COLORECTAL-CARCINOMA - DO ELDERLY PATIENTS PRESENT DIFFERENTLY

A cohort of patients with a histological diagnosis of colorectal carci noma was enrolled prospectively. All subjects were interviewed by one observer using a structured questionnaire. One hundred and fifty 'youn g' (under 70 years) and 123 'elderly' (70 years or more) subjects form ed the study sample. The elderly patients did not present more frequen tly as emergencies than the young, but were more often referred to med ical or geriatric rather than surgical units (p < 0.01). There was no difference in median overall delay from symptom onset to histological diagnosis between the age groups (19.5 weeks in each). Symptomatic ana emia and nonspecific symptoms were more often the presenting complaint in the elderly subjects (p < 0.05). On direct questioning, there were no differences in symptom reporting with respect to age group for sub jects with colonic cancer. For rectal cancer the following symptoms we re more common in the young group: tenesmus (odds ratio 4.2; 95% confi dence intervals 2.0-10.0), abdominal or rectal pain (4.0; 1.9-10.6), c hange in flatus production (2.6; 1.3-5.8), passage of mucus per rectum (2.2; 1.1-4.8). Anorexia was more common in the elderly patients (0.4 ; 0.1-0.8). This study suggests that symptomatic presentation of recta l cancer is different in the elderly but does not necessarily lead to greater delays in diagnosis nor higher rates of non-elective presentat ion.