Changing patterns in colorectal carcinoma: a 25-year experience.

The pattern of colorectal carcinoma, especially with respect to stage and tumor location, has changed noticeably over the past 25 years. During that time period, 1,959 patients came to Hahnemann University Hospital with colorectal cancer, 1,584 of whom were reviewed in this study. There was a significant relationship between extent of disease and date of diagnosis, with the trend being toward decreasing stage at the time of diagnosis. In addition, there has been a demonstrable "rightward shift" in tumor location, especially over the past 15 years. This has been accompanied by a slight increase in the detection of rectal lesions as well. The trend toward earlier and more proximal lesions is likely due in large part to the increasingly widespread use of surveillance colonoscopy and sigmoidoscopy.