Colon Cancer

Abstract

Purpose: To compare the clinical profile of colon cancer patients with those of asymptomatic people submitted to colonoscopy starting at the minimal age of 50. Methods: Between December 2003 and November 2005, 390 consecutive colonoscopies were performed in a prospective study in 152 asymptomatic people over the age 50 Group A and in 238 colon cancer patients with diagnosis done at the time of endoscopy Group B. Biopsies, polypectomies and mucosectomies were carried out as needed. Age, family history FH, symptoms, Body Mass Index BMI, location of tumor and histopathology were analyzed. Student's t and chi-square tests were used. P value <0.05 was considered significant. Results: Mean age Group A 62 ± 9 years and 61 ± 13 Group B p > 0.05. 79 patients (31%) of colon cancer had positive FH for cancer and positive FH was present in 34 patients without cancer (23%) p>0,05.BMI was 26 ± 4 Group A and 27 ± 4 for B p>0.05. 9 patients (5%) from Group A was found to have cancer, being one of then superficial (11%). Adenoma was diagnosed in 45 patients (29%) in this group. Left colon cancer was seen in 6 (66%). On Group B 21 patients (8%) had superficial cancer. On the total of malign lesions diagnosed in this Group, 168 (69%) were on the left colon. Adenoma was found in 61 patients (25%). Synchronous malign lesions were detected in 6 (2%). None of then in Group A. Change of bowel habits with bleeding was more common on the left colon cancer, being 56 (60%) against 13 (31%) on the right p < 0.01. Important weigth loss and anemia occurred more frequently on the right when compared to the left 30 (44%)X31 (17%) and 36 (46%)X 15 (8%) p < 0.01. In two patients, right colon cancer was associated with Fournier syndrome and in another one, tumor was in the appendix. 157 patients (63%) had symptoms for more than 6 months and acute obstruction was seen in 21 (8%). In one, tumor was associated with massive bleeding from diverticular disease. Moderated-differentiated adenocarcinoma was found in 166 (67%), well-differentiated 63 (25%), mucinous and poorly-differentiated in 18 (7%) of patients. Conclusions: We need to improve our methods to diagnose colon cancer better.