Aspects épidémiologiques, nutritionnels et anatomopathologiques des cancers colorectaux dans la région du grand Casablanca

Introduction: le cancer colorectal constitue un problème majeur de santé publique. L'objectif de notre étude est d'analyser le profil épidémiologique, nutritionnel, clinique et anatomo-pathologique des cancers colorectaux recrutés au CHU de Casablanca.Méthodes: notre étude cas-témoins a porté sur les patients pris en charge pour un cancer colorectal durant l'année 2015, comparés à des témoins non suivi pour un cancer. Résultats: l'âge moyen des patients était de 56,65 ans avec un écart type de 14,64. Le type histologique le plus fréquent chez nos patients était représenté par l'adénocarcinome Lieberkhünien avec une proportion de 82 %. L'analyse de l'indice de masse corporelle a permis de retrouver une obésité chez 50% des patients contre 20% des témoins et un diabète chez 19% des patients versus 8% des témoins (p < 0,019). Par ailleurs, l'étude du régime alimentaire des patients comparé à celui des témoins semble montrer que la moyenne de la fréquence de consommation hebdomadaire de viandes rouges est plus élevée chez les patients que chez les témoins (4,24 vs 3,26; p = 0,009) et inversement pour la consommation du poissons (0,97 contre 1,76; p = 0,0001). En revanche, la moyenne de consommation des légumes et des fruits est plus faible chez les patients que chez les témoins (5,00 vs 9,50; p = 0,0001). Concernant les habitudes toxiques de nos patients, 32% des patients étaient fumeurs vs 13 % des témoins.Conclusion: nos résultats montrent que la prise de conscience à propos du régime alimentaire et des changements dans nos habitudes de vie pourrait réduire l'incidence du cancer colorectal et par conséquent la mortalité et la morbidité

Emergence of colorectal cancer in West Africa : accepting the inevitable - review

It seems not too long ago that colon and rectal cancer was called a 'rare' disease in rural Africa, however over the last 30 years in West Africa, published evidence has shown decade by decade increases in the incidence of Colorectal cancer (CRC). Therefore CRC should now be accepted as a recognized disease in native Africans; nevertheless we must acknowledge that the incidence is a fraction of what obtains in the developed countries of Europe and America. This presentation will attempt to examine the emergence of CRC within the West African axis over the last 4 decades

Les cancers colorectaux en milieu hospitalier à Ouagadougou : aspects épidémiologiques et diagnostiques, approche endoscopique (à propos de 43 cas)

le but de l'étude est de décrire les aspects épidémiologiques et diagnostiques des cancers colorectaux en milieu hospitalier à ouagadougou. il s'est agi d'une étude rétrospective et transversale sur une durée de 9 ans et 6 mois. elle a concerné les malades porteurs d'une lésion colorectale suspecte de malignité à la coloscopie. les variables étudiées étaient sociodémographiques, cliniques, endoscopiques et histologiques. l'étude a été réalisée dans 5 structures sanitaires et 3 laboratoires d'anatomie pathologique. 43 lésions suspectes ont été histologiquement confirmées. la fréquence annuelle était de 4,53 nouveaux cas, le sexratio de 0,87 et l'âge moyen de 49,56 ans. les femmes au foyer (30,09%) et les employés subalternes (20,37 %) étaient les professions les plus concernées. il était retrouvé 26 cancers coliques (60,47 %) et 17 cancers du rectum (39,53 %). les formes bourgeonnantes (47,06 %) étaient les plus visualisées pour le cancer du rectum et ulcéro-bourgeonnantes, ulcéro-bourgeonnantes et sténosantes (26,92 % chacune) pour le côlon. l'adénocarcinome était le plus retrouvé (86,42 %). l'histologie et l'endoscopie étaient concordantes dans 65,49 % des cas. enfin les cancers colorectaux semblent rares dans notre pays. Toutefois, seule la mise en place d'un registre des cancers pourrait permettre d'en déterminer l'incidence réelle

Morphology of Colorectal Carcinoma among Nigerians: A 30-Year Review

Background: The incidence of colorectal carcinoma has been on the increase in the developing countries; including Nigeria; as a result of change in diet and adoption of western lifestyle. Objectives: The aim of this review is to highlight the prevalence; age and sex distribution; anatomical location; and morphological characteristics of colorectal carcinomas in Ilorin; Nigeria. Materials and Methods: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital; Ilorin; Nigeria; over a 30-year period (January 1979-December 2008); using the departmental record and histological slides of the cases. Result: A total of 241 cases of colorectal carcinoma were reported; 144 cases (60) in males and 96 cases (40) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years; while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2of the cases; while the least affected site is the descending colon (1.2). The exophytic occluding masses were found in 82.2of the cases; and the most common histological type is adenocarcinoma (77.2) with well-; moderately; and poorly differentiated forms constituting 52.3; 32.8; and 14.9respectively. Of the 241 cases that were seen over the last 30 years; 93 cases (38.6) were seen in the last 5 years. Conclusion: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control; with emphasize on colonoscopic screening for those with family history; and possibly making digital rectal examination a mandatory aspect of clinical examination; because most colorectal carcinomas are within the reach of examining finger

Colorectal carcinoma in Port Harcourt

Background: Colorectal carcinoma, the commonest malignant tumour of the gastrointestinal tract, is rather uncommon in Nigeria, occurring often at a relatively early age. Aim: To report experience with colorectal carcinoma in the University of Port Harcourt Teaching Hospital (UPTH). Methodology: Patients treated for colorectal cancer at the UPTH over a 19- year period (1987-2006) and had complete information, were studied. Data were collected from patients/' case notes, ward registers, theatre records and histopathology reports. The data were analyzed with respect to age, gender, clinical features and investigations. Other indices studied were treatment, postoperative complications, duration of hospital stay and outcome/mortality. Results: The records of 36 cases were available for study. Male to female ratio was 2:1. The 41-60 year age range recorded the highest number of cases (52.8%). Weight loss, change in bowel habit, rectal bleeding, and abdominal/rectal mass constituted the main symptoms. Diagnosis was made from clinical examination, double contrast barium enema and proctosigmoidoscopy/biopsy. The rectum and caecum/ascending colon were commonly affected. The appropriate surgical treatment was duly performed. Some patients had postoperative adjuvant treatment using 5-fluorouracil only. Postoperative complications included surgical site infection, persistent perineal discharge, perineal pain, and obstruction of colostomy, hepatic encephalopathy and obstructive uropathy. The average duration of hospital stay was 12 days and follow-up assessment ranged from 3 months to 14 years. The postoperative mortality at three years was high. Conclusion: Colorectal carcinoma is relatively uncommon in our environment. The younger age groups tend to be more affected. Late presentation resulted in poor survival in spite of surgical treatment and adjuvant therapy