Theaim of this study is to demonstrate the current panorama of colorectal cancerin a general hospital in Rio de Janeiro, focusing on aspects related to the clinicalpresentation and delayed diagnosis. This is a retrospective study that includedpatients followed at the outpatient section of colorectal cancer follow-up ofthe Segunda Clínica Cirúrgica do Hospital Federal Bonsucesso inthe past five years (2004-2009). The most common symptoms were abdominal pain(60.1%), intestinal obstruction (41.1%), weight loss (36.7%), bleeding (33.5%),anemia (14.5%), perforation (6.3 %) and fistula (1.2%). Patients with right colontumors presented with weight loss (54.5%), pain (45.4%), obstruction (45.4%) andanemia (27.2%). In patients with tumors of the left colon and sigmoid, the mostcommon symptoms were pain (60.5%), obstruction (42.9%), weight loss (38.5%), bleeding(32.4%) and anemia (16.6%). Patients with rectal tumors presented with bleeding(70%), obstruction (60%), pain (60%), weight loss (20%) and perforation (10%).At surgery, 53 patients had distant metastases (33.5%), the liver being the organmost affected in 36 patients (67.9%), followed by the peritoneum in 11 cases (20.7%)and ovaries with 4 cases (7.5%). Eighty-eight patients (55.6%) had nodal metastasis.Regarding TNM staging, we found that the emergency group distribution was as follows:Stage I 0%, 28.2% Stage II, Stage III 30.4% and 41 3% Stage IV, whereas the electivegroup staging distribution was: 2.7% Stage I, Stage II 27.7%, 25% Stage III andStage IV 44%. Conclusion: The profile of patients operated in our institution(which reflects the national reality) is composed mainly with patients with advancedcancer stages. Based on the data presented, it is necessary to implement a nationalscreening program for colorectal cancer.
