2. Cancer of the Large Bowel: Presenting Symptoms in Relation to the Dukes' Classification and the Site of the Lesion

Abstract

279 patients with a rectal cancer and 120 patients with a colonic cancer proven histologically on operative specimens were seen at the Aichi Cancer Center Hospital between Dec. 1964 and Dec. 1972. To promote an earlier diagnosis, the presenting symptoms and signs in relation to the Dukes' classification and the site of the cancer were studied.
399 patients were classified into 103 patients of Dukes'A, 90 of Dukes'B and 206 of Dukes'C. Rectal bleeding was much more common in patients with cancer of the rectum and the sigmoid colon in the Dukes'A. Altered bowel habit and abdominal mass noticed by patients were relatively late symptoms. Although patients with a right-sided lesion and cancer of the transverse colon were more likely to present with abdominal pain in the Dukes'A, bleeding from the large bowel, i.e. not only over bleeding but also positive occult blood (more than + + by Benzidine method) and/or anemia (less than 350×10⁴mm³. in R.B.C. and⁄or 70% Sahli in Hb) was confirmed in the vast majority of patients.
It is, therefore, concluded that testing occult blood in the stools plays an important role in early detection of cancer of the large bowel.