Sammanfattning
Introduction: Colorectal cancer is among the most frequent cancers in Denmark, and the survival rate is lower in Denmark than in the rest of Scandinavia and several European countries. A national register for colorectal cancer was established in 1994, and the aim of the present study was to evaluate preoperative staging, operative treatment and short-term outcome. Materials and methods: Prospective data were collected on 5034 patients presenting in a surgical department with a first-time diagnosis of rectal adenocarcinoma from September 1994 to August 1999. A limited set of data on preoperative diagnostic procedures, treatment, stage of disease and short-term outcome was registered. Results: The estimated inclusion rate of data was 93%. During the study an increasing number of patients had preoperative X-rays of the lungs and ultrasonography of the liver. The stage of disease at admission did not change favourably during the study period, and curative surgery was performed in 70% of the patients. Preoperative radiotherapy for advanced disease was not used for all patients in need of it, 45% of the patients had a permanent colostomy, and 13% suffered anastomotic leakage after an anterior resection. The postoperative mortality rate was 7%, and 12% following anastomotic leakage. Discussion: To improve the rate of survival of colorectal cancer in Denmark, preoperative radiotherapy should be used for more patients, and the frequency of anastomotic leakage and postoperative mortality must be reduced. One of the starting points for the National Cancer Plan is now established for rectal cancer, and surveys by the Danish Colorectal Cancer Group's national colorectal cancer register will show if the necessary improvement occurs.