RETROSPECTIVE STUDY OF DISTRIBUTION OF COLORECTAL CANCERS IN NORTH COASTAL ANDHRA PRADESH

BACKGROUND Colorectal cancers are the third most common cancers in India. Indian data on epidemiological factors and site of distribution of colorectal cancers is very limited. Colorectal cancer is the fourth most common newly diagnosed cancer after ca prostate, ca breast, and ca lung. Age standardized incidence rate of colorectal cancer in developed countries is between 25 to 30 per 100,000 population. In India it is 3 to 4 per 100,000 population. High ratios of colon to rectal cancer (≥2: 1) prevail in high-risk areas such as North America. Ratios below 1 are often found in low-risk Asian and African populations. Temporal trends in western studies showed increase in proximal colon malignancies and decrease in distal colon and rectal malignancies. Western studies showed increase in rectal cancer in individuals less than 50 yrs. probably attributable to dietary changes. Screening Guidelines- Faecal occult blood test every 3 yrs, Sigmoidoscopy every 5 yrs., Colonoscopy every 10 yrs. MATERIALS AND METHODS This is a retrospective study of all diagnostic colonoscopies of patients aged 18 and above who presented to Department of Gastroenterology, KGH between 2007 and 2014. Data is drawn to age, sex and site of cancer and analysed. RESULTS 1045 oncoscopies were done. 129 cases were diagnosed as colorectal malignancies and confirmed by biopsy. 52 cases were seen in rectum. 42 cases were seen in ascending colon. 10 malignancies in transverse colon, 12 in descending colon, 13 in sigmoid colon, 65 cases approximating 50% were seen in rectum and sigmoid colon. CONCLUSION Colorectal malignancies are not as frequent in India as in western world. Observational studies show increasing incidence of colorectal malignancies probably related to increased fatty diet and decreased fibre diet. Carcinoma rectum is more common than ascending colon cancers in India which is also found in studies done in other geographical regions. This could be attributed to genetics, environmental factors and dietary habits. Routine colonoscopy as a screening method for colorectal cancers need not be enforced in our geographical area. This observation needs to be confirmed by further studies.