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Colorectal cancer in the south of Israel; comparison of the clinical characteristics and survival between two periods, 1981–2 and 1986–7
Author(s) -
Lebel E.,
Fraser D.,
Fraser G. M.,
Niv Y.
Publication year - 2003
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1046/j.1463-1318.2003.00387.x
Subject(s) - medicine , incidence (geometry) , colorectal cancer , cancer registry , stage (stratigraphy) , cancer , general surgery , gastroenterology , surgery , paleontology , physics , optics , biology
Background Colorectal cancer has the highest incidence of all malignant tumours in men and women in Israel. The public was introduced to the concept of screening in the early 1980s, and full programs began in 1983. Objectives The study compares patients with colorectal cancer (CRC) who were diagnosed before screening and five years later, for stage differences and survival. Methods All patients with CRC who were diagnosed from 1981 to 1982 (period I) and 1986–87 (period II) at Soroka Medical Centre and who were residents of the Negev area were eligible for the study. Data were collected retrospectively from the Israel Cancer Registry and patient files and endoscopic, histological and surgical reports from the Departments of Pathology, Gastroenterology, Oncology and Surgery at Soroka Medical Centre. Results The study groups included 207 patients with CRC, 85‐from period I and 122‐from period II. The mean annual incidence of CRC for these 2 periods was 18 and 24.8 cases per 100, 000, respectively, for an increase of 37% ( P < 0.001). Five‐year‐survival in period I was 53.3% and in period II, 39.6% ( P = 0.025). Survival did not differ by origin or gender. Dukes' stage, well and moderately differentiated tumours, and left‐sided tumours were associated with better prognosis ( P = 0.03). Forty‐two percent of the cases were less than 64‐year‐old‐at diagnosis, compared with 27% of 2069 Israeli patients in whom CRC was diagnosed in 1991 ( P < 0.001). Conclusions Before a nation wide decision is made with regard to public screening for CRC with fecal occult blood tests or sigmoidoscopy, the available data should be thoroughly evaluated, and further in‐depth investigations performed to determine trends in diagnosis and prognosis.