Prognosis in relation to symptom duration in colon cancer

Between 1950 and 1978 754 patients underwent operation by one of the authors for carcinoma of the colon. Follow-up data were available on 99 per cent. Tumour stage distribution did not differ significantly with increasing duration of symptoms. The proportion of curative to palliative operative procedures was unrelated to symptom duration. Cancer specific survival for the entire patient series was worse when symptoms had been present for less than 3 months compared with 3-6 months, 6-12 months or 12 months or more (P less than 0.001, P less than 0.02 and P less than 0.04, respectively). Cancer specific survival after curative resection was also worse in patients with a symptom duration of less than 3 months compared with 3-6 months or 12 months or more (P less than 0.02 and P less than 0.03, respectively). These results show that colon cancer patients in whom the diagnosis is made and operation performed after a short symptomatic period do not have less advanced tumours nor better survival prospects.