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  • Title: The changing distribution of colorectal cancer in Barbados: 1985-2004.
    Author: Zbar AP, Inniss M, Prussia PR, Shenoy R.
    Journal: Dis Colon Rectum; 2007 Aug; 50(8):1215-22. PubMed ID: 17566831.
    Abstract:
    PURPOSE: Recent reports have suggested a shift to the right in older female patients of colon cancer. This is believed to be representative of more accessible national endoscopic screening programs. METHODS: We report the demographic shift in colorectal cancer based on an analysis of resection specimens during four five-year time periods from 1985 to 2004 at the University Hospital, Barbados. Differences in population-based colorectal cancer incidence, age, gender, site, stage, and presentation (emergency vs. elective) are analyzed. RESULTS: A total of 1,014 specimens obtained from 993 patients were analyzed, showing a progressive population-based increase in colorectal cancer in Barbados during this 20-year time period. There was an increase in right-sided tumors (P < 0.0001) without a concomitant decline in left-sided tumors. There was a significant increase in Dukes A cancers (P < 0.0001) without gender predilection. During the time period, there was a significant reduction in right-sided tumors presenting as emergencies (P < 0.005) without an effect of stage or gender. CONCLUSIONS: There has been a steady increase in both right-sided and left-sided colonic cancers without gender predilection. The increase in early-stage tumors and reduction in emergency presentations during the latter part of the study suggests value in instituting a formal national colonoscopic screening program to assess its prospective effect on these parameters.
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