Colon cancer incidence, presentation, treatment and outcomes over 25 years

Aim The aim of this study was to evaluate changes in the incidence, presentation, treatment and outcome of colon cancer in a complete cohort of patients treated at a single institution over a 25-year period. Method All 869 patients at Levanger Hospital, Norway with colon cancer during 1980-2004 were included in the study. Results The incidence of colon cancer increased by 2.1% per year. During the later years, patients presented with less advanced stages, and fewer patients had emergency presentation with obstruction. The rate of operations performed by a colorectal specialist attending increased from 56 to 98%. Postoperative mortality after resection with curative intent decreased from 6.3 to 3.2%, and the presence of a colorectal specialist during the operation was an independent factor that reduced the risk of postoperative death. The local recurrence rate after curative surgery was 10.9% (19 of 174) in 1980-1989, 5.9% (14 of 239) in 1990-1999 and 0.6% (1 of 154) in 2000-2004 (P < 0.001). The 5-year relative survival after resection with curative intent was 71, 81 and 85% in the three periods 1980-1989, 1990-1999 and 2000-2004, respectively. Conclusion The outcome of colon cancer improved from 1980 to 2004. Patients presented at earlier stages, and fewer had emergency presentation. The local recurrence and postoperative mortality rates were reduced, and relative survival improved.