Past, present and future of colorectal cancer in the Kingdom of Saudi Arabia

Abstract

Background/Aims:The crude frequency of colorectal cancer (CRC) is second to breast cancer in the Kingdom of Saudi Arabia (KSA). To assess the future burden of CRC in the country, we designed a model that takes into consideration the recent lifestyle pattern and the growth and aging of the population.Methods:We compared CRC statistics for KSA (using data from the National Cancer Registry) with that from the Surveillance, Epidemiology and End Results (SEER) databases of the United States of America (USA). We used the Joinpoint regression program to identify changes in secular trends, while the GLOBOCAN 2002 software was used to project future incidence and mortality.Results:Between 1994 and 2003, age-standardized rates (ASRs) for CRC in KSA almost doubled, as compared to a nonsignificant decline in USA. Between 2001 and 2003, while the annual percent change (APC) of CRC incidence in the USA showed a nonsignificant decrease in females, APC in Saudi females showed a nonsignificant rise of six percent. On the other hand, the rising incidence among Saudi males, during the years 1999 to 2003, was significant, with an APC of 20.5%. The projection model suggested that the incidence of CRC in KSA could increase fourfold in both genders by the year 2030.Conclusions:In KSA, the present and expected increase in CRC rates is alarming. Pragmatic recommendations to face that challenge are discussed. The present work could serve as a model to study other prevalent types of cancer, particularly in developing countries.

Patients' Profile, Clinical Presentations and Histopathological Features of Colo-rectal Cancer in Al Hassa Region, Saudi Arabia

“…Nevertheless, this finding is comparable to other studies carried out in Saudi Arabia, suggested the possibility for the presence of a familial risk factors for the development of CRC among Saudis for which more controlled and validated studies are warranted (Mansoor et al, 2002;Al Jabreen, 2007). The current recommendation for CRC screening at the age of 50 would be of very questionable reliability as a high proportion of those patients will not be diagnosed by the time of the proposed screening (Mansoor et al, 2002;Ibrahim et al, 2008).…”

“…Ibrahim et al (2008) postulated correlation of changing trends in incidence and mortality of CRC with high and low rates areas, globally. The incidence is increasing much faster in areas where rate was formerly low, as in case of KSA.…”

“…If the 'subsite shift' is a true phenomenon, this might emphasize abandoning sigmoidoscopy and favoring pancolonoscopy or new modalities as the technique of choice for screening individuals at risk of colorectal cancer (Cancer Incidence Report Saudi Arabia, 2005). A changing pattern of CRC is reported in Saudi Arabia (Ibrahim et al, 2008). These studies were conducted in major tertiary care centre of mega Saudi cities (Isbister, 1992;Mansoor et al, 2002;Ibrahim et al, 2008).…”

“…A changing pattern of CRC is reported in Saudi Arabia (Ibrahim et al, 2008). These studies were conducted in major tertiary care centre of mega Saudi cities (Isbister, 1992;Mansoor et al, 2002;Ibrahim et al, 2008). Al Ahsa region in Eastern province is a mix of sub urban and rural population with a mix of traditional Arab and western living style.…”

Clinico-Pathological Patterns and Survival Outcome of Colorectal Cancer in Young Patients: Western Saudi Arabia Experience

“…In Saudi Arabia, CRC incidence, morbidity and related mortality have been steadily increasing over the past twenty years (Ibrahim et al, 2008). There were 904 new cases of CRC accounting for 10.2 % of all newly diagnosed cancer patients in 2008 (Bazarbashi et al, 2008).…”