Objective: To explore the changing of clinical features of colon cancer within 20 years, in order to help early diagnosis and screening of colon cancer in China.
Methods: A total of 1233 cases of colon cancer in Peking Union Medical College Hospital during 1989 - 2008 were retrospectively studied. All patients were divided into two groups according to the date of onset (1989 - 1998 and 1999 - 2008), the demographic features, clinical manifestations, laboratory examination, colonoscopy characteristics and pathological stage were analyzed.
Results: Comparing with 1989 - 1998, in recently 10 years, the morbidity of colon cancer increased, more female and old patients appeared; hematochezia significant less (51.8% vs 31.7%, P < 0.05); abdominal mass and following ileus also decreased (30.2% vs 13.6%, P < 0.05); patients with low of Hb decreased, the positive of stool occult blood increased from 43.6% to 61.2% (P < 0.05), According with the more patients who detected serum CEA, the positive rate significant increased (32.4% vs 57.9%, P < 0.05). Colonoscopy became the mainly method for diagnosis, more and more early stage lesion and polyps were detected. The location of tumor from ascending colon in 1989 - 1998 (44.6%) shift to sigmoid colon (38.7%) and descending colon (22.7%) up to now. Operation was the first choice of treatment, the early stage (Duke A) patients significant increased (9.3% vs 23.8%, P < 0.05).
Conclusions: In the recently 10 years, the morbidity of colon cancer obviously increased, the age was become elder and female patients were increased. The clinical manifestation became more nonspecific. According with the improvement of stool occult blood, serum CEA and colonoscopy detective method and wild spread using, more and more early stage patients were diagnosed. The location of tumor shift from right side to left side, and coincidence with west countries gradually.