Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention?
Objective. To establish whether there was any difference in disease stage in patients with screening-detected colorectal cancer (CRC) in a Caribbean country. Methods. The mode of presentation (elective vs. emergent), method of diagnosis (screening vs. symptomatic), and disease stage were retrospecti...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Pan American Health Organization
2022-04-01
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| Series: | Revista Panamericana de Salud Pública |
| Subjects: | |
| Online Access: | https://iris.paho.org/handle/10665.2/55891 |
| _version_ | 1818915029946204160 |
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| author | Shamir O. Cawich Emil Phillips Sierra Moore Solange Ramkissoon Greg Padmore Sahle Griffith |
| author_facet | Shamir O. Cawich Emil Phillips Sierra Moore Solange Ramkissoon Greg Padmore Sahle Griffith |
| author_sort | Shamir O. Cawich |
| collection | DOAJ |
| description | Objective. To establish whether there was any difference in disease stage in patients with screening-detected colorectal cancer (CRC) in a Caribbean country.
Methods. The mode of presentation (elective vs. emergent), method of diagnosis (screening vs. symptomatic), and disease stage were retrospectively compared in all consecutive patients who had resections for CRC over a five-year period. Early CRC was defined as disease that could be completely resected with no involvement of adjacent organs, lymph nodes, or distant sites. Locally advanced CRC was disease that involved contiguous organs without distant metastases that was still amenable to curative resection.
Results. There were 97 patients at a mean age of 64.9 ± 12.2 years treated for CRC, and only 21 (21.6%) had their diagnoses made through screening. Significantly more screening-detected lesions were early-stage CRCs (21.7% vs. 9.3%; p < 0.001). At the time of diagnosis, patients who did not have screening-detected lesions had a greater proportion of locally advanced (42.3% vs. 0) and metastatic (26.8% vs. 0) CRC. Those who did not have screening-detected lesions had a greater incidence of emergency presentations at diagnosis (26.8% vs. 0).
Conclusions. The incidence of screening-detected CRC in this Caribbean nation was low. Consequently, most patients presented with locally advanced or metastatic CRC, for which there is less opportunity to achieve a cure. Significantly more screening-detected lesions were early-stage CRCs. It is time for policymakers to develop a national CRC screening program. |
| first_indexed | 2024-12-19T23:55:47Z |
| format | Article |
| id | doaj.art-bef2e06836d24b7e912cb54835e750b6 |
| institution | Directory Open Access Journal |
| issn | 1020-4989 1680-5348 |
| language | English |
| last_indexed | 2024-12-19T23:55:47Z |
| publishDate | 2022-04-01 |
| publisher | Pan American Health Organization |
| record_format | Article |
| series | Revista Panamericana de Salud Pública |
| spelling | doaj.art-bef2e06836d24b7e912cb54835e750b62022-12-21T20:01:01ZengPan American Health OrganizationRevista Panamericana de Salud Pública1020-49891680-53482022-04-0146181510.26633/RPSP.2022.18rpspColorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention?Shamir O. Cawich0Emil Phillips1Sierra Moore2Solange Ramkissoon3Greg Padmore4Sahle Griffith5Port of Spain General Hospital, Port of Spain, Trinidad and TobagoQueen Elizabeth Hospital, Bridgetown, BarbadosQueen Elizabeth Hospital, Bridgetown, BarbadosPort of Spain General Hospital, Port of Spain, Trinidad and TobagoQueen Elizabeth Hospital, Bridgetown, BarbadosQueen Elizabeth Hospital, Bridgetown, BarbadosObjective. To establish whether there was any difference in disease stage in patients with screening-detected colorectal cancer (CRC) in a Caribbean country. Methods. The mode of presentation (elective vs. emergent), method of diagnosis (screening vs. symptomatic), and disease stage were retrospectively compared in all consecutive patients who had resections for CRC over a five-year period. Early CRC was defined as disease that could be completely resected with no involvement of adjacent organs, lymph nodes, or distant sites. Locally advanced CRC was disease that involved contiguous organs without distant metastases that was still amenable to curative resection. Results. There were 97 patients at a mean age of 64.9 ± 12.2 years treated for CRC, and only 21 (21.6%) had their diagnoses made through screening. Significantly more screening-detected lesions were early-stage CRCs (21.7% vs. 9.3%; p < 0.001). At the time of diagnosis, patients who did not have screening-detected lesions had a greater proportion of locally advanced (42.3% vs. 0) and metastatic (26.8% vs. 0) CRC. Those who did not have screening-detected lesions had a greater incidence of emergency presentations at diagnosis (26.8% vs. 0). Conclusions. The incidence of screening-detected CRC in this Caribbean nation was low. Consequently, most patients presented with locally advanced or metastatic CRC, for which there is less opportunity to achieve a cure. Significantly more screening-detected lesions were early-stage CRCs. It is time for policymakers to develop a national CRC screening program.https://iris.paho.org/handle/10665.2/55891colorectal neoplasmsbarbadoscaribbean region |
| spellingShingle | Shamir O. Cawich Emil Phillips Sierra Moore Solange Ramkissoon Greg Padmore Sahle Griffith Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? Revista Panamericana de Salud Pública colorectal neoplasms barbados caribbean region |
| title | Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? |
| title_full | Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? |
| title_fullStr | Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? |
| title_full_unstemmed | Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? |
| title_short | Colorectal cancer in an Eastern Caribbean nation: are we missing an opportunity for secondary prevention? |
| title_sort | colorectal cancer in an eastern caribbean nation are we missing an opportunity for secondary prevention |
| topic | colorectal neoplasms barbados caribbean region |
| url | https://iris.paho.org/handle/10665.2/55891 |
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