Colorectal Carcinomas in Uyo City, Southern Geopolitical Zone of Nigeria: A Review of Clinicopathological Characteristics and Literature

Abstract

Colorectal carcinomas (CRC) were initially thought to be rare in Africa including Nigeria, but recent studies have shown a reverse trend in our environment. This study is aimed to identify the clinical and pathological characteristics of CRC diagnosed between July 2006 and June 2015 in the University of Uyo Teaching Hospital, and a Private Specialist Laboratory, Uyo, Akwa Ibom State, Nigeria. All histological diagnosed cases of CRC seen in the two laboratories (University teaching and a private facility) in Uyo, Akwa-Ibom state, Nigeria during the study period were retrieved noting their bio-data, pathological and clinical variables. A total of 45 patients of age range 26-80 years with a mean of 55.9 years (SD 3.9) and a male to female ratio of 1.4:1 were seen. The two most common age groups affected in CRCs were 61-70 years (28.9%) and 51-60 years (24.4%) respectively. Majority of CRC patients were older than 40 years (86.7%) with identifiable predisposing factors being tubulo-villous adenoma (4 cases, 8.8%), villous adenoma (2 cases 4.4%), polyposis syndromes (2 cases, 4.4%) and schistosomiasis (1 case, 2.2%). Features of large intestinal obstruction were the most common presenting symptom of CRC (53.3%). Rectal bleeding, alteration in bowel habit and fecal incontinence were other symptoms, accounting for 33.3%, 8.9% and 4.4% of cases respectively. Left-sided CRCs were commoner (68.9%) with the majority appearing as annular-constricting type macroscopically (60.0%). Recto-sigmoid region was the preponderant site involved in CRC (29 cases, 64.5%). Adenocarcinoma (84.4%) was the most frequent histological subtype. Mucinous carcinoma, signet ring carcinoma and carcinoid tumor were other histologic subtypes seen in 8.9, 4.4 and 2.2% of cases respectively. The 22.0% of CRC patients presented at advanced stages of the disease. It can be concluded that majority of CRC patients were older than 40 years (86.7%) with features of intestinal obstruction (53.3%) and adenocarcinoma (84.4%) being the predominant mode of clinical presentation and histological subtype respectively.