Adenomatous polyposis coli in an elderly female Nigerian

Alese, Olatunji B.; Irabor, David O.

doi:10.4314/gmj.v43i3.55341

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…The enquirers ask why such low ADR figures should explain the perceived increase in the number of CRC cases [ 6 ]. The adenoma-carcinoma sequence as the explanation for CRC’s etiopathogenesis in this population has been questioned and alternative route or routes to the cancer’s development opined [ 17 – 19 ]. The rectosigmoid was the site in 77% of the polyps, and all the adenomatous lesions were also in this part of the colon.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Oluyemi¹,

Awolola²,

Oyedeji³

2016

Pan Afr Med J

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IntroductionColorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria.MethodsThis is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria.ResultsA total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis.ConclusionThe study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.

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Section: Discussionmentioning

confidence: 99%

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Oluyemi¹,

Awolola²,

Oyedeji³

2016

Pan Afr Med J

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“…Only four cases of adenomatous polyposis have been reported in Nigeria in the last 35 years [ 7 , 23 – 25 ], and two cases of hereditary nonpolyposis colon cancer have been reported within the last 15 years [ 26 ]. This relative absence of premalignant conditions like adenomatous polyps in the West African has been reported by several authors [ 8 , 12 , 21 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Colorectal Carcinoma: Why Is There a Lower Incidence in Nigerians When Compared to Caucasians?

Irabor

2011

Journal of Cancer Epidemiology

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Carcinoma of the colon and rectum is the 2nd commonest cancer in the United States; the leading cancer being lung cancer. It has been estimated that 130,200 new cases of colorectal cancer will be diagnosed annually while 56,300 sufferers will die from the disease (Murphy et al., 2000). In developing countries especially West Africa, the rate has not yet reached such magnitude. This suggests that there may be factors either anthropomorphic or environmental which may be responsible for this. The paper acknowledges the reduced incidence of colorectal cancer in native West Africans living in Africa and endeavours to highlight the various factors that produce this observation in medical literature. A diligent search through available literature on the aetiology, epidemiology and comparative anthropology of colorectal cancer was done. Internet search using Pubmed, British library online and Google scholar was also utilized. The rarity of adenomatous polyposis syndromes in the native West African contributes to the reduced incidence of colorectal cancer. Cancer prevention and cancer-protective factors are deemed to lie in the starchy, high-fiber, spicy, peppery foodstuff low in animal protein which many West African nations consume.

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“…Germline mutations in APC are also key factors in familial adenomatous polyposis syndrome. This syndrome is quasi-nonexistent in African populations, with only a few cases having ever been reported in the literature [54][55][56][57][58][59][60][61][62][63]. Mutations in the APC gene in CRC have been reported in more than 50% of cases [44].…”

Section: New Mutations In the Apc Genementioning

confidence: 99%

Clinicopathological Characteristics and Mutational Landscape of APC, HOXB13, and KRAS among Rwandan Patients with Colorectal Cancer

Manirakiza

Rutaganda

Yamada

et al. 2023

CIMB

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Cancer research in Rwanda is estimated to be less than 1% of the total African cancer research output with limited research on colorectal cancer (CRC). Rwandan patients with CRC are young, with more females being affected than males, and most patients present with advanced disease. Considering the paucity of oncological genetic studies in this population, we investigated the mutational status of CRC tissues, focusing on the Adenomatous polyposis coli (APC), Kirsten rat sarcoma (KRAS), and Homeobox B13 (HOXB13) genes. Our aim was to determine whether there were any differences between Rwandan patients and other populations. To do so, we performed Sanger sequencing of the DNA extracted from formalin-fixed paraffin-embedded adenocarcinoma samples from 54 patients (mean age: 60 years). Most tumors were located in the rectum (83.3%), and 92.6% of the tumors were low-grade. Most patients (70.4%) reported never smoking, and 61.1% of patients had consumed alcohol. We identified 27 variants of APC, including 3 novel mutations (c.4310_4319delAAACACCTCC, c.4463_4470delinsA, and c.4506_4507delT). All three novel mutations are classified as deleterious by MutationTaster2021. We found four synonymous variants (c.330C>A, c.366C>T, c.513T>C, and c.735G>A) of HOXB13. For KRAS, we found six variants (Asp173, Gly13Asp, Gly12Ala, Gly12Asp, Gly12Val, and Gln61His), the last four of which are pathogenic. In conclusion, here we contribute new genetic variation data and provide clinicopathological information pertinent to CRC in Rwanda.

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Adenomatous polyposis coli in an elderly female Nigerian

Cited by 5 publications

References 8 publications

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Colorectal Carcinoma: Why Is There a Lower Incidence in Nigerians When Compared to Caucasians?

Clinicopathological Characteristics and Mutational Landscape of APC, HOXB13, and KRAS among Rwandan Patients with Colorectal Cancer

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