The New Zealand Herald

Appendix problems linked to cancer

For over 45s, there was overall risk six times greater than expected

- Amy Wiggins

If you’re over the age of 45 and get acute appendicit­is you are six times more likely to have underlying colorectal cancer, a new study has found.

The results have led researcher­s to recommend doctors consider checking for colorectal cancer in older adults following a diagnosis of appendicit­is.

Colorectal cancer, also known as bowel or colon cancer, is the second highest cause of cancer death in New Zealand but it can be treated successful­ly if detected and treated early.

New Zealand has one of the highest bowel cancer rates in the world — in 2011, 3030 people were diagnosed with bowel cancer and 1191 died from the disease.

The study was published in the New Zealand Medical Journal yesterday and headed up by Rebecca Shine, the general surgery registrar at the Bay of Plenty District Health Board.

It found that a presentati­on of appendicit­is in patients over 45 years old may constitute a sign of underlying colorectal cancer.

Patients aged between 45 and 60 with acute appendicit­is had more than 17 times more chance of underlying colorectal cancer than would be expected, the study reported. For everyone over 45, there was an overall risk six times greater than expected.

Of the 629 Bay of Plenty patients with a diagnosis of acute appendicit­is who were included in the study, 15 were diagnosed with colorectal cancer during the study period — six times more than would be expected given their demographi­cs.

Eight patients were diagnosed with colorectal cancer as a result of tissue samples People who are diagnosed with bowel cancer, and receive treatment when it is at an early stage, have a 90 per cent chance of longterm survival. collected during treatment for appendicit­is.

The other seven were found during or after treatment for their appendicit­is or other issues. One was diagnosed one month later on follow-up colonoscop­y and the other was diagnosed 28 months later because they had abdominal pain.

The remaining five patients were detected a median of 12 months later suggesting these cancers were also present at the time of appendicit­is.

The study author concluded the possibilit­y of a co-existent cancer should always be kept in mind when treating patients over 45 who had symptoms of appendicit­is and said clinicians should pay particular attention to any factors that may raise the suspicion of colorectal cancer.

The authors stopped short of recommendi­ng universal colonic investigat­ion for these patients but said if a person’s appendicit­is was treated without operating or if their initial tissue specimen revealed malignancy they should be offered it. Even if tissue samples were benign, doctors should consider whether colonic investigat­ion might be worthwhile, they said.

The study comes as the government begins the roll-out of the national bowel screening programme. Herald Herald. Waiheke resident Nobilangel­o Ceramalus to change the name in March last year. The proposal was accepted for consultati­on, with submission­s open until September 22. To date, 135 objections to the change have been received, compared with five in support.

 ??  ?? Marina Erakovic says her rackets were “deemed as a weapon” as she tried to board a flight to Los Angeles.
Marina Erakovic says her rackets were “deemed as a weapon” as she tried to board a flight to Los Angeles.

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