Demographic features of patients with colorectal carcinoma based on 14 years of experience at Jordan University Hospital

Abstract

BACKGROUNDColorectal cancer (CRC) is the third most common cancer worldwide. In the West, the incidence has stabilized or decreased. There are only occasional published studies that describe the epidemiology of CRC and its changing trends in Jordan and other Middle Eastern countries.OBJECTIVESDescribe the epidemiological features of CRC, predict future trends and compare the results with those from other Arab and Middle Eastern countries and the West.DESIGNRetrospective epidemiologic study.SETTINGTertiary center, teaching hospital.PATIENTS AND METHODSA retrospective study covering 14 years (2003 to 2016). All cases of CRC were retrieved from the computerized system. Demographic data were recorded and analyzed using Mathematica 11.2 and IBM SPSS version 23 software. Mathematical grey forecasting models were used to predict future trends.MAIN OUTCOME MEASURESNumber of cases and accumulated average over time, percentages of demographic variables and results of mathematical forecasting models.SAMPLE SIZE970.RESULTSThe male-to-female ratio was 1.5:1 and 97.4% were adenocarcinomas. The accumulated mean number of diagnosed cases doubled from 44.8 between 2003 and 2007 to 82.9 from 2008 to 2016. The accumulated annual average increased beginning in 2008. The forecasting models predicted a further increase in CRC. The mean age was 60.5 years and the median 62.0. Half of the cases presented at an advanced stage (TNM stage III or IV).CONCLUSIONCRC is increasing and is expected to increase further. Better health care planning that includes education and screening is needed to reverse these rising trends and to improve early detection.LIMITATIONSSingle institution study.

Incidence of colorectal cancer and survival rates of older patients in Turkey, 2002 – 2016: a population - based registry study

“…In addition, during this period, CIR per 100,000 increased across all time periods for both males (14.4, 16.8, and 21.9) and females (11.4, 10.7, and 13.7). These results are consistent with those of an earlier study reporting that the incidence of CRC was higher among males and that sex differences were the highest in the population aged ≥65 years 14 .…”

Colorectal Cancer in the Arab World

“…Majority of studies of CRC in Arab countries found that the most affected site is the rectum, followed by sigmoid and distal colon. This is similar to reports from western and regional countries [7,9,[11][12][13][14][15][16][17]. In fact, there is a noticeable shift toward proximal colon cancer in western countries which has been explained by the high success rate of CRC screening for detection of rectal and distal colon tumors, leaving the proximal colon cancer undetected till late in the disease [1,18,19].…”

“…From table 23.1, Comoros reported the least CRC Age-Standardized Rate (ASR) (4.5/100,000) of both genders among Arab countries, while Gaza Strip reported the maximum ASR (18.6/100,000). It is very noticeable from the GLOBOCAN report that there is a multi-fold increase in the ASR in this region compared to previously reported ASR in the region [4,[6][7][8][9].…”

“…The median age for CRC among Arabs is found to be 60+/− 15 compared to the average age of 70 years in Westernized countries. The population structure of Arabs might explain this finding as the majority of the Arab population are in this age group [7,9,[11][12][13][14][15][16] but more studies are needed to find out if this is a real increase in the incidence in this age group or is it the population structure effect. [7,9,[11][12][13][14][15][16].…”

“…The population structure of Arabs might explain this finding as the majority of the Arab population are in this age group [7,9,[11][12][13][14][15][16] but more studies are needed to find out if this is a real increase in the incidence in this age group or is it the population structure effect. [7,9,[11][12][13][14][15][16]. It has been attributed mainly to lack of screening, poor awareness of the disease early symptoms and disconnected healthcare system.…”