Colorectal Cancer in Egypt: Clinical, Life-Style, and Socio-Demographic Risk Factors

INTRODUCTION

CRC is a type of cancer that affects the colon and rectum. The mucosa of the colon, rectum, or both are the commonest site of origin.¹

CRC affects people of all races and ethnicities.² It is the third most often recognized cancer in the world, behind lung and breast cancer. In developed regions and countries, such as Europe, North America, and Australia, the greatest rates (60%) are seen. In developing areas, such as Africa and South-Central Asia, the rate was lower. In 2008, over 1.200000 new CRC patients were diagnosed worldwide, with 608,700 deaths, so that it is the 4th most reported reason for cancer death, reporting about 8.0 % of all cancer deaths (1). In the United States, CRC is the 4th more reported cancer.³

In Egypt, the estimated rate of CRC is 6.5 % of all malignant tumors,⁴ CRC became the sixth most commonly recorded tumor in the years 2002-2003, regarding the National Cancer Institute registry at Cairo University.⁵ It was 4.2 % in men and 3.8 % in females.⁶ CRC is also widespread in Egypt, with 14.0 % of all colonoscopies revealing the presence of the disease.⁷

A population-based study in Garbiah, Egypt has reported higher the rates of colorectal cancer in cases aged 40 years and younger. This rate was slightly higher than rate of the same age groups in the US.⁸

CRC affects both men and women.² It is the 3rd most reported cancer in males and the 2nd most common cancer in females.¹ In Egypt, a low rate of CRC (6.9/100,000 for men and 5.1/100,000 for women) were recorded by the Middle East Cancer Consortium in the duration of 1999 -2001.⁹ Also, a lower rate was recorded from Garbiah Cancer Registry in Egypt for duration from 2000-2002; Age-standardized incidence rates (ASRs) were 6.5/100,000 for men and 4.2/100,000 for women.⁸

High socioeconomic status (SES) is also related to an elevated risk of the development of colorectal cancer. It is predicted that CRC risk being approximately 30.0% increase in the lowest in comparison with the highest SES quintile.^10,11

There is also evidence that lifestyle can increase the risk of cancer and that changing one's lifestyle can significantly reduce the cancer burden.¹²

Quitting smoking, increasing physical activity, losing weight, improving diet, and restricting alcohol consumption are the most considerable risk factors that can be modified to decrease the risk of many cancers.¹³ When determining the cancer prevention measures that will be used to change these risk factors, it's also important to consider genetic data that can determine the impact of changing these factors,¹⁴ It is estimated that 50.0 % of cancer can be avoided as a result of the large effect of changing one's lifestyle on the most common tumors.¹⁵

Aim of this study was to determine the clinical, lifestyle, and socio-demographic risk factors of colorectal cancer in Egypt.