Colorectal cancer is the most common malignancy in the gastrointestinal tract. Worldwide, colorectal cancer shows large geographic differences, with a crude incidence of 6.5/7.7 cases per 100,000 females/males in less developed areas as opposed to 50.9/60.8 in more developed regions. Adenocarcinoma is the most common type of colorectal malignancy responsible for more than 90% of the cases. Recent technological advances in computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI) have made the diagnosis easy and accurate. Although surgery is the mainstay of treatment, radiotherapy (RT) and chemotherapy (CT) play a vital role, particularly in locally advanced tumours. A prospective study of 72 patients of colorectal malignancy conducted during a period of 24 months JUNE 2013-June2015 in GGH, and Kakinada.

Background: Despite colorectal carcinoma being one of the common cancers with an increasing incidence over the past few decades, there are only a few studies that have assessed its demographic, clinical, and pathological profile in the north Indian population. Objective: To assess the demographic and clinicopathological patterns of colorectal cancer (CRC) among patients in the subhimalayan region of North IndiaMaterials and Methods: This retrospective cross-sectional study analyzed the data of 244 patients with CRC who were referred to a state-owned medical college in Himachal Pradesh, India, between January 2016 and April 2020. Demographic, clinical, and pathological information was extracted from patient record files. Results: The mean age of patients in the study was 51.2 years, with an age range from 19 to 81 years. Approximately 48% of the patients were aged between 40 and 60 years, 15% were younger than 40 years, 56% of the patients were male, and 44% of the patients were female. Rectal bleeding (~46%), change in bowel habits (~41%), and abdominal pain (39%) were the common clinical symptoms. Overall, 73% of the patients were diagnosed at a mean duration of five months after the onset of their symptoms, and approximately 36% of the patients were in stage II and 48% were in stage III at the time of diagnosis. Colon carcinoma accounted for 76% of the patients, 17% had rectal carcinoma, 5% had carcinoma of recto-sigmoid, and 2% of the patients were diagnosed with ano-rectal carcinoma. Histopathologically ~ 81% patients had adenocarinoma, 14% had mucous carcinoma, 3% had signet ring carcinoma, and 2% had NET. Conclusions: In the subhimalayan region in North India, CRC has a higher male gender predominance, with a substantial number of patients younger than 40 years. Most of the cases are diagnosed after a mean duration of five months of the symptoms. Colon carcinomas are more common than rectal carcinomas, with left-sided colon carcinomas being more common than right-sided colon carcinomas. The majority of tumors are adenocarcinomas, whereas mucinous carcinomas are less common and signet ring carcinomas are rare. A greater number of patients with right-sided colon carcinomas have a higher stage and a more aggressive tumor grade at the time of diagnosis. The study also shows that there is a need to be more vigilant for colorectal carcinoma in patients with lower GIT symptoms and it lays emphasis on a colorectal screening program in such patients, to enable early detection of this tumor.