Demographic profile and clinicopathological patterns of colorectal cancer in subhimalayan North India

Abstract

Background: Despite colorectal carcinoma being one of the common cancers with an increasing incidence over the past few decades, there are only a few studies that have assessed its demographic, clinical, and pathological profile in the north Indian population. Objective: To assess the demographic and clinicopathological patterns of colorectal cancer (CRC) among patients in the subhimalayan region of North IndiaMaterials and Methods: This retrospective cross-sectional study analyzed the data of 244 patients with CRC who were referred to a state-owned medical college in Himachal Pradesh, India, between January 2016 and April 2020. Demographic, clinical, and pathological information was extracted from patient record files. Results: The mean age of patients in the study was 51.2 years, with an age range from 19 to 81 years. Approximately 48% of the patients were aged between 40 and 60 years, 15% were younger than 40 years, 56% of the patients were male, and 44% of the patients were female. Rectal bleeding (~46%), change in bowel habits (~41%), and abdominal pain (39%) were the common clinical symptoms. Overall, 73% of the patients were diagnosed at a mean duration of five months after the onset of their symptoms, and approximately 36% of the patients were in stage II and 48% were in stage III at the time of diagnosis. Colon carcinoma accounted for 76% of the patients, 17% had rectal carcinoma, 5% had carcinoma of recto-sigmoid, and 2% of the patients were diagnosed with ano-rectal carcinoma. Histopathologically ~ 81% patients had adenocarinoma, 14% had mucous carcinoma, 3% had signet ring carcinoma, and 2% had NET. Conclusions: In the subhimalayan region in North India, CRC has a higher male gender predominance, with a substantial number of patients younger than 40 years. Most of the cases are diagnosed after a mean duration of five months of the symptoms. Colon carcinomas are more common than rectal carcinomas, with left-sided colon carcinomas being more common than right-sided colon carcinomas. The majority of tumors are adenocarcinomas, whereas mucinous carcinomas are less common and signet ring carcinomas are rare. A greater number of patients with right-sided colon carcinomas have a higher stage and a more aggressive tumor grade at the time of diagnosis. The study also shows that there is a need to be more vigilant for colorectal carcinoma in patients with lower GIT symptoms and it lays emphasis on a colorectal screening program in such patients, to enable early detection of this tumor.