Colorectal Cancer Screening: Are we Missing an Opportunity in Trinidad & Tobago?
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Abstract
Objectives: Opportunistic (ad-hoc) screening for colorectal cancer is practiced in Trinidad & Tobago, but there is no data on the outcomes of opportunistic screening. We carried out this study to determine the proportion of persons with colorectal ancer who were screen-detected.
Methods: We retrospectively audited the records of all patients who underwent colectomies for colorectal cancer at a public hospital over a 10-year period from January 1, 2012 to January 30, 2022. We compared American Joint Committee on Cancer stage based on method of diagnosis (screening vs symptomatic). Descriptive statistical analyses were generated using SPSS version 21.0.
Results: We analyzed 340 patients with colorectal cancer at a mean age of 63.3 years (SD +/- 13.4). There were 52 (15.3%) patients who had diagnoses made at screening and 283 (84.7%) had investigations after developing symptoms. Significantly more screen-detected lesions were early-stage colorectal cancer (73.1% vs 25%; P <0.001). Table 1 compares the cancer stage in both patient groups.
Conclusions: Although significantly more patients with colorectal cancer are diagnosed at early stages by screening, the incidence screen-detected disease in Trinidad & Tobago is low. Most patients present with locally advanced (52%) or metastatic (15%) disease, when the opportunity for curative treatment is reduced. The time has come for policy makers to develop and institute a national screening programme for colorectal cancer in Trinidad & Tobago.
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