This overview focuses on what has changed in the diagnosis and treatment of
colorectal cancer over the last 50 years.
Methods
The most important international registers (SEER, European and Italian) as
well as the literature have been consulted. Furthermore, many prognostic
factors are analyzed with the aim to understand the reasons why 5-year
survival has improved over the last two decades.
Results
Since the biologic characteristics of the tumor cannot be changed, improved
survival must be supported by concomitant multiple factors, such as earlier
diagnosis (as given by a more informed educational behavior and the advent
of screening) as well as the wide use of colonoscopy and the technical
improvement of surgical and medical treatment. However, it seems that the
greatest improvement in survival is limited to 5-year controls, whereas
long-term survival does not appear to show any significant improvement.
Conclusions
We can hypothesize that our efforts have just delayed the inevitable end:
death. Nevertheless, further research should be done to confirm this
hypothesis, perhaps in the field of molecular biology, which may also be the
right approach to understanding the biologic aggressiveness of each
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