A community-based hospital experience with colorectal cancer

Background: 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. Methods: 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 longterm survival. Results: 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. Conclusions: 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.