Increase Young Age Incidence of Colorectal Carcinoma Among Cohort of Egyptian Population.

INTRODUCTION

Colorectal carcinoma (CRC) is not uncommon cancer moreover it is a leading cause of cancer related death worldwide.¹

In Egypt CRC represented the seventh most common cancer and the third most common male neoplasm and fifth most common female neoplasm. ²

Early screening and diagnosis of CRC plays a crucial role in improving the prognosis and decreasing the CRC related mortality rate,³ fortunately there is approved guidelines for CRC screening that greatly helps in prevention and early detection.⁴

Although the standard age for CRC screening is above 50 years old,there is a new emerging term of early onset colorectal carcinoma (CRC diagnosed before the age of 50 years old). ⁵ Even more suggestion of CRC screening in average-risk individuals between ages 45 and 49 years to reduce incidence of advanced adenoma, CRC, and mortality from CRC still Conditional recommendation of very low-quality evidence.⁶

  So, we feel that more studies addressing age distribution changes related to Colorectal carcinoma and lacking well established guidelines for screening

below standard age leading to missing of many cases of early onset colorectal carcinoma.⁷

In Egypt also more studies were needed to clarify age distribution related to CRC, ^8,9 So we conducted this study for revision age incidence of colorectal carcinoma among Egyptian population.  

PATIENTS AND METHODS

In retrospective study we investigated the demographic data of 965 patients those had been diagnosed as colorectal carcinoma over eighteen years from 2000 to 2018, data had been collected from the medical records at gastroenterology and endoscopy units at Tanta university hospital and Kafr Elsheikh university hospital, Egypt (both are tertiary care hospitals covering most of Egyptian Nile delta region), we included 965 patients those who had investigated by colonoscopy for different clinical presentations and had been  diagnosed as colorectal carcinoma at first time colonoscopy examination, we excluded patients already known to have CRC or those came for follow up of CRC. Data were retrieved from patients' files included demographic data age, sex and special habits as well as site of CRC, data statically analysed.

The research was conducted in line with the ethical principles of the Declaration of Helsinki.

Statistical Analysis:

Data were collected and tabled, other demographic data were studied and analyzed, the full detailed form is SPSS 20, IBM, Armonk, NY, United States of America.

Quantitative data were expressed as mean ± standard deviation (SD).

RESULTS

There was progressive increase in the number of patients diagnosed to have CRC over yeas from 2000 to 2018 (table 1).

However, the mean age of all studied patients was 50.63 years old with standard deviation 14.02 as shown in (table 2), still 46.4% of total patients were below the age of 50 years old as shown in (table 3).

Male predominance in the incidence of CRC in our studied patients, as male   represent 52.6 % of total studied patients versus 47.4 % females as shown in (table 4).

Left side cancer were obviously predominant in our studied patients as mainly rectosigmoid cancer were diagnosed in 35.9% of studied patients as well as cancer in descending colon represents 26.9% in our studied patients versus 7.5% and 8.2% in ascending and transverse colon respectively as shown in (table 5).

Table 1: number of cases per year.

Table 2: Distribution of patient's age.

                                                                                                             Table 3: Distribution of patient's age above and below 50 years old.

Table 4: Distribution of patient's sex.

Table 5: characters of studies patients and related Colorectal carcinoma.