Changing trends in colorectal cancer: possible cause and clinical implications

Fisher, Mikhail; Fisher, Leon; Waxman, Bruce P.; Fisher, Alexander A.

doi:10.4236/health.2010.28127

Cited by 4 publications

(5 citation statements)

References 55 publications

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“…The reasons for this trend may include risk factors modification and improvements in medical intervention which are lacking in our setup compared to the developed world. Rise in incidence of colorectal cancer among young females as reported by few series is not evident in the present study (Fisher et al, 2010) The predominant symptom was bleeding per rectum compared to pain abdomen which was the most frequent symptom of the earlier time period. Bleeding per rectum, alteration of bowel habits and pain abdomen were the common modes of presentation in other series too (Fante et al, 1997;Fletcher, 2009).…”

Section: Discussioncontrasting

confidence: 69%

“…In our study, though the total number of patients with colorectal carcinoma was higher (120 vs 99 patients), the proportion of younger patients remained the same (28%). In contrast, there is a trend of decreasing incidence of colorectal carcinoma worldwide, the proportion of younger age groups is on an increase (Nelson et al, 1999;Fisher et al, 2010). This declining trend of CRC has largely been associated with an increase in screening rates in 50 yrs or older age groups.…”

Section: Discussionmentioning

confidence: 99%

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Changing Trends of Colorectal Carcinoma in Nepalese Young Adults

Кансакар¹,

Singh²

2012

Asian Pacific Journal of Cancer Prevention

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The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were 34±4.7 and 31.8±5.1 years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Changing Trends of Colorectal Carcinoma in Nepalese Young Adults

Кансакар¹,

Singh²

2012

Asian Pacific Journal of Cancer Prevention

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“…26,27 Fisher et al in his study suggested that estrogen receptor B predominantly present in colonic mucosa is responsible for preventing malignant change of colonic epithelial cells and their reduction have been shown in colonic adenocarcinoma. 28 Though different mechanisms how estrogen is responsible for causing or preventing colorectal tumorogenesis have been proposed, none of them have been really elucidated.…”

Section: Resultsmentioning

confidence: 99%

Histomorphological Profile of Colonoscopic Biopsies and Pattern of Colorectal Carcinoma in Kavre District

Rajbhandari

Karmacharya

Khanal

et al. 2015

Kathmandu Univ. Med. J.

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Background Colonoscopy is the method to visualize the mucosa of the entire colon and terminal ileum to detect the intestinal abnormalities and obtain biopsy for definitive diagnosis. For clinical decisions in the diagnosis of various colonic lesions unambiguous interpretation of colorectal biopsies is necessary. Objectives To assess the prevalence pattern of colonic diseases and to correlate the incidence of colorectal carcinoma with age, sex, site and symptoms presented at Dhulikhel Hospital. Methods The materials consisted of 126 biopsies which were submitted to the Department of Pathology, Kathmandu University School of Medical Sciences, Dhulikhel, during the period of July 2011- July 2012 .Data collected and entered in MS-Excel and were analyzed using SPSS-16. Results Out of 126 colonoscopic biopsies 34(27%) showed chronic nonspecific inflammation, followed by carcinoma 25(19.8%), non-neoplastic polyps 21(16.7%), granulomatous inflammation 14(11.1%), neoplastic polyps 8(6.3%), ulcerative colitis 4(3.2%) Miscellaneous lesions; Acute focal colitis, Eosinophilic colitis were also observed in 19 (15.1%). A higher frequency of colonic diseases in males with a male to female ratio of 1.4:1 and age range of two years to 84 years was observed. Out of 25 patients diagnosed with colorectal carcinoma,48% (n=12) were males and 52% (n=13) were females with a mean age of 55.17 years in men and 59.46 years in females. Male and female ratio among cancer groups was 1:1.08. Total 36% (n=9) were diagnosed with cancer before the age of 50. Out of these nine cases, 6( 66.7%) were males and 3(33.3%) were females. The male and female ratio in younger and older age groups were 2:1 and 1:1.7 . 17( 68%) of the lesions were left sided and 8(32%) were right sided. Below age 50 , left to Right sided lesions in males were 2:1 and in females 1:2. However, above 50 years the ratio among proximal and distal lesions were 5:1 in males and 2.3:1 in females. A statistically significant association was seen between the growth (p=0.000) and per rectal bleeding (p= 0.006) with carcinoma. Conclusion The most prevalent lesion in colorectal biopsies was non-specific colitis followed by carcinoma colon. The incidence of colorectal carcinoma is on rise in Nepalese society. Although colorectal carcinoma is more common in older age group the incidence are also increasing among young especially among women. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12503 Kathmandu Univ Med J 2013; 43(3):196-200

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“…Explanations for proximal shifting of colorectal adenomas are not clear: There may be a true increase in incidence in right-sided lesions (namely due to different genetic pathways of carcinogenesis between left and right locations 22,23 ) or adenoma detection rate may have improved due to implementation of various quality-assessment indicators during colonoscopy 24,25 (adenoma detection rate, recommended screening and surveillance intervals, adequate withdrawal times, and appropriate cecal intubation rates with photographic documentation 24 ).…”

Section: Discussionmentioning

confidence: 99%