Trends in frequency and management of obstructing colorectal cancers in a well-defined population

Few population-based studies investigate obstructing colorectal cancers. This study was designed to describe trends in their frequency and management.

Data were obtained for 13,331 colorectal cancers registered by the population-based cancer registry of Burgundy, France, between the years 1976 and 2000.

Obstructing cancers represented 8.3 percent of all colorectal cancers. This proportion was stable throughout the study. Resection for cure increased from 54.9 percent (1976-1980) to 71.4 percent (1996-2000; P = 0.011). Using multivariate analysis, site of cancer and period of diagnosis were the only factors significantly associated to a curative resection. Postoperative mortality for obstructing colorectal cancers decreased from 32.6 percent (1976-80) to 15.2 percent (1996-2000; P < 0.001). The presence of obstruction was significantly associated with a higher postoperative mortality, independent of age and tumor stage (odds ratio = 2.55; 95 percent confidence interval = 2.13-3.5).

The frequency of obstructing colorectal cancers has remained unchanged for 25 years. Operative mortality is still high, although some improvements have occurred. Efforts must be made to diagnose colorectal cancers before obstruction occurs. Mass screening represents a promising approach.