PWE-030 Audit of Bowel Cancer Presentation in a Community Hospital Setting

• Published in: Gut Vol. 62; no. Suppl 1; pp. A142 - A143
• Main Authors: Tharakan, J, Tiwari, I, Beesley, D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.06.2013; BMJ Publishing Group LTD
• Subjects: Anemia; Bleeding; Cancer; Cancer screening; Colon; Colorectal cancer; Intestine; Medical screening; Pain; Rectum; Sigmoidoscopy; Spleen; Tumors
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2013-304907.319

Introduction Most data on bowel cancer presentation are from an acute hospital setting. There have not been many reports from a community hospital. Our audit looked into the presentation of bowel cancer from a community hospital setting. Methods We audited the results of bowel cancer presentation from our community hospital with data collected over a two year period from June 2010 to May 2012. We analysed the presenting symptoms, the male:female ratio, ages and location of bowel cancer. Results 1795 colonoscopies and 2589 flexible sigmoidoscopies were performed at our hospital during this two year period. The total number of colonic cancers found were 87(47 found on colonoscopy and 40 on flexible sigmoidoscopy), giving an incidence of about 2%. The ages ranged from 33 years to 86years with 49 males and 38 females. The main presenting symptoms were analysed and were as follows. Anaemia in 16 patients Abdominal pain in 8 patients. Per rectal (PR) bleeding in 45 patients Change in bowel habit in 25 patients. We followed the established norm of dividing colon cancers proximal to the splenic flexure as right colonic and distal to this as left colonic. On this basis, the locations of the bowel cancers were found to be 19 in the right colon and 68 in the left. We attempted to corelate clinical findings with site of tumours. It was observed that anaemia was more commonly associated with a right colonic lesion as compared to PR Bleeding which was seen with a left sided pathology. Abdominal pain and change in bowel habit were not strongly associated with any particular location for a tumour. Conclusion Our audit data of colon cancers from a community based setting is one of the few to be published in recent years. We have shown an incidence of about 2% of colon cancers from this setting. There appears to be a definite association between PR bleeding and left colon tumours as compared to anaemia which appeared to be associated with right colonic lesions. The overwhelming majority of cases referred to us were lesions located in the left colon suggesting that one-off flexible sigmoidoscopy as a tool for bowel cancer screening should have a very good diagnostic yield. Disclosure of Interest None Declared.