Abstract
Many recent reports in the North American literature have documented an increase in the ratio of proximal to distal colorectal cancers with an increase in right-sided lesions. In order to assess trends in the distribution of large bowel carcinoma at our hospital we reviewed the files of 1553 patients who presented with primary colorectal carcinoma over a 30-year period. Thirtynine percent of patients were over 70 years old and 51% were in the 50–69 year age group. Seventy five percent of the carcinomas were left-sided, 22% right-sided and caecal carcinomas accounted for 18%. This distribution varied only slightly over the study period. Left-sided lesions were more common in males (55%; p<0.005), and rightsided lesions were more common in females (57%; p<0.005). Caecal carcinoma was more common in patients over 69 years old than in younger patients (p<0.001). In elderly females (>69 years) 30% of colorectal carcinomas occurred in the caecum. These findings may have important implications for the investigation of patients with suspected colorectal disease or for sereening programmes.
Résumé
Plusieurs travaux récents dans la littérature Nord Américaine ont montré une augmentation du pourcentage des cancers dolo-rectaux proximaux par rapport aux distaux avec une augmentation des cancers situés à droite. Afin d'affirmer les tendances dans la distribution des cancers du colon dans notre hôpital nous avons revu les dossiers de 1553 patients avec un cancer primaire colorectal pendant une période de trente ans. 39% des patients étaient âgés de plus de 70 ans et 51% atteignaient des sujets dans la période 50–69 ans. 73% des cancers étaient situés à gauche, 22% à droite tandis que les cancers du coecum figuraient pour 18%. Cette distribution a trés peu varié pendant la période d'étude. Les lésions situées à gauche étaient plus fréquentes chez les hommes (55%;p<0.005), et les lésions situées à droite étaient plus fréquentes chez les femmes (57%; p<0.005). Les cancers du coecum étaient plus fréquents chez les patients de plus de 69 ans que chez les patients plus jeunes (p<0.001). Chez les femmes âgées (>à 69 ans) 30% des cancers colo-rectaux survenaient au niveau du coecum. Ces découvertes peuvent avoir une implication importante au cours des investigations chez les patients suspectés d'une maladie colo-rectale ou pour les programmes de dépistage.
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Crerand, S., Feeley, T.M., Waldron, R.P. et al. Colorectal carcinoma over 30 years at one hospital: no evidence for a shift to the right. Int J Colorect Dis 6, 184–187 (1991). https://doi.org/10.1007/BF00341386
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DOI: https://doi.org/10.1007/BF00341386