Annals of Oncology 15:940-946, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Trend of incidence, subsite distribution and staging of colorectal neoplasms in the 15-year experience of a specialised cancer registry
Received 23 January 2004; revised 4 February 2004; accepted 4 February 2004Background:
Two-thirds of colorectal malignancies are localised in the left colon and rectum. Recent studies suggest a trend towards an increase of right-sided tumours which might have important implications for screening and surveillance. A colorectal cancer registry was set up in Modena, northern Italy, with the purpose of examining incidence, subsite distribution and staging of colorectal malignancies over a 15-year period.
Patients and methods:
From 1984 to 1998, 2517 tumours in 2462 patients were detected and staged with the tumour node metastasis (TNM) system. The ‘right colon’ was considered from caecum to splenic flexure; the ‘left colon’ included descending and sigmoid colon; and the ‘rectum’ included rectosigmoid junction, ampulla and anus.
Results:
Cancer incidence showed an overall increase. Considering the various subsites, an increase of 33.7% in all colonic segments was shown whereas rectal tumours tended to decline. TNM staging showed a gradual increase of localised lesions (41.2% in 1984 versus 53.3% in 1998), with a proportional reduction of advanced tumours.
Conclusions:
Our study indicates an increase of tumour incidence in all colonic segments more than a shift to the right colon. TNM staging tended to improve with an appreciable increase of localised lesions. These findings could be consequent to a more extensive use of colonoscopy.
1 Dipartimento di Medicine e Specialità Mediche, Medicina I and 2 Dipartimento di Anatomia Patologica e di Medicina Legale, Università di Modena e Reggio Emilia; 3 Dipartimento di Anatomia Patologica, Ospedale di Carpi (Modena), Italy
Key words: cancer, colon, incidence, rectum, registry