A community-based hospital experience with colorectal cancer

Survival figures for patients with colorectal cancer are often based on data from tertiary referral centres for colorectal surgery. The relevance of such data to community-based hospitals is questionable. The aim of the present study was to determine the long-term survival in patients presenting with colorectal cancer to a large community-based teaching hospital.

A search was conducted on the hospital computerized database to determine those patients who were admitted with a diagnosis of colorectal cancer between 1989 and 1994. These records were linked to the Deaths Registry to determine long-term survival.

A total of 477 patients were managed at Fremantle Hospital over the 5-year period. Nearly half of these patients (47.6%) presented via the hospital emergency centre. At diagnosis, 57.8% of patients had advanced cancers with either nodal or distant metastases. Surgery was undertaken on 455 patients, with a postoperative mortality of 4.5%. The corrected 5-year survival rate for patients undergoing curative resections (i.e. complete local excision and no evidence of metastases) was 62.9% for colon cancers and 48.2% for rectal cancers. Local recurrence developed in 21.4% of patients with rectal cancers.

A majority of patients with colorectal cancers are continuing to present with advanced disease. Earlier diagnosis of these cancers through community-based screening programmes could well serve as an achievable solution to this problem.