3/2007Alarm symptoms in patients with colorectal cancer referred by family doctors to the chair of gastroenterology in 2006

MARCIN MANEROWSKI (Katedra i Klinika Gastroenterologii, Chorób Naczyń i Chorób Wewnętrznych Collegium Medicum w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu; Kierownik: prof. dr hab. med. Maciej Świątkowski)

Background
The aim of this analysis was to estimate the frequency of alarm symptoms in patients with colorectal cancer, benign polyps of large bowel and in individuals, in whom suspected neoplasm was not confirmed.

Material and methods
Retrospective analysis of 158 medical documentation of patients referred to Department of Gastroenterology by family doctors because of abdominal tumor suspicion was made. This population amounted 2.4% of all hospitalizations in 2006. In every subjects at least panendoscopy, colonoscopy and abdominal ultrasonograpy were performed.

Results
Patients with colorectal cancer amounted to 24.5% (39 persons), whereas the benign polyps in 58% (n = 91) were diagnosed. Colon neoplasm was not confirmed in 17.5% (n = 28). The patients with colorectal cancer were older then subjects with benign polyps (67.7 ± 10,8 vs 62.1 ± 11.7 years, p = 0.011). Rectal bleeding (34% vs 3,5%, p = 0.005), constipation (69% vs 3,5%, p = 0,001) and change in bowel habit (74% vs 7%, p = 0.001) were more often in persons with colerectal cancer than in patients without abdominal tumor confirmation. Individuals with colorectal cancer more often than subjects with non malignant polyps presented the alarm symptoms, such as: change in defecation habit (74% vs 52%, p = 0.011), iron deficiency anaemia (79,5% vs 19%, p = 0.0001) or weight loss (74% vs 17,5%, p = 0.0001). The frequency of respective alarm symptoms in patients with proximal colorectal cancer (up to transverse colon) did not differ its distal localization (descending, sigmoid colon and rectal, n = 20).

Key words: colorectal cancer, alarm symptoms, family physician