Skip to main content

Advertisement

SpringerLink
Log in

The Changing Distribution of Colorectal Cancer in Barbados: 1985–2004

  • Published:
Diseases of the Colon & Rectum

Purpose

Recent reports have suggested a shift to the right in older female patients of colon cancer. This is believed to be representative of more accessible national endoscopic screening programs.

Methods

We report the demographic shift in colorectal cancer based on an analysis of resection specimens during four five-year time periods from 1985 to 2004 at the University Hospital, Barbados. Differences in population-based colorectal cancer incidence, age, gender, site, stage, and presentation (emergency vs. elective) are analyzed.

Results

A total of 1,014 specimens obtained from 993 patients were analyzed, showing a progressive population-based increase in colorectal cancer in Barbados during this 20-year time period. There was an increase in right-sided tumors (P < 0.0001) without a concomitant decline in left-sided tumors. There was a significant increase in Dukes A cancers (P < 0.0001) without gender predilection. During the time period, there was a significant reduction in right-sided tumors presenting as emergencies (P < 0.005) without an effect of stage or gender.

Conclusions

There has been a steady increase in both right-sided and left-sided colonic cancers without gender predilection. The increase in early-stage tumors and reduction in emergency presentations during the latter part of the study suggests value in instituting a formal national colonoscopic screening program to assess its prospective effect on these parameters.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. B Hanchard G Blake C Wolff et al. (2001) ArticleTitleAge-specific incidence of cancer in Kingston and St. Andrew, Jamaica 1993–1997 West Indian Med J 50 123–129 Occurrence Handle11677908 Occurrence Handle1:STN:280:DC%2BD3MrntFaluw%3D%3D

    PubMed  CAS  Google Scholar 

  2. ME McFarlane A Rhoden PR Fletcher R Carpenter (2004) ArticleTitleCancer of the colon and rectum in a Jamaican population. Diagnostic implications of the changing frequency and subsite distribution West Indian Med J 53 170–173 Occurrence Handle15352746 Occurrence Handle1:STN:280:DC%2BD2cvksFaktQ%3D%3D

    PubMed  CAS  Google Scholar 

  3. C Cucino AM Buchner A Sonnenberg (2002) ArticleTitleContinued rightward shift of colorectal cancer Dis Colon Rectum 45 1035–1040 Occurrence Handle12195187 Occurrence Handle10.1007/s10350-004-6356-0

    Article  PubMed  Google Scholar 

  4. PB Mensink JJ Kolkman J Baarlen Particlevan JH Kleibeuker (2002) ArticleTitleChange in anatomic distribution and incidence of colorectal carcinoma over a period of 15 years, clinical considerations Dis Colon Rectum 45 1393–1396 Occurrence Handle12394441 Occurrence Handle10.1007/s10350-004-6431-6 Occurrence Handle1:STN:280:DC%2BD38njs1elsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. L Rabeneck JA Davila HB El-Serag (2003) ArticleTitleIs there a true “shift” to the right colon in the incidence of colorectal cancer? Am J Gastroenterol 98 1400–1409 Occurrence Handle12818288

    PubMed  Google Scholar 

  6. D Gomez Z Dalal E Raw C Roberts PJ Lyndon (2004) ArticleTitleAnatomical distribution of colorectal cancer over a 10 year period in a district general hospital: is there a true “rightward shift”? Postgrad Med J 80 667–669 Occurrence Handle15537853 Occurrence Handle10.1136/pgmj.2004.020198 Occurrence Handle1:STN:280:DC%2BD2crms1GlsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  7. JB Rhodes FF Homes GM Clark (1977) ArticleTitleChanging distribution of primary cancers in the large bowel JAMA 238 1641–1643 Occurrence Handle578250 Occurrence Handle10.1001/jama.238.15.1641 Occurrence Handle1:STN:280:DyaE2s3lt1Klsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. L Sarli M Michiara P Sgargi et al. (2005) ArticleTitleThe changing distribution and survival of colorectal carcinoma: an epidemiological study in an area of northern Italy Eur J Gastroenterol Hepatol 17 567–572 Occurrence Handle15827448 Occurrence Handle10.1097/00042737-200505000-00014

    Article  PubMed  Google Scholar 

  9. KN Syrigos A Charalampopoulos JL Ho A Zbar VA Murday RJ Leicester (2002) ArticleTitleColonoscopy in asymptomatic individuals with a family history of colorectal cancer Ann Surg Oncol 9 439–443 Occurrence Handle12052753 Occurrence Handle10.1007/BF02557265 Occurrence Handle1:STN:280:DC%2BD38zgvFyjuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. Coding classification: Department of Health and Human Services. The International classification of diseases. 9th revision. Clinical modification. 3rd ed. Vol 1. Diseases: tabular list. Washington: Government Printing Office, March 1989. DHHS Publication no (PHS) 89–1260

  11. L Rabeneck LF Paszat DM Rothwell J He (2005) ArticleTitleTemporal trends in new diagnoses of colorectal cancer with obstruction, perforation or emergency admission in Ontario: 1993–2001 Am J Gastroenterol 100 672–676 Occurrence Handle15743367 Occurrence Handle10.1111/j.1572-0241.2005.41228.x

    Article  PubMed  Google Scholar 

  12. Population and Housing Census. Barbados, Government of Barbados Statistical Service, 1980; 1990; 2000

  13. PP Vassilopoulos N Kelessis G Plataniotis E Gondikakis A Galanos (2000) ArticleTitleColorectal cancer trends by anatomic sides, age and staging. A twenty-year study of 1412 Greek cases Anticancer Res 20 4773–4776 Occurrence Handle11205217 Occurrence Handle1:STN:280:DC%2BD3M7is1entA%3D%3D

    PubMed  CAS  Google Scholar 

  14. A Miller M Gorska M Bassett (2000) ArticleTitleProximal shift of colorectal cancer in the Australian Capital Territory over 20 years ANZ J Med 30 221–225 Occurrence Handle1:STN:280:DC%2BD3cvisVWqtA%3D%3D

    CAS  Google Scholar 

  15. H Takada T Ohsawa S Iwamoto et al. (2002) ArticleTitleChanging site distribution of colorectal cancer in Japan Dis Colon Rectum 45 1249–1254 Occurrence Handle12352244 Occurrence Handle10.1007/s10350-004-6400-0

    Article  PubMed  Google Scholar 

  16. M Ponz de Leon M Marino P Benatti et al. (2004) ArticleTitleTrend of incidence, subsite distribution and staging of colorectal neoplasms in the 15-year experience of a specialized cancer registry Ann Oncol 15 940–946 Occurrence Handle15151952 Occurrence Handle10.1093/annonc/mdh224 Occurrence Handle1:STN:280:DC%2BD2c3lt12jtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. M Li J Gu (2005) ArticleTitleChanging patterns of colorectal cancer in China over a period of 20 years World J Gastroenterol 11 4685–4688 Occurrence Handle16094710

    PubMed  Google Scholar 

  18. E Svensson T Grotmol G Hoff F Langmark J Norstein S Tretli (2002) ArticleTitleTrends in colorectal cancer incidence in Norway by gender and anatomic site: an age-period-cohort analysis Eur J Cancer Prev 11 489–495 Occurrence Handle12394247 Occurrence Handle10.1097/00008469-200210000-00012 Occurrence Handle1:STN:280:DC%2BD38njsV2lsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. JM Kiely EG Kavanagh AM Guiney C Fiuza-Castineira PV Delaney (2005) ArticleTitleChanges in outcome following surgery for colorectal cancer: one surgeon’s experience Ir J Med Sci 174 10–16 Occurrence Handle16445154 Occurrence Handle1:STN:280:DC%2BD28%2FmtV2mtQ%3D%3D Occurrence Handle10.1007/BF03168975

    Article  PubMed  CAS  Google Scholar 

  20. K Kotake S Honjo K Sugihara et al. (2003) ArticleTitleChanges in colorectal cancer during a 20-year period: an extended report from the multi-institutional registry of large bowel cancer, Japan Dis Colon Rectum 46 IssueIDSuppl S32–S43 Occurrence Handle14530656

    PubMed  Google Scholar 

  21. TM Al-Jaberi F Ammari K Gharieybeh et al. (1997) ArticleTitleColorectal adenocarcinoma in a defined Jordanian population from 1990–1995 Dis Colon Rectum 40 1089–1094 Occurrence Handle9293941 Occurrence Handle10.1007/BF02050935 Occurrence Handle1:STN:280:DyaK2svjvVWltA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. RJ Troisi AJ Freedman SS Devessa (1999) ArticleTitleIncidence of colorectal carcinoma in the U.S.: an update of trends by gender, race, age, subsite and stage, 1975–1994 Cancer 85 1670–1676 Occurrence Handle10223559 Occurrence Handle10.1002/(SICI)1097-0142(19990415)85:8<1670::AID-CNCR5>3.0.CO;2-M Occurrence Handle1:STN:280:DyaK1M3jvVSksg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  23. JM Jessup LS McGinnis GD Steele SuffixJr HR Menck DP Winchester (1996) ArticleTitleThe National Cancer Data Base: Report on colon cancer Cancer 78 918–926 Occurrence Handle8756390 Occurrence Handle10.1002/(SICI)1097-0142(19960815)78:4<918::AID-CNCR32>3.0.CO;2-W Occurrence Handle1:STN:280:DyaK28zis1artw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  24. SL Blair GR Sadler RL Bristol C Summers S Tahar S Saltzstein (2006) ArticleTitleEarly cancer detection among rural and urban Californians BMC Public Health 6 194 Occurrence Handle16869975 Occurrence Handle10.1186/1471-2458-6-194

    Article  PubMed  Google Scholar 

  25. JM Jessup AK Stewart HR Menck (1998) ArticleTitleThe National Cancer Data Base report on patterns of care for adenocarcinoma of the rectum. 1985–1995 Cancer 83 2408–2418 Occurrence Handle9840542 Occurrence Handle10.1002/(SICI)1097-0142(19981201)83:11<2408::AID-CNCR22>3.0.CO;2-G Occurrence Handle1:STN:280:DyaK1M%2FlsVaktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  26. H Frizis A Papadopoulos G Akritidis HR Frizis G Hatzitheoharis (2004) ArticleTitleAre there any differences in colorectal cancer between young and elderly patients? Tech Coloproctol 8 IssueIDSuppl S147–S148 Occurrence Handle15655603 Occurrence Handle10.1007/s10151-004-0139-4

    Article  PubMed  Google Scholar 

  27. M Barchana I Liphshitz P Rozen (2004) ArticleTitleTrends in colorectal cancer incidence and mortality in the Israeli Jewish ethnic populations Fam Cancer 3 207–214 Occurrence Handle15516843 Occurrence Handle10.1007/s10689-004-9546-y

    Article  PubMed  Google Scholar 

  28. Z Rudzki J Stachura (1999) ArticleTitlePreliminary report on pathology of colorectal cancer in Poland in 1995 and 1975: is it still the same disease? Int J Colorectal Dis 14 277–281 Occurrence Handle10663894 Occurrence Handle10.1007/s003840050228 Occurrence Handle1:STN:280:DC%2BD3c7jtVeiuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  29. Z Rudzki M Zazula K Okon J Stachura (2002) ArticleTitleColorectal carcinoma in Poland in 1975 and 1995: not only more but different Int J Colorectal Dis 17 161–170 Occurrence Handle12049310 Occurrence Handle10.1007/s00384-001-0373-4

    Article  PubMed  Google Scholar 

  30. J Keating P Pater S Lolohea K Wickeremesekara (2003) ArticleTitleThe epidemiology of colorectal cancer: what can we learn from the New Zealand Cancer Registry? N Z Med J 116 U437 Occurrence Handle12766783

    PubMed  Google Scholar 

  31. JH Wong DS Johnson D Hemmings A Hsu T Imai GT Tominaga (2005) ArticleTitleAssessing the quality of colorectal cancer staging: documenting the process in improving the staging of node-negative colorectal cancer Arch Surg 140 881–887 Occurrence Handle16172297 Occurrence Handle10.1001/archsurg.140.9.881

    Article  PubMed  Google Scholar 

  32. P Jestin L Pahlman B Glimelius U Gunnarsson (2005) ArticleTitleCancer staging and survival in colon cancer is dependent on the quality of the pathologists’ specimen examination Eur J Cancer 41 2071–2078 Occurrence Handle16125926 Occurrence Handle10.1016/j.ejca.2005.06.012 Occurrence Handle1:STN:280:DC%2BD2MrhtVWhtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  33. NA Scott J Jeacock RD Kingston (1995) ArticleTitleRisk factors in patients presenting as an emergency with colorectal cancer Br J Surg 82 321–323 Occurrence Handle7795995 Occurrence Handle10.1002/bjs.1800820311 Occurrence Handle1:STN:280:DyaK2Mzhs1eksQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  34. HS Chen SM Sheen-Chen (2000) ArticleTitleObstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends Surgery 127 370–376 Occurrence Handle10776426 Occurrence Handle10.1067/msy.2000.104674 Occurrence Handle1:STN:280:DC%2BD3c3jvVOhtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  35. RJ Davies CD Collins CJ Vickery I Eyre-Brook R Welbourn (2004) ArticleTitleReduction in the proportion of patients with colorectal cancer presenting as an emergency following the introduction of fast-track flexible sigmoidoscopy: a three-year prospective observational study Colorectal Dis 6 265–267 Occurrence Handle15206971 Occurrence Handle10.1111/j.1463-1318.2004.00598.x Occurrence Handle1:STN:280:DC%2BD2czgsFartQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  36. AM Pollock N Vickers (1998) ArticleTitleDeprivation and emergency admissions for cancers of the colorectum, lung and breast in South East England: ecological study BMJ 317 245–252 Occurrence Handle9677214 Occurrence Handle1:STN:280:DyaK1czkt1artQ%3D%3D

    PubMed  CAS  Google Scholar 

  37. S Crerand TM Feeley RP Waldron et al. (1991) ArticleTitleColorectal carcinoma over 30 years at one hospital: no evidence for a shift to the right Int J Colorectal Dis 6 184–187 Occurrence Handle1770282 Occurrence Handle10.1007/BF00341386 Occurrence Handle1:STN:280:DyaK387itFOhtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  38. JR Jass (1991) ArticleTitleSubsite distribution and incidence of colorectal cancer in New Zealand, 1974–1983 Dis Colon Rectum 34 56–59 Occurrence Handle1991421 Occurrence Handle10.1007/BF02050208 Occurrence Handle1:STN:280:DyaK3M7itF2nsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  39. R Dubrow C Johansen T Skov TR Holford (1994) ArticleTitleAge-period-cohort modeling of large-bowel-cancer incidence by anatomic sub-site and sex in Denmark Int J Cancer 58 324–329 Occurrence Handle8050812 Occurrence Handle10.1002/ijc.2910580303 Occurrence Handle1:STN:280:DyaK2czislagug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  40. M Thorn R Bergstrom U Kressner et al. (1998) ArticleTitleTrends in colorectal cancer incidence in Sweden 1959–93 by gender, localization, time period and birth cohort Cancer Causes Control 9 145–152 Occurrence Handle9578291 Occurrence Handle10.1023/A:1008826109697 Occurrence Handle1:STN:280:DyaK1c3jslCjsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  41. SJ Winawer AG Zauber RH Fletcher et al. (2006) ArticleTitleGuidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society CA Cancer J Clin 56 143–159 Occurrence Handle16737947 Occurrence Handle10.3322/canjclin.56.3.143

    Article  PubMed  Google Scholar 

  42. DK Whynes EJ Frew R Edwards WS Atkin (2003) ArticleTitleCosts of flexible sigmoidoscopy screening for colorectal cancer in the United Kingdom Int J Technol Assess Health Care 19 384–395 Occurrence Handle12862195 Occurrence Handle10.1017/S0266462303000345

    Article  PubMed  Google Scholar 

  43. AK Gupta LJ Melton Suffix3rd GM Petersen et al. (2005) ArticleTitleChanging trends in the incidence, stage, survival and screen-detection of colorectal cancer: a population-based study Clin Gastroenterol Hepatol 3 150–158 Occurrence Handle15704049 Occurrence Handle10.1016/S1542-3565(04)00664-0

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, School of Clinical Medicine and Research, The University of the West Indies, Queen Elizabeth Hospital Barbados, St. Michael, Barbados

    Andrew P. Zbar M.D., M.B.B.S., F.R.C.S.(Edinb.), F.R.C.S.(Gen.), F.R.A.C.S., F.C.C.S.

  2. Department of Radiotherapy, Queen Elizabeth Hospital Barbados, St. Michael, Barbados

    Michael Inniss M.B.B.S. & Radhakanth Shenoy M.B.B.S., M.D.R.T., D.M.R.T.

  3. Department of Pathology, School of Clinical Medicine and Research, The University of the West Indies, Queen Elizabeth Hospital Barbados, St. Michael, Barbados

    Patsy R. Prussia M.B.B.S., D.M.(U.W.I.), F.I.A.C.

  4. The School of Clinical Medicine and Research, Queen Elizabeth Hospital, Martindales Road, St. Michael, Barbados

    Andrew P. Zbar M.D., M.B.B.S., F.R.C.S.(Edinb.), F.R.C.S.(Gen.), F.R.A.C.S., F.C.C.S.

Authors
  1. Andrew P. Zbar M.D., M.B.B.S., F.R.C.S.(Edinb.), F.R.C.S.(Gen.), F.R.A.C.S., F.C.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Inniss M.B.B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patsy R. Prussia M.B.B.S., D.M.(U.W.I.), F.I.A.C.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Radhakanth Shenoy M.B.B.S., M.D.R.T., D.M.R.T.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew P. Zbar M.D., M.B.B.S., F.R.C.S.(Edinb.), F.R.C.S.(Gen.), F.R.A.C.S., F.C.C.S..

About this article

Cite this article

Zbar, A.P., Inniss, M., Prussia, P.R. et al. The Changing Distribution of Colorectal Cancer in Barbados: 1985–2004. Dis Colon Rectum 50, 1215–1222 (2007). https://doi.org/10.1007/s10350-007-0238-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-0238-1

Key words

Search

Navigation