CHARACTERISTICS OF PATIENTS WITH COLORECTAL CANCER IN

NORTHWESTERN GREECEDimitrios Christodoulou, Ioannis Mitselos, Chrisanthi Tzika, Epameinondas V. Tsianos

Department of Gastroenterology, University Hospital of Ioannina – Greece and School of Health Sciences, University of Ioannina - Greece

Background• Colorectal cancer is one of the leading causes of

morbidity and mortality in the globe• It affects more than 1 million people annually• It usually develops by a malignant

transformation of a polyp• There may be a positive family history in up to

70% of patients

Basic characteristics

• The most frequent type is adenocarcinoma, which is usually secreting mucus

• Macroscopically it can look like a polypoid tumor, an ulcerated lesion or a stenotic infiltrative lesion

• It can extend to the surrounding tissues, to the lymph nodes and hematogenously to distant organs such as the liver and lungs

Duke’s stages• A: Limited to the mucosa and submucosa

• B: Infiltration of the muscle layer

• C1: Infilitration of local lymph nodes near the tumor

• C2: Infiltration of all lymph nodes up to the ligation of the vessels

• D: Distant metastases to liver, lungs and other organs

Aim

• To analyze the basic characteristis of the disease in our area

• To identify probable predisposing factors

• To give information about the natural course of the disease

Patients - Methods

• We recorded 51 subsequent patients who were diagnosed with colorectal cancer (CRC) after an endoscopic procedure in our Unit

Collected information• Personal and family history of cancer• Demographics• Level of education• Alcohol and tobacco use• Clinical symptoms• Location• Extent• Stage

Results - Demographics

• 51 patients

• 26 males / 25 females

• Age 67 ± 12 years

• 53% between 70-80 years

Age distribution

Results - Location

• Rectosigmoid: 78%

• Descending or left transverse colon: 6%

• Right colon: 16%

Location of cancer

Results – Clinical symptoms

• Overt rectal blood loss: 31%

• Altered bowel habits: 24%

• Abdominal pain: 14%

• Weight loss: 2%

• Fatigue due to anemia: 20%

• Screening: 15%

Blood in the stool

Pain

Fatigue

Level of education

• Low: 71%

• High: 29%

Economic condition

• Poor: 31%

• Average: 63%

• Rich: 6%

Habits

• Smokers: 61%

• Frequent consumption of alcohol (> 4 drinks per week): 29%

History of cancer

• 80% had a first degree relative with cancer• 12% had a first degree relative with

colorectal cancer• 17% personal history of cancer of any origin• 37% personal or family history of colorectal

polyps

Family history of cancer

Large bowel Liver NoneBreastLeukemia Lung Stomach

PancreasEsophagus

Positive history of colorectal polyps

Histology and stage• Adenocarcinoma in all cases

• Differentiation– Low: 14%– Moderate: 84% – High: 2%

• Infiltrated lymph nodes: 76%

• Distant metastases: 17%

Lymph nodes’ infiltration

YesNo

Conclusions

• A small proportion of patients were diagnosed during a screening colonoscopy

• Most cases were located at the left colon

• Colorectal cancer was diagnosed at an advanced stage in our area

• Increasing the efficacy of screening programs may reduce the morbidity and mortality from CRC