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Published in: International Journal of Colorectal Disease 8/2009

01-08-2009 | Original Article

Changes on the disease pattern of primary colorectal cancers in Southern China: a retrospective study of 20 years

Authors: Shenghong Zhang, Yi Cui, Zijin Weng, Xiaorong Gong, Minhu Chen, Bihui Zhong

Published in: International Journal of Colorectal Disease | Issue 8/2009

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Abstract

Purpose

Some changes on the disease pattern of colorectal cancer (CRC) have occurred in some Asian countries recently. However, nothing is known about it in China lately. The present study is to determine whether there are any changes on the disease pattern of CRC in Southern China.

Patients and methods

Data were collected from all consecutive patients accepting colonoscopy in our endoscopy center during the last 20 years. The sociodemographic data, clinical presentations, endoscopic descriptions, and histological subtypes of patients confirmed as CRC by pathology were analyzed retrospectively.

Results

A total of 37,578 patients accepted colonoscopy from 1987 to 2006, in which 2,876 patients were diagnosed as CRC. The median age of patients in the 2nd decade (1997–2006; 62 years) was getting older than the 1st decade (1987–1996; 58 years; P = 0.043). Hematochezia was the most frequent symptom (55.8%), while rectum was the most common site distribution of CRC (51.0%). The incidence of right-sided colonic cancers in the 2nd decade (21.0%) was higher than the 1st decade (17.3%; P = 0.0314). Histologically, adenocarcinoma was the most common (92.4%), of which moderately differentiated tumors were more frequent (67.7%). CRCs with high-grade malignancy were more likely to occur in the 1st decade (P < 0.0001).

Conclusions

Rectum remains the most common site of CRC in southern China. But a rightward shift in the site distribution has occurred and patients are getting older. Tumors with high-grade malignancy have the tendency to decrease.
Literature
1.
go back to reference Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMedCrossRef Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMedCrossRef
2.
go back to reference Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al (2008) Cancer statistics, 2008. CA Cancer J Clin 57:71–96CrossRef Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al (2008) Cancer statistics, 2008. CA Cancer J Clin 57:71–96CrossRef
3.
go back to reference Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592PubMedCrossRef Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592PubMedCrossRef
4.
go back to reference Stanley R, Lauri A (2000) Pathology and genetics of tumors of the digestive system. WHO classification of tumors. IARC, Lyon Stanley R, Lauri A (2000) Pathology and genetics of tumors of the digestive system. WHO classification of tumors. IARC, Lyon
5.
go back to reference Yiu HY, Whittemore AS, Shibata A (2004) Increasing colorectal cancer incidence rate in Japan. Int J Cancer 109:777–781PubMedCrossRef Yiu HY, Whittemore AS, Shibata A (2004) Increasing colorectal cancer incidence rate in Japan. Int J Cancer 109:777–781PubMedCrossRef
6.
go back to reference Bae JM, Jung KW, Won YJ (2002) Estimation of cancer death in Korea for the upcoming years. J Korean Med Sci 17:611–615PubMed Bae JM, Jung KW, Won YJ (2002) Estimation of cancer death in Korea for the upcoming years. J Korean Med Sci 17:611–615PubMed
7.
go back to reference Tamura K, Ishiguro S, Munakata A, Yoshida Y, Nakaji S, Sugawara K (1996) Annual changes in colorectal carcinoma incident in Japan: analysis of survey data on incidence in Aomori Prefecture. Cancer 78:1187–1194PubMedCrossRef Tamura K, Ishiguro S, Munakata A, Yoshida Y, Nakaji S, Sugawara K (1996) Annual changes in colorectal carcinoma incident in Japan: analysis of survey data on incidence in Aomori Prefecture. Cancer 78:1187–1194PubMedCrossRef
8.
go back to reference Dong ZW, Qiao YL, Li LD, Chen YD, Wang RT, Lei TH et al (2002) Report of Chinese cancer control strategy. Chin Cancer 11:250–260 Dong ZW, Qiao YL, Li LD, Chen YD, Wang RT, Lei TH et al (2002) Report of Chinese cancer control strategy. Chin Cancer 11:250–260
9.
go back to reference WHO (1994) International classification of disease, 10th edn. World Health Organization, Geneva WHO (1994) International classification of disease, 10th edn. World Health Organization, Geneva
10.
go back to reference Armstrong B, Doll R (1975) Environmental factors and cancer incidence and mortality in different countries with special reference to dietary practices. Int J Cancer 15:617–631PubMedCrossRef Armstrong B, Doll R (1975) Environmental factors and cancer incidence and mortality in different countries with special reference to dietary practices. Int J Cancer 15:617–631PubMedCrossRef
11.
go back to reference Prentice RL, Sheppard L (1990) Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1:81–87PubMedCrossRef Prentice RL, Sheppard L (1990) Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption. Cancer Causes Control 1:81–87PubMedCrossRef
12.
go back to reference Giovannucci E (2002) Modifiable risk factors for colon cancer. Gastroenterol Clin North Am 31:925–943PubMedCrossRef Giovannucci E (2002) Modifiable risk factors for colon cancer. Gastroenterol Clin North Am 31:925–943PubMedCrossRef
13.
go back to reference Waterhouse JA, Muir CS, Shanmugaratnam K (1982) IARC scientific publication no. 42. International Agency for Research on Cancer, Lyon Waterhouse JA, Muir CS, Shanmugaratnam K (1982) IARC scientific publication no. 42. International Agency for Research on Cancer, Lyon
14.
go back to reference Huang X (2000) Cancers of large bowel intestine. In: Zheng Z (ed) Gastroenterology, 3rd edn. People’s Medical, Beijing, pp 857–871 Huang X (2000) Cancers of large bowel intestine. In: Zheng Z (ed) Gastroenterology, 3rd edn. People’s Medical, Beijing, pp 857–871
15.
go back to reference Takada H, Ohsawa T, Iwamoto S, Yoshida R, Nakano M, Imada S et al (2002) Changing site distribution of colorectal cancer in Japan. Dis Colon Rectum 45:1249–1254PubMedCrossRef Takada H, Ohsawa T, Iwamoto S, Yoshida R, Nakano M, Imada S et al (2002) Changing site distribution of colorectal cancer in Japan. Dis Colon Rectum 45:1249–1254PubMedCrossRef
16.
go back to reference Kim DH, Shin MH, Ahn YO (2000) Incidence pattern of colorectal cancer in Korea by subsite of origin. J Korean Med Sci 15:675–681PubMed Kim DH, Shin MH, Ahn YO (2000) Incidence pattern of colorectal cancer in Korea by subsite of origin. J Korean Med Sci 15:675–681PubMed
17.
go back to reference Mostafa G, Matthews BD, Norton HJ, Yoshida Y, Nakaji S, Sugawara K (2004) Influence of demographics on colorectal cancer. Am Surg 70:259–264PubMed Mostafa G, Matthews BD, Norton HJ, Yoshida Y, Nakaji S, Sugawara K (2004) Influence of demographics on colorectal cancer. Am Surg 70:259–264PubMed
18.
go back to reference Fazeli MS, Adel MG, Lebaschi AH (2007) Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum 50:990–995PubMedCrossRef Fazeli MS, Adel MG, Lebaschi AH (2007) Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum 50:990–995PubMedCrossRef
19.
go back to reference Goh KL, Quek KF, Yeo GT, Hilmi IN, Lee CK, Hasnida N et al (2005) Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy. Aliment Pharmacol Ther 22:859–864PubMedCrossRef Goh KL, Quek KF, Yeo GT, Hilmi IN, Lee CK, Hasnida N et al (2005) Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy. Aliment Pharmacol Ther 22:859–864PubMedCrossRef
20.
go back to reference El-Bolkainy T, Sakr MA, Nouh AA, El-Din NH (2006) A comparative study of rectal and colonic carcinoma: demographic, pathologic and TNM staging analysis. J Egypy Natl Canc Inst 18:258–263 El-Bolkainy T, Sakr MA, Nouh AA, El-Din NH (2006) A comparative study of rectal and colonic carcinoma: demographic, pathologic and TNM staging analysis. J Egypy Natl Canc Inst 18:258–263
21.
go back to reference Griffin PM, Liff JM, Greenberg RS, Clark WS (1991) Adenocarcinomas of the colon and rectum in persons under 40 years old: a population-based study. Gastroenterology 100:1033–1040PubMed Griffin PM, Liff JM, Greenberg RS, Clark WS (1991) Adenocarcinomas of the colon and rectum in persons under 40 years old: a population-based study. Gastroenterology 100:1033–1040PubMed
22.
go back to reference O’connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY (2003) Rates of colon and rectal cancers are increasing in young adults. Am Surg 69:866–872PubMed O’connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY (2003) Rates of colon and rectal cancers are increasing in young adults. Am Surg 69:866–872PubMed
23.
go back to reference Chiang JM, Chen MC, Changchien CR, Chen JS, Tang R, Wang JY et al (2003) Favorable influence of age on tumor characteristics of sporadic colorectal adenocarcinoma. Dis Colon Rectum 46:904–910PubMedCrossRef Chiang JM, Chen MC, Changchien CR, Chen JS, Tang R, Wang JY et al (2003) Favorable influence of age on tumor characteristics of sporadic colorectal adenocarcinoma. Dis Colon Rectum 46:904–910PubMedCrossRef
24.
go back to reference Mitry E, Benhamiche AM, Jouve JL, Clinard F, Finn-Faivre C, Faivre J (2001) Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a well-defined French population. Dis Colon Rectum 44:380–387PubMedCrossRef Mitry E, Benhamiche AM, Jouve JL, Clinard F, Finn-Faivre C, Faivre J (2001) Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a well-defined French population. Dis Colon Rectum 44:380–387PubMedCrossRef
25.
go back to reference Fairley TL, Cardinez CJ, Martin J, Alley L, Friedman C, Edwards B et al (2006) Colorectal cancer in U.S. adults younger than 50 years of age, 1998–2001. Cancer 107:1153–1161PubMedCrossRef Fairley TL, Cardinez CJ, Martin J, Alley L, Friedman C, Edwards B et al (2006) Colorectal cancer in U.S. adults younger than 50 years of age, 1998–2001. Cancer 107:1153–1161PubMedCrossRef
26.
go back to reference Parkin DM, Whelan S, Ferlay J (1997) Cancer incidence in five continents IARC. Scientific publication no. 143. IARC, Lyon Parkin DM, Whelan S, Ferlay J (1997) Cancer incidence in five continents IARC. Scientific publication no. 143. IARC, Lyon
27.
go back to reference Okamoto M, Shiratori Y, Yamaji Y, Kato J, Ikenoue T, Togo G et al (2002) Relationship between age and site of colorectal cancer based on colonoscopy findings. Gastrointest Endosc 55:548–551PubMedCrossRef Okamoto M, Shiratori Y, Yamaji Y, Kato J, Ikenoue T, Togo G et al (2002) Relationship between age and site of colorectal cancer based on colonoscopy findings. Gastrointest Endosc 55:548–551PubMedCrossRef
28.
go back to reference Matanoski G, Tao XG, Adade AA, Adade AA, Davies-Cole JO (2006) Demographics and tumor characteristics of colorectal cancers in the United States, 1998–2001. Cancer 107:1112–1120PubMedCrossRef Matanoski G, Tao XG, Adade AA, Adade AA, Davies-Cole JO (2006) Demographics and tumor characteristics of colorectal cancers in the United States, 1998–2001. Cancer 107:1112–1120PubMedCrossRef
29.
go back to reference Axtell LM, Chiazze L (1966) Changing relative frequency of cancers of the colon and rectum in United States. Cancer 19:750–754PubMedCrossRef Axtell LM, Chiazze L (1966) Changing relative frequency of cancers of the colon and rectum in United States. Cancer 19:750–754PubMedCrossRef
30.
go back to reference Cucino C, Parente F, Bianchi G (2004) Rightward shift of colorectal cancer in Italy during the past three decades. Scand J Gastroenterol 39:783–786PubMedCrossRef Cucino C, Parente F, Bianchi G (2004) Rightward shift of colorectal cancer in Italy during the past three decades. Scand J Gastroenterol 39:783–786PubMedCrossRef
31.
go back to reference Obrand DI, Gordon PH (1998) Continued change in the distribution of colorectal carcinoma. Br J Surg 85:246–248PubMedCrossRef Obrand DI, Gordon PH (1998) Continued change in the distribution of colorectal carcinoma. Br J Surg 85:246–248PubMedCrossRef
32.
go back to reference Qing SH, Rao KY, Jiang HY, Wexner SD (2003) Racial differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients. World J Gastroenterol 9:721–725PubMed Qing SH, Rao KY, Jiang HY, Wexner SD (2003) Racial differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients. World J Gastroenterol 9:721–725PubMed
33.
go back to reference Reddy BS, Narisawa T, Maronpot R, Weisburger JH, Wynder EL (1975) Animal models for the study of dietary factors and cancer of the large bowel. Cancer Res 35:3421–3426PubMed Reddy BS, Narisawa T, Maronpot R, Weisburger JH, Wynder EL (1975) Animal models for the study of dietary factors and cancer of the large bowel. Cancer Res 35:3421–3426PubMed
34.
go back to reference Chattar-Cora D, Onime GD, Valentine IS, Cudjoe E, Rivera L (2000) Colorectal cancer in a multi-ethnic urban group: its anatomical and age profile. Int Surg 85:137–142PubMed Chattar-Cora D, Onime GD, Valentine IS, Cudjoe E, Rivera L (2000) Colorectal cancer in a multi-ethnic urban group: its anatomical and age profile. Int Surg 85:137–142PubMed
35.
go back to reference Stewart SL, Wike JM, Kato I, Lewis DR, Michaud F (2006) A population-based study of colorectal cancer histology in the United States, 1998–2001. Cancer 107:1128–1141PubMedCrossRef Stewart SL, Wike JM, Kato I, Lewis DR, Michaud F (2006) A population-based study of colorectal cancer histology in the United States, 1998–2001. Cancer 107:1128–1141PubMedCrossRef
Metadata
Title
Changes on the disease pattern of primary colorectal cancers in Southern China: a retrospective study of 20 years
Authors
Shenghong Zhang
Yi Cui
Zijin Weng
Xiaorong Gong
Minhu Chen
Bihui Zhong
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 8/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-009-0726-y

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