Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Abstract

Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ 2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

Clinical-Pathological Characteristics of Colorectal Carcinoma and Factors Influence 2-Years Survival among Patients Attending Ocean Road Cancer Institute Dar es Salaam Tanzania

“…The majority of patients diagnosed with CRC are males, In general, a four-to ten-year age difference by gender has been reported, with female incidence higher in the age range of 70 -74 and male incidence higher in the age range of 60 -64 [2].…”

“…There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015 [2]. Although estimates seem to suggest that the incidence is low, there is significant under-diagnosis and under-reporting.…”

Dietary pattern as a predictor of colorectal cancer among general health population in Arusha Tanzania: A population based descriptive study

“…This pattern may be related to a 2% increase in rate of colon cancer and 1.5% decrease in rate of rectal cancer found in the pattern and distribution of CRC in Tanzania study (Katalambula et al, 2016). Evidence has linked colon cancer with lifestyle factors more than rectal cancer (Pischon et al, 2006).…”

“…It is hypothesized that, a number of factors may be acting either singly or in combination to influence the observed trend. Epidemiological studies suggest correlation between the incidence of CRC and several lifestyle factors (diet, alcohol intake, cigarette smoking, lack of physical activities, etc) and genetic factors (Katalambula et al, 2016). The authors decided to evaluate the status of these factors in the general population of Arusha Tanzania.…”

Colorectal Cancer in Northern Tanzania: Increasing Trends and Late Presentation Present Major Challenges

“…7 In Tanzania, a six-fold increase in CRC incidence has been documented in the past decade, with the incidence in the Kilimanjaro region estimated at 4.4 per 100,000 population-the third highest in the country after Dar-es-Salaam and the Pwani region. 8 With our communities rapidly moving toward urbanization, alteration in diet and inactivity are among the major risk factors attributed to this observation. However, together with these behavioral changes, there are other unexplored genetic, familial factors and infectious causes whose contribution to the development of CRC in our population is yet to be fully investigated.…”