Colorectal cancer in South Tyneside: a personal audit

A detailed retrospective audit over a 10-year period of 162 patients presenting with colorectal cancer to one surgeon without a specific interest in colorectal surgery was undertaken. The modes of presentation and potential sources of delay in treatment were analysed. The 30-day hospital mortality rate was 10.1% and most of these patients had incurable disease. The crude survival 1 year after the study was 34% (mean follow-up 6 years); at 3 years after study, it was the same (8 years mean follow-up). Survival data are also given in relation to the presentation, and operative and histological findings. Preoperative radiotherapy for rectal cancers is discussed and assessed. During the last 3 years, 49 further patients have presented. The operative mortality rate was 8%. It is suggested that improved surgical treatment, particularly in the acute case, has been responsible for the reduced mortality rate. Only 51% of patients underwent operation with a reasonable prospect of cure. It is suggested that no improvement in the prospects of patients with colorectal cancer will occur until pre-symptom diagnosis from screening techniques is more commonly available.