Colorectal Carcinoma: an Update of Current Trends in Accra

ABSTRACT

BACKGROUND: Clinical experience and earlier studies indicate that the number of colorectal cancer cases seen annually in the Accra metropolis is increasing. OBJECTIVE: This study was aimed at providing a current update on colorectal cancer in Accra; Ghana. METHODS: A prospective study of confirmed cases of colorectal cancer diagnosed from January 1997 - December 2007. RESULTS: Three hundred and fifty-nine colorectal cancer cases were studied. Males were 192(53.5) and females 167(46.5) with an annual incidence of 32.6 new cases. The crude incidence rates were 12.53; 9.87 and 11.18 per 100;000 population for males; females and overall respectively. Rectal bleeding 185(51.1); abdominal mass 76(21.1); intestinal obstruction 62(17.3); intestinal perforation nine (2.5) and iron deficiency anaemia nine (2.5) cases were the main presentations. There were 168 (46.8) rectal and 191(53.2) colon tumours. Two hundred and thirty-one patients had laparotomy with 225 resections; and 128 patients for various reasons did not undergo surgery. The Astler Coller stages of the tumours at diagnosis were C2 84(36.7); C1 53(22.1); B2 49(21.4); D 17(7.4); B1 14(6.1) and A 12(5.1) cases. Adenocarcinoma was the commonest histological type 321(89.4); with the majority either well-differentiated (62.5) or moderately well-differentiated (25.6) carcinomas. Poorly differentiated carcinomas accounted for 28 cases (7.8). Post-operative mortality was 6.1. Long term survival could not be assessed as the majority of patients were lost to follow up. CONCLUSION: The incidence of colorectal cancer has increased over the last four decades in tandem with an aging population of Accra with adenocarcinoma as the predominant histological type