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A bi‐national perspective on the management of young patients with colorectal cancer
Author(s) -
Warrier Satish K.,
Lynch A. Craig,
Heriot Alexander G.
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12071
Subject(s) - medicine , colorectal cancer , respondent , colorectal surgery , family history , general surgery , family medicine , lynch syndrome , cancer , dna mismatch repair , political science , law , abdominal surgery
Background Young patients with colorectal cancer pose diagnostic and management challenges. The study aim was to assess colorectal surgical practice in A ustralia and N ew Z ealand with respect to management of young patients with colorectal cancer and the impact of family history. Methods An electronic survey was sent to members of the C olorectal S urgical S ociety of A ustralia and N ew Z ealand ( CSSANZ ). The survey assessed the clinical practice of the respondent and utilized scenario‐based questions to investigate their clinical approach to patients under 50 years who develop colorectal cancer with respect to management and surveillance. Colorectal society trainees, members and fellows were also questioned on a scenario of polyposis and no vertical transmission, and which operation they would perform. Results Of the 189 surveys sent out, 114 respondents completed the survey (60.3%) with 99 (86.8%) respondents practicing colorectal surgeons and 13.2% (15) CSSANZ trainees. Ninety‐five percent of respondents had a practice with greater than 70% colorectal work. Of the surgeons and trainees, 92.1% (105) would perform a limited resection in a young patient with a right‐sided cancer. Six percent altered the approach if there was a first‐degree relative with colorectal cancer, and 68% altered the approach if the family history fulfilled criteria for hereditary non‐polyposis colorectal cancer. Only 22.8% of respondents could recognize potential MutYH ‐associated polyposis with moderate polyposis and absence of vertical transmission. Discussion Colorectal surgeons in A ustralia will modify their management of patients under 50 years with colorectal cancer based on a family history and risk of inherited colorectal cancer syndromes. Further education could improve management.