Skip to main content

Advertisement

SpringerLink
Log in

Current Options in the Management of Colorectal Cancer in Developing Countries: Central America Experience

  • Surgery and Surgical Innovations in Colorectal Cancer (S Huerta, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of Review

Evaluate the current options in the management of colorectal cancer (CRC) in developing countries. We emphasize the experience in Central America, highlighting the disparities that persist in these countries as compared with developed countries; these are pronounced in many aspects of the health-care system, including lack of health investment, education, and cancer research in the setting of a global increase in malignant diseases.

Recent Findings

Our analysis demonstrates a multifactorial problem with the absence of government initiatives. There is also lack of interest in the medical community in providing screening for potential curable diseases. Currently, colonoscopy is a screening test widely underutilized in industrialized countries. In developing countries, this is much more pronounced.

Summary

Central American countries suffer also from lack of current available data to provide an accurate assessment of the status of colorectal cancer. The current report demonstrates the most available evidence in the screening, diagnosis, and treatment of colorectal cancer, with a focus at a county hospital in Guatemala.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Colorectal cancer mortality rates in adults aged 20 to 54 years in the United States, 1970-2014. JAMA. 2017;318(6):572–4.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bishehsari F, Mahdavinia M, Vacca M, Malekzadeh R, Mariani-Costantini R. Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol. 2014;20(20):6055–72.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Helsingen LM, et al. Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline. BMJ. 2019;367:l5515.

    Article  PubMed  Google Scholar 

  5. Schoen RE, Weissfeld JL, Trauth JM, Ling BS, Hayran M. A population-based, community estimate of total colon examination: the impact on compliance with screening for colorectal cancer. Am J Gastroenterol. 2002;97(2):446–51.

    Article  PubMed  Google Scholar 

  6. Green AR, Peters-Lewis A, Percac-Lima S, Betancourt JR, Richter JM, Janairo MP, et al. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med. 2008;23(6):834–40.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Flood D, Chary A, Austad K, Coj M, Lopez W, Rohloff P. Patient navigation and access to Cancer Care in Guatemala. J Glob Oncol. 2018;4:1–3.

    PubMed  Google Scholar 

  8. Sanchez-Barriga JJ. Mortality trends and risk of dying from colorectal cancer in the seven socioeconomic regions of Mexico, 2000-2012. Rev Gastroenterol Mex. 2017;82(3):217–25.

    CAS  PubMed  Google Scholar 

  9. HA, C., Perfil clínico y manejo médico-quirúrgico de pacientes con diagnóstico de cáncer colorrectal [thesis]. 2009, Universidad de San Carlos de Guatemala: Guatemala. p. 55. One of the most specific study in this topic that shows statistic in Guatemala.

  10. Corral JE, Arnold LD, Argueta EE, Ganju A, Barnoya J. Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians. PLoS One. 2012;7(10):e48640.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sierra MS, et al. Cancer patterns and trends in Central and South America. Cancer Epidemiol. 2016;44(Suppl 1):S23–42.

    Article  PubMed  Google Scholar 

  12. Sierra MS, Forman D. Burden of colorectal cancer in Central and South America. Cancer Epidemiol. 2016;44(Suppl 1):S74–81.

    Article  PubMed  Google Scholar 

  13. Pedro Rizo-Ríos AG-R. Felipe Sánchez-Cervantes, Pedro Murguía-Martínez, Trends in cancer mortality in Mexico: 1990-2012. Med J Hospital General de Mexico. 2015;78:85–94.

    Google Scholar 

  14. Darío Fernando Burbano Luna MAM, García MÁC, Corona TP, Velázquez NNH, Espinoza YME, Urrutia JMG, et al. Epidemiology of colorectal cancer in patients under 50 years old in the Hospital Juárez of México. Endoscopia. 2016;28:160–5.

    Article  Google Scholar 

  15. Imran JB, Ochoa-Hernandez A, Herrejon J, Madni TD, Clark AT, Huerta S. Surgical approach to gallbladder disease in rural Guatemala. J Surg Res. 2017;218:329–33.

    Article  PubMed  Google Scholar 

  16. Imran JB, Ochoa-Hernandez A, Herrejon J, Ortiz C, Mijangos B, Madni T, et al. Barriers to adoption of laparoscopic cholecystectomy in a county hospital in Guatemala. Surg Endosc. 2019;33(12):4128–32.

    Article  PubMed  Google Scholar 

  17. Ochoa-Hernandez, A., et al., Emergent groin hernia repair at a County Hospital in Guatemala: patient-related issues vs. health care system limitations. Hernia, 2019.

  18. Benson AB, Venook AP, al-Hawary MM, Cederquist L, Chen YJ, Ciombor KK, et al. NCCN guidelines insights: colon cancer, version 2.2018. J Natl Compr Cancer Netw. 2018;16(4):359–69.

    Article  Google Scholar 

  19. Wells KO, Peters WR. Minimally invasive surgery for locally advanced rectal Cancer. Surg Oncol Clin N Am. 2019;28(2):297–308.

    Article  PubMed  Google Scholar 

  20. Imran JB, et al. Barriers to adoption of laparoscopic cholecystectomy in a county hospital in Guatemala. Surg Endosc. 2019.

  21. Argo, M., et al., Current status of local anesthesia for inguinal hernia repair in developing countries and in the United States. Hernia, 2019.

  22. Sergio Waldemar Macario Nimatuj, M., Maxi Alexander Méndez Morán, Jorge San José Gómez, Herman De Mata Quinto, José Ricardo Guzmán Villatoro, Cirugía Colorrectal Laparoscópica. Experiencia de los últimos 5 años de un solo Equipo Quirúrgico. Revista Guatemalteca de Cirugia 2018. 24. Demonstrate the lack of experience in minimal invasive approach in this country.

  23. HM, C., Aspectos clínicos, abordaje terapéutico y complicaciones más frecuentes en pacientes con diagnóstico de cáncer colorrectal, atendidos en el hospital escuela Roberto Calderón en el periodo del 1ro enero 2013 al 30 junio 2014. 2014, Universidad Nacional Autónoma de Nicaragua: Nicaragua. p. 59. One of the few studies availables in Central America about this topic.

  24. Tsoi KKF, Hirai HW, Chan FCH, Griffiths S, Sung JJY. Predicted increases in incidence of colorectal cancer in developed and developing regions, in association with ageing populations. Clin Gastroenterol Hepatol. 2017;15(6):892–900 e4.

    Article  PubMed  Google Scholar 

  25. Benson AB, Venook A, Al-Hawary MM, Arain MA, Chen YJ, Ciombor KK, et al. NCCN clinical practice guidelines in oncology (NCCN guidelines) rectal Cancer. J Natl Compr Cancer Netw. 2019.

  26. Matsuda T, Yamashita K, Hasegawa H, Oshikiri T, Hosono M, Higashino N, et al. Recent updates in the surgical treatment of colorectal cancer. Ann Gastroenterol Surg. 2018;2(2):129–36.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Polanco PM, Mokdad AA, Zhu H, Choti MA, Huerta S. Association of adjuvant chemotherapy with overall survival in patients with rectal cancer and pathologic complete response following neoadjuvant chemotherapy and resection. JAMA Oncol. 2018;4(7):938–43.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683–91.

    Article  PubMed  Google Scholar 

  29. Ginsberg GM, et al. Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis. Cost Eff Resour Alloc. 2010;8:2.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Issa IA, Noureddine M. Colorectal cancer screening: an updated review of the available options. World J Gastroenterol. 2017;23(28):5086–96.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Corter AL, Speller B, McBain K, Wright FC, Quan ML, Kennedy E, et al. Evaluating a multidisciplinary cancer conference checklist: practice versus perceptions. J Multidiscip Healthc. 2019;12:883–91.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Varela JE, Asolati M, Huerta S, Anthony T. Outcomes of laparoscopic and open colectomy at academic centers. Am J Surg. 2008;196(3):403–6.

    Article  PubMed  Google Scholar 

  33. Lopez RI, et al. Consensus on management of metastatic colorectal cancer in Central America and the Caribbean: San Jose, Costa Rica, August 2016. ESMO Open. 2018;3(3):e000315 This document includes the formal expert consensus recommendations in various scenarious in colorectal cancer.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Serrano PE, Gu CS, Husien M, Jalink D, Ritter A, Martel G, et al. Risk factors for survival following recurrence after first liver resection for colorectal cancer liver metastases. J Surg Oncol. 2019;120(8):1420–6.

    Article  PubMed  Google Scholar 

  35. Argo M, Timmerman C, Ochoa-Hernandez A, Ortiz C, Lopez-Huertas V, Huerta S. Current status of local anesthesia for inguinal hernia repair in developing countries and in the United States. Hernia. 2019;23(3):621–2.

    Article  CAS  PubMed  Google Scholar 

  36. Timmerman C, Hernandez AO, Ortiz C, Huertas VL, Lopez R, Huerta S. Current view on the nonoperative management of acute appendicitis in a county hospital in Guatemala. J Surg Res. 2019;237:108–9.

    Article  PubMed  Google Scholar 

  37. Huerta S, Murray B, Olson C, Patel P, Anthony T. Current evidence-based opinions in the management of adenocarcinoma of the rectum. Indian J Surg. 2009;71(6):356–62.

    Article  PubMed  Google Scholar 

  38. Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C, Fietkau R, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731–40.

    Article  CAS  PubMed  Google Scholar 

  39. Rahbari NN, Elbers H, Askoxylakis V, Motschall E, Bork U, Büchler MW, et al. Neoadjuvant radiotherapy for rectal cancer: meta-analysis of randomized controlled trials. Ann Surg Oncol. 2013;20(13):4169–82.

    Article  PubMed  Google Scholar 

  40. Song JH, Jeong JU, Lee JH, Kim SH, Cho HM, Um JW, et al. Preoperative chemoradiotherapy versus postoperative chemoradiotherapy for stage II-III resectable rectal cancer: a meta-analysis of randomized controlled trials. Radiat Oncol J. 2017;35(3):198–207.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Boland GM, Chang GJ, Haynes AB, Chiang YJ, Chagpar R, Xing Y, et al. Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer. Cancer. 2013;119(8):1593–601.

    Article  PubMed  Google Scholar 

  42. Grothey A, Sobrero AF, Shields AF, Yoshino T, Paul J, Taieb J, et al. Duration of adjuvant chemotherapy for stage III colon cancer. N Engl J Med. 2018;378(13):1177–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, et al. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005;352(26):2696–704.

    Article  CAS  PubMed  Google Scholar 

  44. Andre T, et al. Three versus 6 months of oxaliplatin-based adjuvant chemotherapy for patients with stage III colon cancer: disease-free survival results from a randomized, open-label, international duration evaluation of adjuvant (IDEA) France, Phase III Trial. J Clin Oncol. 2018;36(15):1469–77.

    Article  CAS  PubMed  Google Scholar 

  45. Bregni G, Rebuzzi SE, Sobrero A. The optimal duration of adjuvant therapy for stage III colon cancer: the European perspective. Curr Treat Options in Oncol. 2019;20(1):8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Hospital de San Benito, Peten, San Benito, Guatemala

    Anny Ochoa-Hernandez

  2. Department of Surgical Oncology, National cáncer institute “Dr. Bernard S. Valley” (INCAN), Guatemala City, Guatemala

    Karen Giron

  3. Department of Surgery, University of Texas Southwestern of Medical Center, Texas, USA

    Jennie Meier

  4. Department of Surgery, Hospital de San Benito, Peten, San Benito, Guatemala

    Ana Paulina Charchalac

Authors
  1. Anny Ochoa-Hernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen Giron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennie Meier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ana Paulina Charchalac
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anny Ochoa-Hernandez.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Surgery and Surgical Innovations in Colorectal Cancer

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ochoa-Hernandez, A., Giron, K., Meier, J. et al. Current Options in the Management of Colorectal Cancer in Developing Countries: Central America Experience. Curr Colorectal Cancer Rep 16, 49–54 (2020). https://doi.org/10.1007/s11888-020-00452-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11888-020-00452-5

Keywords

Search

Navigation