Clinicopathological Assessment of Colorectal Carcinoma in Mymensingh Medical College Hospital, Bangladesh.

Colorectal carcinoma (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the US. It is mainly a disease of the developed countries with a western culture, yet the disease is not uncommon in developing countries. There is substantial geographical variation in the incidence and demographic characteristics of the disease. Variations are also observed in the risk factors, mode of presentation, sub site distribution and stage of the disease at presentation. This cross-sectional, descriptive study was intended to explore the age and sex distribution, pattern of presentation, sites and histological types of colorectal carcinoma. This cross-sectional, descriptive study was conducted in the department of surgery, Mymensingh Medical College Hospital, Bangladesh from October 2011 to September 2012. Purposively selected sixty patients irrespective of age and sex with histologically proven colorectal cancer were included in the study. A pre-tested, structured case record form was used for collection of data. Most of the patients (80.0%) were above 50 years of age. Mean age was 60.83 years with an SD of 11.2 years. Male to female ratio was almost equal (1.3:1). Positive family history was present in 3.3% cases. More than half of the patients (53.3%) were smokers, 76.7% patients had the history of taking fresh fruits irregularly. Pain in abdomen was the leading symptom followed by alteration of bowel habit and weight loss. Anaemia was found in 71.6% patients followed by wasting in 70.0% cases. Proctosigmoidoscopy was the principal diagnostic modality (61.7%) followed by double contrast barium enema (30.0%). Patients with rectal growth were detected by digital rectal examination (23.3%). Rectum was the principal site of cancer (36.7%) followed by sigmoid colon (33.3%). Cancer in caecum and ascending colon were in 15.0% and 6.7% patients respectively. Adenocarcinoma was the principal histological type (88.0%) and 36.7% were well differentiated carcinoma. Majority of the patients (63.3%) were in advanced stage (stage III and stage IV). Some forms of palliative surgical treatment were offered to all colorectal cancer patients in the study. Postoperative outcome was uneventful in most of the patients. However, there was wound infection in (13.3%) patients. Colorectal cancer was found mainly in elderly. Male and females were affected almost equally. Smoking was the most commonly found risk factor. Colorectal carcinoma involved rectum and sigmoid colon in majority of the patients. Adenocarcinoma was the principal histological type and the most of which were well differentiated. Majority of the patients were diagnosed at an advanced stage and palliative treatment was offered to them. Postoperative period was uneventful in most of them. Policies should be taken to promote health education & screening programmes which will lead to early diagnosis, affordable and effective treatment and better prognosis.