1. CHARACTERISTICS OF PATIENTS WITH COLORECTAL CANCER IN NORTHWESTERN GREECE Dimitrios Christodoulou, Ioannis Mitselos, Chrisanthi Tzika, Epameinondas V. Tsianos Department of Gastroenterology, University Hospital of Ioannina – Greece and School of Health Sciences, University of Ioannina - Greece

2. Background Colorectal cancer is one of the leading causes of morbidity and mortality in the globe It affects more than 1 million people annually It usually develops by a malignant transformation of a polyp There may be a positive family history in up to 70% of patients

3. Basic characteristics The most frequent type is adenocarcinoma, which is usually secreting mucus Macroscopically it can look like a polypoid tumor, an ulcerated lesion or a stenotic infiltrative lesion It can extend to the surrounding tissues, to the lymph nodes and hematogenously to distant organs such as the liver and lungs

4. Duke’s stages A: Limited to the mucosa and submucosa B: Infiltration of the muscle layer C1: Infilitration of local lymph nodes near the tumor C2: Infiltration of all lymph nodes up to the ligation of the vessels D: Distant metastases to liver, lungs and other organs

5. Aim To analyze the basic characteristis of the disease in our area To identify probable predisposing factors To give information about the natural course of the disease

6. Patients - Methods We recorded 51 subsequent patients who were diagnosed with colorectal cancer (CRC) after an endoscopic procedure in our Unit

7. Collected information Personal and family history of cancer Demographics Level of education Alcohol and tobacco use Clinical symptoms Location Extent Stage

8. Results - Demographics 51 patients 26 males / 25 females Age 67 ± 12 years 53% between 70-80 years

9. Age distribution

10. Results - Location Rectosigmoid: 78% Descending or left transverse colon: 6% Right colon: 16%

11. Location of cancer

12. Results – Clinical symptoms Overt rectal blood loss: 31% Altered bowel habits: 24% Abdominal pain: 14% Weight loss: 2% Fatigue due to anemia: 20% Screening: 15%

13. Blood in the stool Pain Fatigue

14. Level of education Low: 71% High: 29%

15. Economic condition Poor: 31% Average: 63% Rich: 6%

16. Habits Smokers: 61% Frequent consumption of alcohol (> 4 drinks per week): 29%

17. History of cancer 80% had a first degree relative with cancer 12% had a first degree relative with colorectal cancer 17% personal history of cancer of any origin 37% personal or family history of colorectal polyps

18. Family history of cancer Large bowel LiverNone Breast Leukemia Lung Stomach Pancreas Esophagus

19. Positive history of colorectal polyps

20. Histology and stage Adenocarcinoma in all cases Differentiation –Low: 14% –Moderate: 84% –High: 2% Infiltrated lymph nodes: 76% Distant metastases: 17%

21. Lymph nodes’ infiltration Yes No

22. Conclusions A small proportion of patients were diagnosed during a screening colonoscopy Most cases were located at the left colon Colorectal cancer was diagnosed at an advanced stage in our area Increasing the efficacy of screening programs may reduce the morbidity and mortality from CRC