KATHERESAN V¹, KESAVAN B², PONCHIDAMBARAM M², PRAKASHEN OK³, SIVASANKAR A^*

¹M.ch Resident, Department of Surgical Gastroenterology, Government Mohan Kumaramangalam Medical College and Hospital, Salem, TamilNadu, Email: kaddy7375@gmail.com; kesav_92@yahoo.co.in

²Associate Professor, Department of Surgical Gastroenterology, Government Mohan Kumaramangalam Medical College and Hospital, Salem, TamilNadu, Email: drponchi@gmail.com

³Assistant Professor, Department of Surgical Gastroenterology, Government Mohan Kumaramangalam Medical College and Hospital, Salem, TamilNadu, Email: prakashen.ok@gmail.com

*Corresponding author: Dr Sivasankar A M.ch., Professor and the Head of the Department, Department of Surgical Gastroenterology, Government Mohan Kumaramangalam Medical College and Hospital, Salem, TamilNadu, Email: gastrocon2020@gmail.com

Citation: Katheresan V, Kesavan B, Ponchidambaram M0, Prakashen OK, Sivasankar A*, (2022) Clinicopathological Trends of Colorectal Carcinoma Patients in a Tertiary Care Centre in South India. Int J Gastroenterol Hepatol Endosc, 1(1);1-5.

Copyright: © 2022, Sivasankar A*. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

ABSTRACT:

Background: Cancer is attributed to 10 million deaths worldwide in 2020. One in six deaths is due to Cancer. colorectal carcinoma ranked third contributing 1.93 million cases while deaths due to it stood second contributing 916000 next to lung cancer. The sustainable development goal 3 emphasizes on “Ensuring healthy lives and promote well-being for all at all ages”. Regular screening is the process of detecting colorectal cancer in patients with no symptoms. The treatment for colorectal carcinoma is surgical removal of primary tumor, adjuvant chemotherapy and palliative radiotherapy. Methodology: We reviewed data of colorectal carcinoma operated patients retrospectively for three consecutive years in a tertiary care centre in the South Indian State, Tamil Nadu (2018, 2019 & 2020). There were about 336 participants enrolled for the study. Their medical records were reviewed for data collection. Data collection was done by trained Senior Resident Doctors posted in the Department of Surgical Gastroenterology. Results: The study found that the colorectal carcinoma is highly prevalent in the 40 – 60 years age group. It is predominant among male. The most common anatomical location being rectum, rectosigmoid junction, right colon and sigmoid colon. The most common symptoms at presentation were anorexia, bleeding, constipation, altered bowel habits and weight loss. Well differentiated adenocarcinoma was the most common histopathological type in all the three years. Recommendations: The screening for the same can be done at a young age of 30 years itself as we do for other non-communicable diseases like systemic hypertension and diabetes. The symptoms at presentation ought to be explained in health education sessions to improve the general awareness of the public.

KEYWORDS: colorectal carcinoma, histopathological trends, trends in colorectal carcinoma, gastrointestinal tumours.

INTRODUCTION

Cancer is attributed to 10 million deaths worldwide in 2020. One in six deaths is due to Cancer [1]. Neoplasms/ tumors are abnormal growth of cells. They may be benign or malignant. Generally, benign tumors are slow growing and can’t spread to other tissues whereas malignant tumors grow rapidly and can spread to other organs known as metastasis. Incident cases of cancer account for 18.1 million cases universally in 2018 and is expected to rise to 29.4 million cases by 2040. Depending on the incidence of new cancer cases, colorectal carcinoma ranked third contributing 1.93 million cases while deaths due to it stood second contributing 916000 next to lung cancer [2]. The first target as per the WHO action plan for prevention and control of non-communicable diseases (2013 – 2020) is 25% reduction in overall mortality due to the major non-communicable diseases like cardiovascular diseases, diabetes, cancers and chronic respiratory diseases [3]. The sustainable development goal 3 emphasizes on “Ensuring healthy lives and promote well-being for all at all ages”. One of the indicators urges us to reduce mortality from NCD’s and promote mental health [4]. This is also in line with the WHO action plan for control of non-communicable diseases.

Genetic and environmental risk factors contribute to the development of colorectal carcinoma. The risk doubles if a first degree relative is diagnosed with colorectal cancer when his age is greater than 70 years. The risk triples if his age is less than 50 years when diagnosed [5].

Acquired risk factors include diet, lifestyle, side effects of medical interventions and medical co-morbidities. Diet includes reduced consumption of fruits, vegetables, dietary fibre and increased intake of red meat and saturated fats. Drinking coffee and alcohol adds to the risk. Lifestyle comprises sedentary lifestyle and smoking [6]. Most cancers of the colon start as a polyp. These are over growth of the cells on the inner walls of the colon. These are called adenomas which are non-cancerous and may take long time to develop into an invasive colon carcinoma. These adenomas can be removed surgically during a colonoscopy called polypectomy [7].

Regular screening is the process of detecting colorectal cancer in patients with no symptoms. This can eventually prevent colorectal cancer. The five-year survival rate for detection at an early stage is 90% for colorectal carcinoma [8].

The treatment for colorectal carcinoma is surgical removal of primary tumor, adjuvant chemotherapy and palliative radiotherapy [9]. Nowadays, endoscopic removal practices are also available which is entirely based on the stage and severity of the illness [10].