Clinicopathologic review of 92 cases of colon cancer

This review included 92 cases with confirmed primary colon cancer seen at the Veterans Administration Hospital in Sioux Falls, South Dakota between 1988 and 1992. The presenting symptoms and signs and their relation to the site of the tumor, as well as the diagnostic procedures used, methods of treatment and follow-up are presented. Anemia was the initial presentation in 48 patients (52.2%), rectal bleeding in 19 patients (20.4%), and change in bowel habits in 15 patients (16.4%). Seventy-one of these cases (77.2%) were diagnosed by colonoscopy and biopsy, and the remaining 21 patients (23%) were diagnosed by exploratory laparotomy. Invasive adenocarcinoma was the predominant cell type and was present in 75 patients (81%). At the time of diagnosis, 64 (69%) of the patients were in stage I and II and 28 (30.4%) were in stage III and IV. The extent of the disease clearly affects survival, with high mortality in those patients diagnosed at late stages. This review again emphasizes the importance of early diagnosis in reducing the morbidity and mortality from this common neoplasm.