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.