Change towards earlier stage at presentation of colorectal cancer

A study was carried out to investigate the change in stage at presentation of patients with colorectal cancer over 10 years. Cases were identified from the control group of subjects enrolled into a randomized controlled study based on Haemoccult screening for colorectal neoplasia. Of 405 subjects in the control group presenting with symptomatic colorectal cancer, 206 presented before 1989 and 199 since then. The number of patients with Dukes' stage A carcinoma diagnosed since 1989 rose from 21 (10·4 per cent) to 35 (18·1 per cent); this change occurred for rectosigmoid tumours (9·9 per cent before 1989, 28 per cent after 1989) but not for colonic cancer (10·9 per cent before 1989, 11·5 percent thereafter). An increase in the proportion of patients with symptomatic early-stage rectosigmoid cancer has been observed in the past 10 years. No such change occurred in those with colonic cancer. This may reflect a change in awareness of the disease and its symptoms by patients and general practitioners.