The changing distribution of large intestinal cancer

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Abstract
In recent years, several accounts have reported a proximal migration of colorectal cancer. To determine the experience at the Jewish General Hospital in Montreal, Canada, 1044 cases of large-bowel cancer that presented between the years 1955-1978 were analyzed. The colon was arbitrarily divided into 5 anatomic regions and the distribution of cancer in each region for each of 8 3-yr periods was calculated. An increase in right-sided lesions occurred from 15.6% in the first 3-yr period to 37.6% in the final 3-yr period (P < 0.01). No significant change occurred in transverse and left-colon lesions. An increase in sigmoid carcinomas occurred from 14% to 35% (P < 0.01). A dramatic decrease in rectal carcinoma from 53% to 2.1% occurred (P < 0.001). Methods for the early detection and screening of large-bowel carcinoma should probably be directed at the entire colon rather than the distal 25 cm.