Laterality of Colorectal Cancer (CRC) in Oman

Abstract

Introduction: Colorectal cancer (CRC) is the first most predominant malignancy in men, a bit less 3rd commonest in women. The prevalence rate is higher in developed than in developing economies, though the pattern is gradually changing. In Oman, CRC prevalence rate has shown a significant escalating pattern in the recent past. From 1996 to 2012, CRC incidence in Oman has increased by 282% in females and 386% in males. There is emerging data that right and left sided lesions are different in terms of aetiology, pathogenesis, biologic behaviour, genetic makeup, response to treatment and outcome. This study has looked at this issue in the Omani population of CRC. Methods: Eligible CRC patients treated at the Royal Hospital were identified from electronic medical record (Al-SHIFA 3) and Oman cancer registry data base (Ministry of Health) from 1998-2013. The BMI (body mass index), age, gender, stage, tumour location, K-Ras status, and Diabetes mellitus (DM) were explored. The RAS mutation status test (mutant type MT or wild type WT) was carried out in Lab21. Log regression was conducted to estimate the association between food intake, BMI, presence of metabolic syndrome, and level of physical activity with both cancers. Data was analysed using the SPSS. Results: Total number of patients treated at Royal Hospital were 492, 193 females (44%) and 214 males (56%). About 71.9% of patients were less than 60 years of age. The obese and overweight patients were 201 (57.3%). The rectum was found to be the predominant site of the tumor. The left sided tumors were significantly higher, 4 out of every 5 tumors (80.3% Vs 16.4%). The patients with right sided CRC were slightly younger, had a higher BMI, and more likely to be diabetic. The tumors of the left colon are more K-ras wild while those of the right colon are more K-ras mutant. Conclusions and Discussion: The right sided tumors as per our study are younger; with significant obesity, diabetes, and K-Ras mutant, and this correlates with high meat and protein consumption in the Omani population. The sidedness or laterality of CRC needs further study in Oman. There is emerging data that right and left-sided lesions are different in terms of etiology, pathogenesis, biologic behaviour, genetic makeup, response to treatment and outcome.

Health-Related Quality of Life of Omani Colorectal Cancer Survivors

“…These findings support those reported by previous studies conducted in Oman and neighboring countries which indicate that CRC in this region of the world is diagnosed at a younger age and more advanced stage compared to Western populations, particularly if patients are obese, overweight, or have existing comorbidities such as diabetes. [24][25][26] With regards to the functional scale of the EORTC QLQ-CR29, the mean score for body image in this study was high (88.9), while those for weight (79.3) and anxiety (75.4) were satisfactory. Previous studies conducted in nearby countries such Saudi Arabia, Jordan, and Egypt have shown that Arab CRC patients demonstrate similarly high scores in terms of functioning.…”

“…These findings support those reported by previous studies conducted in Oman and neighboring countries which indicate that CRC in this region of the world is diagnosed at a younger age and more advanced stage compared to Western populations, particularly if patients are obese, overweight, or have existing comorbidities such as diabetes. 24 – 26 …”

Assessment of Immunohistochemical Expression of CD44 in Colorectal Adenoma and Colorectal Carcinoma

“…Colorectal cancer (CRC) is a foremost global health concern and remains one of the major causes of cancer-related morbidity and mortality in both developed and developing countries (14) . It is the third most common cancer in adults after lung cancer and breast cancer worldwide.…”