Young Age and Advanced Disease on Presentation of Pakistani Colorectal Cancer Patients Referred for CT Staging

Abstract

Background: Colorectal cancer is the fourth leading cause of cancer death worldwide.  There are very limited data about colon cancer in Pakistan and this deficiency precludes serious efforts towards early detection and screening. 

Objective: The aim of this study was to elucidate the extent and CT stage of disease in newly diagnosed Pakistani colorectal cancer patients.

Methods: Consecutive patients with newly diagnosed colorectal cancer referred for CT staging were included in this retrospective study.  Data extracted from the records included demographic data as well as data from the CT scan reports.

Results:  98 consecutive patients with colorectal cancer referred for staging CT were included in this study.  The average age was 49 years and 44% (43) were less than age 50.  52% (51) were male. 

The rectosigmoid was the most common tumor site, accounting for 77% (75) of tumors.  The left side of the colon, including the descending colon, sigmoid colon, and rectum, was the site of 83% (81) of the tumors.  38% (37) had CT evidence of disease limited to the tumor site without lymphadenopathy or metastatic lesions.  62% (61) had locoregional or distant metastatic lesions.  Regional lymphadenopathy was seen in 51% (50) of patients. 

Conclusions: The younger age at diagnosis, left side cancer predominance disease, and a significant proportion of patients with advanced malignancy at diagnosis highlights the need for a colon cancer screening program to reduce the incidence of this largely preventable disease.

Keywords: Colorectal cancer, cancer screening, CT