The management of the colorectal cancer: Perspectives

Abstract

Background: The progress of scientific research gives new tracks to be exploited for the management of the colorectal cancers whose the molecular profile study became fundamental. Aim: the aim of this study was to compare the management of the colorectal cancer in our patients to the current international recommendations. Subjects and methods: In a retrospective study, we analysed 256 files between January, 2015 and September 2019. All the adenocarcinoma of colon and rectum were included. Our patients were divided into two groups: 161 patients with colorectal cancer (63%) and 95 patients with rectum cancer (37%). We studied if the management of the disease was actually compliant to the international recommendations. Results: Our study showed that the colorectal cancer occured most frequently in young population, with 45,5% in patients aged more than 60 years, 44% between 40 -60 years and 10 were under 40 years. The tumor was in T3 or more stage in 40,3% for colon cancer and 68,4% for rectum cancer. Elsewhere, none of the patients benefited from a molecular profile study of his tumor. Discussion:The colorectal cancer is diagnosed in relatively young population with 54,5% of patients aged less than 60 years among whom 10% are less than 40, which explains the diagnostic delay. This delay is also due to the lack of a screening in general population and high risk subjects. Moreover, the absence of a molecular examination has a negative impact on the treatment and on the screening in the apparented, especially in case of tumor with micro satellite instability. Conclusion: In order to improve the prognosis of the colorectal cancers in our patients, a screening adapted to the groups at risk has to be implemented and a molecular profil examination achived so that evolution and therapeutics perspectives could be set.

Association between patient, clinic, and geographical-level factors and 1-year surveillance colonoscopy adherence

“…The proportion of patients in our study who completed a 1-year surveillance colonoscopy is consistent with the existing literature ( 13 – 15 , 22 – 24 ). We found multiple demographic factors associated with decreased adherence to 1-year surveillance colonoscopy that have been previously reported, including increasing age, higher CCI, later stage disease, and Medicare insurance ( 13 , 14 ).…”