A retrospective study of colorectal cancer – An audit from a rural medical college hospital over a 6 year period

Abstract

Aim: Colorectal cancer (CRC) is one among the most common cancers all over the world. Though more number of CRC is diagnosed in India it is being underreported. Our aim was to study the data regarding demography and predominant presenting complaint of CRC patients. We also wanted to find out their correlation with the side of tumor and compare with available Indian and Western literature.Methods: A retrospective study was done to collect the data of 214 patients who underwent colonoscopy and diagnosed with CRC over a six-year period in a rural medical college hospital. Their age, gender, anatomical distribution, symptoms and histology reports were collected and analyzed. Results: The mean age of occurrence of CRC in our study was 59.5 years with majority of the cases in the age group 61-70 years. Twenty-seven patients (12.6%) with CRC were less than 40 years age. With 73.8% left sided tumors in our study, rectum was the most common site. As the predominant presenting symptom, bleeding per rectum [PR] and mass had statistically significant association with left sided and right sided tumors respectively. Conclusion: The side of the tumor can be related to the predominant presenting symptom. CRC is more common on left side with majority occurring in the rectum. This can be identified early by screening sigmoidoscopy. With lifestyle changes there is an increase in CRC in younger age even in rural population. In a rural population per rectal examination, sigmoidoscopy and colonoscopy are considered embarrassing which delays the diagnosis. So, a complaint of bleeding PR should not be taken lightly in age group more than 40. Persistent motivation regarding benefits of screening colonoscopy is important particularly in rural areas for early diagnosis and treatment, to reduce disease specific morbidity and mortality.