Clinical Study of Invasive Colorectal Carcinoma in Individuals Undergoing an Annual Ningen Dock

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  • 人間ドック逐年受診者における浸潤大腸がんの臨床的検討
  • ニンゲン ドック チクネン ジュシンシャ ニ オケル シンジュン ダイチョウ ガン ノ リンショウテキ ケントウ

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Objective: We examined the clinical characteristics of individuals with invasive colorectal carcinoma detected in an annual ningen dock. Methods: The subjects were 18 individuals who had annually undergone a ningen dock during the 5-year period from 2002-2006, and in whom invasive colorectal cancer (pSM, with a pathological invasion depth of at least 1000 pm) was identified because of a negative occult blood test in the previous year and a positive occult blood test in the current year. Of these individuals,8 had early cancer, and 10 invasive cancer. Tumor characteristics (location, tumor diameter, gross morphology, invasion depth, and stage) and patient characteristics (the presence or absence of subjective symptoms, family history of cancer, status of lifestyle-related diseases, and number of stool submissions) were analyzed. Results: Cancer was located most frequently in the ascending and sigmoid colons, in 6 patients each. Regarding the gross morphology, all invasive cancers were type 2, and all early cancers were type Ha or II c (superficial-extension type). The mean tumor diameter was 27.4± 10.5 mm, with no significant difference among locations. All cancers were well-differentiated. Two cancers showed extraserosal invasion with no lymph node metastasis, and were staged as I and II. Of the 18 subjects,89% showed no subjective symptoms, only 1 revealed a family history of colon cancer, and 88.9% had lifestyle-related diseases. As high as 28% submitted stool samples only once in the previous year, when the occult blood test was negative. Conclusion: Cancers were frequently located in the right-sided colon, and tended to be of the superficial type. Since the majority of patients exhibited few subjective symptoms, it is desirable that stool samples should be submitted for occult blood testing at least twice to detect colorectal cancer.

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