DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184424

Clinical presentations of colorectal cancer at initial presentation to hospital and its site specific correlation

Rauf Ahmad Bhat, Shams Ul Bari

Abstract


Background: Colorectal cancer is one of the leading cause of death all over the world. It progresses slowly and may be asymptomatic for as many as 5 years. Aim of this study was to find the incidence and the initial clinical presentations of patients with colorectal cancer and its site specific correlation

Methods: This was a prospective hospital-based study conducted over a period of two years from August 2015 to September 2017 in the postgraduate department of surgery, Government medical college, Srinagar. Total of fifty three patients in the age group of 10 years to 80 years were included in the study. Colorectal tumors were divided into right colon growths (caecum, ascending colon and hepatic flexure), left colon growths (splenic flexure, descending colon and sigmoid colon) and rectal growths. Data was collected from their hospital records and analysed using SPSS computer program.

Results: In present study incidence of colorectal cancer was 0.2 per 100,000 people. Thirty percent of our patients were found to be in the sixth decade of their life with male preponderance in almost every age group. Mean age of presentation being 46.44 years (males= 48.5years, females= 43.76years). Out of 53 patients, rectal growths constituted 36%, left colonic growths 36% followed by 28% cases of right colonic growths. More than one symptom was present in several patients. Maximum number of patients (43%) presented with anemia (microcytic hypochromic) with Hb of <9gm% followed by constipation 38% and bleeding per rectum 28%. Pain abdomen was present in 23% of patients. Loss of weight and diarrhoea was equally seen in 19% of patients. Diarrhoea was seen in 6 males and 4 females and was statistically significant (p<0.05).

Conclusions: Colorectal cancer was found to affect the Kashmiri patients at younger age (38% were 40 years or less) with peak incidence at sixth decade. Males were affected more than females. Anaemia, constipation and bleeding per rectum were the most common predominant clinical features in right colon, left colon and rectal growths respectively.


Keywords


Anaemia, Bleeding, Colorectal cancers, Constipation, Weight loss

Full Text:

PDF

References


Brown ML, Goldie SJ, Draisma G, Harford J, Lipscomb J. Health Service Interventions for Cancer Control in Developing Countries. Data from Ferlay and others. 2004. Chapter 29. Available at https://www.ncbi.nlm.nih.gov/books/NBK11756/.

Sameer AS, Ul Rehman S, Pandith AA, Syeed N, Shah ZA, Chowdhri NA, et al. Molecular gate keepers succumb to gene aberrations in colorectal cancer in Kashmiri population, revealing a high incidence area. Saudi J Gastroenterol. 2009 Oct;15(4):244-52.

Mohandas KM, Desai DC. Epidemiology of digestive tract cancers in India. V. Large and small bowel. Indian J Gastroenterol. 1999;18(3):118-21.

Laken SJ, Petersen GM, Gruber SB, Oddoux C, Ostrer H, Giardiello FM, et al. Familial colorectal cancer in Ashkenazim due to a hypermutable tract in APC. Nature Genetics. 1997 Sep;17(1):79.

Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1999. CA Cancer J Clinicians. 1999 Jan;49(1):8-31.

Abdalla AA, Musa MT, Khair RZ. Presentation of colorectal cancer in Khartoum teaching hospital. Sudan J Med Sci. 2007;2(4):263-5.

Woods SE, Narayanan K, Engel A. The influence of gender on colon cancer stage. J Women's Health. 2005 Jul 1;14(6):502-6.

Eltinay OF, Guraya SY. Colorectal carcinoma: Clinico-pathological pattern and outcome of surgical management. Saudi J Gastroenterol. 2006 Apr 1;12(2):83-6.

Sabiston D, Lyerly KL. The biological basis of modern surgical practice. Philadelphia: WB. Saunders. 1995;32(9):1020-30.

Garden OJ, AW B. Forsythe J. Principles and practice of surgery. City: Churchill Livingstone. 2002;23:343-8.

Buechter KJ, Boustany C, Caillouette R, Cohn I. Surgical management of the acutely obstructed colon: a review of 127 cases. Am J Surgery. 1988 Sep 1;156(3):163-8.

Verschueren RC, Mulder NH, Van AL, De AR, Szabo BG. The anatomical substrate for a difference in surgical approach to rectal cancer in male and female patients. Anticancer Res. 1997;17(1B):637-41.

Ragland JJ, Londe AM, Spratt JS. Correlation of the prognosis of obstructing colorectal carcinoma with clinical and pathologic variables. Am J Surgery. 1971 May 1;121(5):552-6.

Barillari P, Aurello P, De RA, Valabrega S, Ramacciato G, D'Angelo F, et al. Management and survival of patients affected with obstructive colorectal cancer. Int Surgery. 1992;77(4):251-5.

Öhman U. Prognosis in patients with obstructing colorectal carcinoma. Am J Surgery. 1982 Jun 1;143(6):742-7.

Loefler I, Hafner CD. Survival rate in obstructing carcinoma of colon. Arch Surgery. 1964 Oct 1;89(4):716-8.

Welch JP, Donaldson GA. Management of severe obstruction of the large bowel due to malignant disease. Am J Surgery. 1974 Apr 1;127(4):492-9.

Serpell JW, McDermott FT, Ketrivessis H, Hughes ESR. Obstructing carcinomas of the colon. Br J Surg. 1989;76:965-9.

Kingston RD, Walsh SH, Jeacock J. Physical status is the principal determinant of outcome after emergency admission of patients with colorectal cancer. Ann Royal Coll Surge England. 1993 Sep;75(5):335-8.

Baquet CR, Horm JW, Gibbs T, Greenwald P. Socioeconomic factors and cancer incidence among blacks and whites. J National Cancer Inst. 1991 Apr 17;83(8):551-7.

Stapley S, Peters TJ, Sharp D, Hamilton W. The mortality of colorectal cancer in relation to the initial symptom at presentation to primary care and to the duration of symptoms: a cohort study using medical records. Br J Cancer. 2006 Nov;95(10):1321.

Postlethwait RW. Malignant tumors of the colon and rectum. Annals Surgery. 1949 Jan;129(1):34.