Trends in colorectal cancer presentation over a twenty year period in Ireland

Aims: To examine if urbanisation of a rural population has led to a change in the pattern of colorectal cancer presentation.

Methods: 'Audit 1' identified and reviewed all cases of colorectal cancer diagnosed in our unit for the five-year period 1976–1980. At that time 68% of the populace lived in rural areas. 'Audit 2' encompassed all cases of colorectal cancer from 1996–2000 with only 38% of the populace in rural dwellings.

Results: In the period 1996–2000, 206 patients were diagnosed with colorectal cancer, a rise of 55% on the previous audit total of 133 patients. The number of patients presenting as emergencies were identical (18%) in both study groups. In both audits the number of patients presenting with Dukes B and C cancers were similar but in Audit 2 there were significantly more patients with Dukes A tumours (18% versus 9%, p=0.003) and less Dukes D tumours (19% versus 32%).

Conclusions: A change in catchment population has led to a larger, predominantly urban setting over a twenty year period is associated with a shift to a more favourable Dukes staging. This may reflect easier access to healthcare in the urban setting and better patient education.