Association of symptoms of colon cancer patients with tumor location and TNM tumor stage

• Published in: Scandinavian journal of gastroenterology Vol. 47; no. 7; p. 795
• Main Authors: Alexiusdottir, Kristin K, Möller, Pall Helgi, Snaebjornsson, Petur, Jonasson, Larus, Olafsdottir, Elinborg J, Björnsson, Einar Stefan, Tryggvadottir, Laufey, Jonasson, Jon G
• Format: Journal Article
• Language: English
• Published: England 01.07.2012
• Subjects: Abdominal Pain - etiology; Aged; Anemia - etiology; Chi-Square Distribution; Colon - pathology; Colonic Neoplasms - complications; Colonic Neoplasms - diagnosis; Colonic Neoplasms - pathology; Defecation; Female; Gastrointestinal Hemorrhage - etiology; Hemoglobins; Humans; Iceland; Incidental Findings; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Odds Ratio; Retrospective Studies; Iceland
• ISSN: 1502-7708
• DOI: 10.3109/00365521.2012.672589

Colon cancer is the second most common cause of cancer death in Iceland and accounts for 8% of malignancies. We related information on symptoms of colon cancer patients with information on tumor location and pTNM-stage. The study is retrospective and population-based. Information on all patients diagnosed with colon cancer in Iceland in 1995-2004 was obtained. Information on symptoms of patients and blood hemoglobin was collected from patients' files. The pathological parameters were derived from a previously performed study. A total of 768 patients (422 males, 346 females) participated in this study. Median age was 73 years. Nearly 60% had anemia at the time of diagnosis, 53% had visible blood in stools, and 65% had changes in bowel habits. Around 84% had visible blood in stools and/or anemia. Of those with right-sided tumors, 75% had anemia and were more likely to be diagnosed incidentally (40%) than those with left-sided tumors (20%). Left-sided tumors were associated with blood in stools (68% compared to 41%, p < 0.05) and changes in bowel habits (74% compared to 57%, p < 0.05). Multivariate analysis indicated that blood in stools was strongly associated with a lower TNM-stage (OR = 0.75, p < 0.05). Anemia was strongly associated with a higher TNM-stage (OR = 1.84, p < 0.05). Right-sided tumors were associated with anemia and incidental diagnosis; left-sided tumors were associated with visible blood in stools and changes in bowel habits. Visible blood in stools was significantly associated with lower TNM-stage, whereas abdominal pain, general and acute symptoms were associated with higher TNM-stage.