Abstract
Aim
Colorectal cancer is one of the major cancers in the developed world. The incidence of colorectal cancer is low in India. The aim of the present study was to describe the anatomical distribution and age at diagnosis of colorectal cancer in India.
Methods
Retrospective descriptive analysis of anatomical distribution, age at diagnosis and demography of 220 cases (149 [67.7%] men) of adenocarcinoma of the colon or rectum diagnosed at colonoscopy over a period of five years.
Results
The mean age at diagnosis was 58.4 years (SD 13.3; range 23–85 years). Twenty-eight (12.7%) cases were below the age of 40 years. The majority (31.8%) cases were aged between 61–70 years. Most of the tumors (n=163, 74%) were located distal to the splenic flexure. Multivariate logistic regression analysis showed that bleeding per rectum (OR 2.8; 95% CI 1.2–6.2) was associated with distal cancer, and palpable mass (OR 3.9; 95% CI 1.7–8.6) was associated with proximal cancer.
Conclusions
Almost one-third of the colorectal cancers in this series occurred in the seventh decade and were located distal to the splenic flexure.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Boyle P, Langman JS. ABC of colorectal cancer: Epidemiology. BMJ 2000;321:805–8.
Goh KL, Quek KF, Yeo GT, et al. Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy. Aliment Pharmacol Ther 2005;22:859–64.
Mohandas KM, Desai DC. Epidemiology of digestive tract cancers in India. V. Large and small bowel. Indian J Gastroenterol 1999;18:118–21.
Zafar SY, Abernethy AP, Abbott DH, et al. Comorbidity, age, race and stage at diagnosis in colorectal cancer: a retrospective, parallel analysis of two health systems. BMC Cancer 2008;8:345.
Pal M. Proportionate increase in incidence of colorectal cancer at an age below 40 years: an observation. J Cancer Res Ther 2006;2:97–9.
Qing SH, Rao KY, Jiang HY, Wexner SD. Racial differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients. World J Gastroenterol 2003;9:721–5.
Cheng X, Chen VW, Steele B, et al. Subsite-specific incidence rate and stage of disease in colorectal cancer by race, gender, and age group in the United States, 1992–1997. Cancer 2001;92:2547–54.
Cress RD, Morris C, Ellison GL, Goodman MT. Secular changes in colorectal cancer incidence by subsite, stage at diagnosis, and race/ethnicity, 1992—2001. Cancer 2006;107:1142–52.
Mensink PB, Kolkman JJ, Van Baarlen J, Kleibeuker JH. Change in anatomic distribution and incidence of colorectal carcinoma over a period of 15 years: clinical considerations. Dis Colon Rectum 2002;45:1393–6.
Fazeli MS, Adel MG, Lebaschi AH. Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum 2007;50:990–5.
Kim DH, Shin MH, Ahn YO. Incidence pattern of colorectal cancer in Korea by subsite of origin. J Korean Med Sci 2000;15:675–81.
Takada H, Ohsawa T, Iwamoto S, et al. Changing site distribution of colorectal cancer in Japan. Dis Colon Rectum 2002;45:1249–54.
Goh KL. Changing trends in gastrointestinal disease in the Asia-Pacific region. J Dig Dis 2007;8:179–85.
Bae JM, Jung KW, Won YJ. Estimation of cancer deaths in Korea for the upcoming years. J Korean Med Sci 2002;17:611–5.
Tamura K, Ishiguro S, Munakata A, Yoshida Y, Nakaji S, Sugawara K. Annual changes in colorectal carcinoma incidence in Japan. Analysis of survey data on incidence in Aomori Prefecture. Cancer 1996;78:1187–94.
Ahuja N, Chang D, Gearhart SL. Disparities in colon cancer presentation and in-hospital mortality in Maryland: a ten-year review. Ann Surg Oncol 2007;14:411–6.
Deo SV, Shukla NK, Srinivas G, et al. Colorectal cancers-experience at a regional cancer centre in India. Trop Gastroenterol 2001;22:83–6.
Boytchev H, Marcovic S, Oettle GJ. The characteristics of large bowel cancer in the low-risk black population of the Witwatersrand. J R Coll Surg Edinb 1999;44:366–70.
D’souza AL. Ageing and the gut. Postgrad Med J 2007;83:44–53.
Shah A, Wani NA. A study of colorectal adenocarcinoma. Indian J Gastroenterol 1991;10:12–3.
Stewart RJ, Stewart AW, Turnbull PR, Isbister WH. Sex differences in subsite incidence of large-bowel cancer. Dis Colon Rectum 1983;26:658–60.
Crerand S, Feeley TM, Waldron RP, et al. Colorectal carcinoma over 30 years at one hospital: no evidence for a shift to the right. Int J Colorectal Dis 1991;6:184–7.
Sharma VK, Vasudeva R, Howden CW. Changes in colorectal cancer over a 15-year period in a single United States city. Am J Gastroenterol 2000;95:3615–9.
Gomez D, Dalal Z, Raw E, Roberts C, Lyndon PJ. Anatomical distribution of colorectal cancer over a 10-year period in a district general hospital: is there a true “rightward shift”? Postgrad Med J 2004;80:667–9.
Nawa T, Kato J, Kawamoto H, et al. Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology. J Gastroenterol Hepatol 2008;23:418–23.
Abou-Zeid AA, Khafagy W, Marzouk DM, Alaa A, Mostafa I, Ela MA. Colorectal cancer in Egypt. Dis Colon Rectum 2002;45:1255–60.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Peedikayil, M.C., Nair, P., Seena, S.M. et al. Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy. Indian J Gastroenterol 28, 212–215 (2009). https://doi.org/10.1007/s12664-009-0087-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12664-009-0087-z