Lim et al. reported that Ktrans values in rectal tumours at presentation in the downstaged group following CRTP were significantly higher than those in the non-downstaged group [38].
Another study also indicates that colon cancer is associated with substantially higher proportion of multiple pre-referral consultations compared with rectal cancer after presentation in primary care (Lyratzopoulos et al, 2012).
However, within the group of patients with bleeding symptoms, there were significant differences in risk of delay by source of bleeding: 35% of patients with rectal bleeding delayed presentation, but only 9% of patients with urinary bleeding.
At presentation, rectal temperature varied from 37.6 to 38.5°C (38.1 ± 0.7°C), heart rate ranged from 45 to 90 beats/min (68 ± 23 beats/min), and respiratory rate ranged from 10 to 30 breaths/min (20 ± 10 breaths/min).
All patients with colon and rectal cancer presented to our department, also those with an urgent or acute presentation, were included.
Presentation of rectal cancer cases at a colorectal cancer multidisciplinary conference (CRC-MDC) is a required standard for the newly formed National Accreditation Program for Rectal Cancer administered by the Commission on Cancer.
Diagnosis rates after presentation with rectal bleeding were the lowest of the four alarm symptoms that we studied, and most patients turned out to have haemorrhoids or an anal fissure.
Although colon and rectal cancer share similar presentations and diagnostic pathways, they differ substantially with respect to treatment patterns and functional outcomes: in contrast with colon cancer patients, approximately two-thirds of patients with rectal cancer treated by surgery require stoma formation, which is permanent in at least a quarter of all patients (Finan et al, 2010).
Rectal cancer is a frequent presentation, with an estimated 35% of cases found situated in the rectum [ 1].
These findings add to the evidence that colonic and rectal cancer differ in their presentation and that these differences affect the outcome.
