Clinicopathological trends in colorectal cancer in a tertiary care hospital

OBJECTIVE: This study aims to retrospectively analyze the pattern of patients with colorectal cancer seen in King Abdul Aziz Hospital and Oncology Center, Jeddah, Kingdom of Saudi Arabia from January 1992 through to December 1997, with a view to determine various epidemiological and clinopathological features of the disease.

METHODS: All cases of colorectal cancer presented to King Abdul Aziz Hospital, Jeddah between January 1992 and December 1997 were retrospectively reviewed and the data was analysed to determine age, gender, ethnicity, subsite distribution, clinical presentation, histological type and staging of disease.

RESULTS: A total of 160 patients were included in the study, with 78% of them being Saudi Nationals. The male to female ratio was 1:0.8. The mean age was 56.3 + 14.98 years. The peak age of onset was in the 6th and 7th decade. The duration of symptoms varied from one to 24 months with the majority of patients having symptoms for more than 6 months. Sixty-eight point two percent of these patients had primary disease originating from rectum or sigmoid colon, whereas 22.5% of patients had primary disease involving ascending and transverse colon, Anemia was present in 55% of patients. Among the 160 patients, 82.5% of them were histologicaly found to have adenocarcinoma. A total of 38.8% of patients were in stage B and 38.1% of patients were in stage C of Aster-Coller classification. No patients was found to be in stage A.

CONCLUSION: In general, we share many epidemiological features of developing countries for colorectal carcinoma. These included left sided subsite distribution and delayed presentation of the disease in an advanced stage. We stress the significance of public health education and a national screening program regarding colorectal cancer to improve the outcome.