease. There were 14 deaths, 10 due to metastatic disease and 4 from postoperative complications. Our findings indicate an increased incidence of right-sided colonic carcinomas which has also been reported by other recent series. Although this colorectal audit provides some information about the patterns of disease seen in our unit, further study of a larger group of patients will be necessary before accurate conclusion can be made. CONCLUSION: The detection of early colorectal carcinoma will require screening at a stage when the disease is asymptomatic in order to improve the chance for cure. The data presented here indicate that the majority of patients presented with advanced right sided lesions that could have been detected earlier with an established screening programme.(AU)