Design and methodology of a study on colorectal cancer in Johannesburg, South Africa

Bebington, Brendan; Singh, Elvira; Fabian, June; Kruger, Christine Jan; Prodehl, Leanne; Surridge, Daniel; Penny, Clem; McNamara, Lynne; Ruff, Paul

doi:10.1002/jgh3.12061

Cited by 19 publications

(31 citation statements)

References 24 publications

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“…A correlation between race and age was also demonstrated as the majority of young patients younger than 50 years old were black (32%) versus white patients (11%) ( P < 0.0001) (NCR 2013–2014) . The burden of disease in SA has also been a challenge to assess due to underreporting of CRC cases as registries are mainly limited to small urban areas …”

Section: Introductionmentioning

confidence: 99%

Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution

et al. 2019

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Background and Aim Epidemiological studies of colorectal cancer (CRC) in South Africa (SA) have been poorly characterized. Black and white SA population groups have demonstrated distinct CRC clinical presentations, suggesting that black SA patients follow a different carcinogenic pathway than their white counterparts. Thus, the aim of this study was to identify unique demographic and histopathological features associated with black SA patients to facilitate earlier diagnosis and to improve disease management. Methods This preliminary descriptive epidemiological study included 665 retrospective CRC cases diagnosed between the period 2011 and 2015 at the Charlotte Maxeke Johannesburg Academic Hospital. Demographic and histopathological features in black versus other race groups (ORG) were compared, and Student's t‐test, Chi‐square, and Fischer's exact tests were used for statistical analysis. Results Statistical analysis demonstrated that patients with left‐sided tumors of invasive adenocarcinoma were predominantly black and male. These patients were considerably younger when compared to ORG (median 56 vs 62 years, respectively), P < 0.0001. However, no significant propensity for other histological features was illustrated. Polyps were mostly tubular adenomas (51%) and tubulovillous adenomas (TVAs) (44%). TVAs were mostly high‐grade lesions (P < 0.0001) and associated with left‐sided CRC (P = 0.0325). Conclusion These findings verify that black SA CRC patients have an earlier disease onset in comparison to ORG; however, no increased tendency for tumor site, precursor lesion, stage of disease, or gender was evident. Thus, a deeper molecular characterization of CRC is required to understand the underlying causes associated with earlier disease onset in black SA CRC patients.

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Section: Introductionmentioning

confidence: 99%

Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution

et al. 2019

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“…A retrospective cohort study design was followed. Permission was granted to access the South African Medical Research Council (SAMRC) CRC study Research Electronic Data Capture (REDCap) database used to record variables for adult patients with CRC for a previous multidisciplinary, longitudinal cohort study ( 21 ). Relevant data of patients recruited specifically at the study hospital were retrieved and further supplemented with preoperative assessment data obtained from the Preoperative Assessment Clinic at the study hospital.…”

Section: Methodsmentioning

confidence: 99%

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

et al. 2021

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Introduction: A scarcity of local published data on colorectal cancer (CRC) postoperative complications, including postoperative ileus (POI), exists. POI is a temporary gastrointestinal (GI) state of absent or reduced gastric motility shown to increase patient morbidity, prolong length-of-stay (LOS), and intensify the healthcare resource burden. The pathogenesis of POI involves a neurogenic and inflammatory phase plus a pharmacological component.Aim and Objectives: This study aimed to determine centre-specific preoperative risk factors associated with the development of ileus post elective therapeutic CRC resection. The objectives were to determine whether patient demographics; functional status; comorbidities; GI history; pharmacotherapy (including neoadjuvant chemotherapy); and lastly neoadjuvant radiation and chemoradiation were associated with the development of POI.Method: Patients who underwent CRC resection between January 2016 and May 2019 were retrospectively identified from an existing database. Urgent—or non-therapeutic surgeries; surgeries with the complication anastomotic leak or GI obstruction; patients under 18 at the time of surgery or surgeries preceded by preoperative parenteral nutrition were excluded. A comparison was done of the incidence of exposure in the study cohort to investigated variables as potential risk factors for the complication POI.Results: A total of 155 patient cases were included, and 56 (36%) of them developed POI. Univariate comparison of patients who developed POI with demographic characteristics of patients who did not suggested that women were at lower risk to develop POI compared to men (p = 0,013; RR 0,56; 95% CI 0,36–0,89). Functional status suggested that all previous smokers were at a higher risk to develop POI compared to lifetime non-smokers (p = 0,0069; RR 1,78; 95% CI 1,17–2,70). Multivariable comparison of ≤ 5 qualifying parameters showed no significance.Conclusion: The high local incidence of POI in this patient population shows that intervention is required to reduce the POI rate and improve postoperative outcomes. This study suggests that for men and all patients with a history of smoking both, CRC resection preoperative recommendations with the intention to prevent POI should include instructions initiating the activation of preventive strategies like the Enhanced Recovery After Surgery (ERAS) programme. More studies are needed to adequately determine local perioperative risk factors for POI.

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“…The CRCSA cohort is a combined cross-sectional and longitudinal cohort of adults with CRC treated in Johannesburg, as described above. [15] Ethics approval for the study was obtained from the Human Research Ethics Committee (Medical) of the University of the Witwatersrand (ref. no.…”

Section: Methodsmentioning

confidence: 99%

“…To address the paucity of information on CRC in SA, the Colorectal Cancer in South Africa (CRCSA) study was established in 2016. [15] It is the first prospective, longitudinal cohort study to describe the clinical presentation, management and outcomes of CRC in SA patients. The study is based in Johannesburg, Gauteng, the largest and wealthiest city in SA, with a population of ~5.7 million people.…”

Section: The Colorectal Cancer In South Africa Studymentioning

confidence: 99%

It’s contrary – comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort

et al. 2020

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According to GLOBOCAN, colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancerrelated death, with 1.85 million new cases diagnosed worldwide in 2018. [1,2] The incidence of CRC appears to be increasing in emerging low-and middle-income countries (LMICs) owing to socioepidemiological transitions, including dietary changes, with countries in sub-Saharan Africa (SSA) reporting a notable increase in colorectal, breast and prostate cancer. [3,4] South Africa (SA) is no exception-the incidence of CRC is increasing steadily, and it was the sixth leading cause of cancer-related death in 2018. [1] It is noteworthy that apart from increasing incidence, the average age of CRC patients at the time of diagnosis in SSA is ~10 years younger than that observed in high-income countries (HICs). [5,6] In addition, other non-communicable diseases (NCDs), including diabetes and respiratory and cardiovascular disease, are on the rise, with the prevalence in SA being reported as two to three times higher than in HICs. [7] While there are no published data on comorbidity with CRC from SSA, many CRC cohorts from HICs describe a considerable comorbidity burden that adversely affects short-(30-day) and long-This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Design and methodology of a study on colorectal cancer in Johannesburg, South Africa

Cited by 19 publications

References 24 publications

Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution

Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

It’s contrary – comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort

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