Initial Diagnosis of Colorectal Cancer through Colonoscopy or Emergent Surgery-Clinicopathological Features that Support Early Screening

Abstract

Colorectal cancer (CRC) is the third most common malignancy in the industrial western world and the second cause of cancer death. Its evolution is slow; therefore it constitutes a favourable disease for the application of prevention methods. To show the diagnostic process of CRC (colonoscopy or surgery), highlight clinicopathological features associated with diagnosis (tumour stage and size, symptoms, etc) and record certain patient characteristics. This study included patients from the prefecture of Drama Greece, who were initially diagnosed with CRC. They were divided into three groups: those who underwent a screening colonoscopy, those who underwent a colonoscopy due to symptoms (diagnostic colonoscopy) and those who were subjected to emergent surgery. Sex, age, symptoms, surgery type, tumour size, stage at diagnosis and habits were investigated. The study included 52.6% (n=118) male and 47.4% (n=106) female patients. The mean age was 74.6 years. The group of screening colonoscopy included 5.8% of patients, the group of diagnostic colonoscopy 87% and the group of emergent surgery 7.2% of patients. Stage I CRC, with the most favourable prognosis, was diagnosed more frequently in the group of screening colonoscopy than in those of diagnostic colonoscopy and emergent surgery (38.5%, 4.6% and 0% respectively). At least 61.5%, 52.3% and 81.25% of each group respectively had never undergone a screening colonoscopy. Nearly 95% of the patients were diagnosed after symptom development and had more advanced disease. The contribution of colonoscopy in prompt CRC diagnosis (asymptomatic tumours) is crucial and well-organised screening programs should be applied in the general population.