Incidence and clinicopathological features of colorectal cancer among multi-ethnic patients in Kuala Lumpur, Malaysia: a hospital-based retrospective analysis over two decades

Abstract

Background The incidence rate of colorectal cancer (CRC) in Asian countries is increasing. Furthermore, recent studies have shown a concerning rise in the incidence of CRC among younger patients aged less than 50 years. This study aimed to analyze the incidence trends and clinicopathological features in patients with early-onset CRC (EOCRC) and later-onset CRC (at age ≥ 50 years). Methods A retrospective analysis was performed on 946 patients with CRC diagnosed from 1997 to 2017 at Universiti Kebangsaan Malaysia Medical Centre. The time trend was assessed by dividing the two decades into four 5-year periods. The mean age-standardized and age-specific incidence rates were calculated by using the 5-year cumulative population of Kuala Lumpur and World Health Organization standard population. The mean incidence was expressed per 100,000 person-years. Results After a stable (all age groups) CRC incidence rate during the first decade (3.00 per 100,000 and 3.85 per 100,000), it sharply increased to 6.12 per 100,000 in the 2008–2012 period before decreasing to 4.54 per 100,000 in the 2013–2017 period. The CRC incidence trend in later-onset CRC showed a decrease in the 2013–2017 period. Contrariwise, for age groups of 40–44 and 45–49 years, the trends showed an increase in the latter 15 years of the study period (40–44 years: 1.44 to 1.92 to 2.3 per 100,000; 45–49 years: 2.87 to 2.94 to 4.01 per 100,000). Malays’ EOCRC incidence rate increased from 2008–2012 to 2013–2017 for both the age groups 40–44 years (1.46 to 2.89 per 100,000) and 45–49 years (2.73 to 6.51 per 100,000). Nearly one-fifth of EOCRC cases were diagnosed at an advanced stage (Dukes D: 19.9%), and the majority of them had rectal cancer (72.8%). Conclusion The incidence of EOCRC increased over the period 1997–2017; the patients were predominantly Malays, diagnosed at a later stage, and with cancer commonly localized in the rectal region. All the relevant stakeholders need to work on the management and prevention of CRC in Malaysia.

Dietary Inflammatory Index, Obesity, and the Incidence of Colorectal Cancer: Findings from a Hospital-Based Case-Control Study in Malaysia

“…It is generally recognised that specific food items are more likely to trigger chronic gut inflammation, which eventually induces cancer cell proliferation. For instance, a pro-inflammatory western-style diet high in red meat, processed meat, fat, and refined grains may trigger the inflammatory process in the colon that leads to colorectal carcinogenesis, whereas anti-inflammatory diets rich in fruits, vegetables, and fibre may reduce gut inflammation and thus protect against CRC risk [ 6 , 7 , 8 , 9 , 10 , 11 ]. Therefore, assessing the potential impact of diet on inflammation could aid in the development of dietary strategies to reduce inflammation and the risk of CRC.…”

Development and Validation of a Dual Language Needs Assessment Tool for People Living With Colorectal Cancer (NeAT-CC)

“…Compared to the previous questionnaires more items related to nancial and employment needs were included in the NeAT-CC, in line with expert recommendations [11]. Notably, the high proportion of younger individuals with colorectal cancer (< 50 years) [50], the high risk of nancial toxicity following a cancer diagnosis [31] and high unmet employment needs amid limited employment protection policies [19] in our settings, necessitated the inclusion of these domains. Moreover, the needs relating to traditional and complementary medicine that were covered in our tool re ect the cultural beliefs of our multiethnic population.…”

Exploration of Malaysian Stakeholders View on Barriers to and Facilitators of Colorectal Cancer Screening Among Older Population

“…For this category, all Malaysians aged ≥40 with no previous history or current diagnosis of any form of cancer were eligible to participate in this study as the age group is commonly associated with the diagnosis of CRCs in low- and middle-income countries. 10 The health care workers consisted of medical officers, postgraduate medical officers, clinical specialists, and academicians from the Department of Primary Care Medicine and Department of Surgery in UMMC with experience in handling CRC screenings and related illnesses. Meanwhile, the policymaker category comprised public health medicine specialists heading various MoH divisions.…”