A COMMUNITY-BASED HOSPITAL EXPERIENCE WITH COLORECTAL-CANCER

Background: Survival figures for patients with colorectal cancer are o ften based on data from tertiary referral centres for colorectal surge ry. The relevance of such data to community-based hospitals is questio nable. The aim of the present study was to determine the long-term sur vival in patients presenting with colorectal cancer to a large communi ty-based teaching hospital. Methods: A search was conducted on the hos pital computerized database to determine those patients who were admit ted with a diagnosis of colorectal cancer between 1989 and 1994. These records were linked to the Deaths Registry to determine longterm surv ival. Results: A total of 477 patients were managed at Fremantle Hospi tal over the 5-year period. Nearly half of these patients (47.6%) pres ented via the hospital emergency centre. At diagnosis, 57.8% of patien ts had advanced cancers with either nodal or distant metastases. Surge ry was undertaken on 455 patients, with a postoperative mortality of 4 .5%. The corrected 5-year survival rate for patients undergoing curati ve resections (i.e. complete local excision and no evidence of metasta ses) was 62.9% for colon cancers and 48.2% for rectal cancers. Local r ecurrence developed in 21.4% of patients with rectal cancers. Conclusi ons: A majority of patients with colorectal cancers are continuing to present with advanced disease. Earlier diagnosis of these cancers thro ugh community-based screening programmes could well serve as an achiev able solution to this problem.