A clinicopathologic analysis of colorectal cancers diagnosed by histology of colonoscopy-derived specimens in Lagos, Nigeria
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Rezumat
Introduction: Colorectal cancer (CRC) is one of the
leading causes of cancer-related deaths in Nigeria.
Emerging data indicate there is a gradual increment
in the uptake of colonoscopy as an essential tool in
CRC diagnosis in the country. This article seeks to
document the clinico-pathologic patterns of CRC that
were diagnosed via histology of colonoscopy-derived
samples and highlight differences and relationships
in site-specific disease.
Methods: This was a retrospective study over a
period of five years, carried out in two private medical
centres in Lagos State, Nigeria. Patients who had a
diagnosis of CRC from the histology of colonoscopy
derived tissue samples were included in the study.
The records were then scoured for the demographic,
clinical presentation and pathology data
Results: A total of 84 subjects were included in this
study and there were 47 (56%) males and 37 (44%)
females with a male to female ratio of 1.3:1. The
mean age and standard deviation was 56.6 ± 13.9
years. Thirty seven subjects (44%) were aged 50
years and below. Patients with left-sided disease
constituted the majority 64 (76.2%) in this series and
the most common colonic sub-site was the rectum/
rectosigmoid 35 (41.7%). Bleeding per rectum was
by far the commonest presenting complaint 45
(53.6%) and this was the only symptom that was
significantly associated with left-sided CRC (p=
0.003) while right-sided lesions were associated with
unexplained anemia (p= 0.032) and abdominal pain/
discomfort (p= 0.02). Adenocarcinoma was the most
frequently encountered histological subtype 61
(72.6%).
Conclusion: The study finds that a high proportion
of subjects afflicted with CRC are in the young age
groups. Hematochezia was the most common
presenting complaint and rectal/rectosigmoid the most
common colonic location of CRC lesions. A significant
relationship was found between sidedness and
specific symptoms at presentation.
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Referințe
Sung H, Ferlay J, Siegel RL, Laversanne M,
Soerjomataram I, Jemal A, et al. Global cancer
statistics 2020: GLOBOCAN estimates of
incidence and mortality worldwide for 36 cancers
in 185 countries. CA Cancer J Clin 2021; 71(3):
-249. doi: 10.3322/caac.21660
Colonoscopy and colorectal cancers in Lagos, Nigeria 137
Olorunda R and Abdulkareem FB. Fifty-three
years of reporting colorectal cancer in Nigerians
- a systematic review of the published literature.
The Nigerian Postgraduate Medical J 2014; 21(1):
-73. PMID: 24956622
Alatise OI, Olasehinde O, Olokoba AB, et al.
Colorectal cancer screening guidelines for
Nigeria in 2019. Niger J Gastroenterol Hepatol
; 11: 42-55. doi: 10.4103/
NJGH.NJGH_15_20
Schreuders EH, Ruco A, Rabeneck L, et al.
Colorectal Cancer Screening: A Global Overview
of Existing Programmes. Gut 2015; 64(10): 1637-
doi: 10.1136/gutjnl-2014-309086
Musa Y, Mohammed MF, Muhammad NO, et al.
Clinical, endoscopic and histological profile of
colorectal cancers seen on colonoscopy in Kano,
North-Western Nigeria. Niger Postgrad Med J
; 28: 22-26. doi: 10.4103/npmj.npmj_288_20
Oluyemi A, Odeghe E and Adeniyi O. Colonoscopy
findings in lower gastrointestinal bleeding in Lagos:
A comparative study based on age. Niger J Clin
Pract 2020; 23(12): 1656-1659. doi: 10.4103/
njcp.njcp_341_20
Umana IOM, Obaseki DE and Ekane VJ. The
clinicopathological features of lower
gastrointestinal tract endoscopic biopsies in Benin
City, Nigeria. Saudi Surg J 2017; 5: 9-20. doi:
4103/2320-3846.204418
Picardo NG, Ajayi NA and Ajayi IA. Lower
gastrointestinal endoscopy in Enugu, Nigeria: An
experience with 151 cases. Niger J Gastroenterol
Hepatol 2017; 9: 15 20.
Olokoba AB, Obateru OA, Bojuwoye MO, et al.
Indications and findings at colonoscopy in Ilorin,
Nigeria. Nigeria Medical J 2013; 54: 111 114.
doi: 10.4103/0300-1652.110044
Aliyu S, Ningi AB and Babayo UD. The Burden
of Colorectal Cancers in Nigeria: Patterns and
Presentations in North-Eastern Nigeria. J Cancer
Research and Oncobiology 2020; 3(1): 128. doi:
31021/jcro.20203128
Benjamin EO and Omoareghan ID. Colorectal
Cancer in Nigeria: Changing Trends and Clinical
Phenotype. J Cancer Sci Ther 2019; 11: 287-291.
Dakubo JCB, Naaeder SB, Tettey Y and Gyasi
RK. Colorectal Carcinoma: An Update of Current
Trends in Accra. West African J Medicine 2010;
(3): 178–183. doi: 10.4314/wajm.v29i3.68218
Cronjé L, Paterson AC and Becker PJ. Colorectal
cancer in South Africa: A heritable cause
suspected in many young black patients. South
African Med J 2009; 99(2): 103-106. PMID:
Medhin LB, Achila OO, Abraham AT, et al.
Incidence of colorectal cancer in Eritrea: Data
from the National Health Laboratory, 2011 2017.
PLoS One 2019;14:e0224045. doi: 10.1371/
journal.pone. 0224045.
Katsidzira L, Gangaidzo I, Thomson S, et al.
The shifting epidemiology of colorectal cancer
in sub-Saharan Africa. Lancet Gastroenterol
Hepatol 2017; 2; 377 383.
Arnold M, Sierra MS, Laversanne M,
Soerjomataram I and Jemal A, Bray F. Global
patterns and trends in colorectal cancer incidence
and mortality. Gut 2017; 66: 683–691. doi:
1136/gutjnl-2015-310912
Graham A, Adeloye D, Grant L, Theodoratou E
and Campbell H. Estimating the incidence of
colorectal cancer in Sub–Saharan Africa: A
systematic analysis. J Global Health 2012; 2(2):
doi: 10.7189/jogh.02.020204.
Richman S and Adlard J. Left and right sided
large bowel cancer. BMJ 2002; 24: 931-932. doi:
1136/bmj.324.7343.931.
Hamilton W, Lancashire R, Sharp D, et al. T.
The importance of anaemia in diagnosing
colorectal cancer: a case-control study using
electronic primary care records. Br J Cancer
; 98(2): 323-327. doi:10.1038/sj.bjc.6604165.
Gonzalez-Hermoso F, Perez-Palma J, MarchenaGomez J, Lorenzo-Rocha N and Medina-Arana
V. Can early diagnosis of symptomatic colorectal
cancer improve the prognosis. World J
Surg 2004; 28: 716–720. doi: 10.1007/s00268-004-
-7238
Stapley S, Peters TJ, Sharp D and Hamilton W.
The mortality of colorectal cancer in relation to
the initial symptom and to the duration of
symptoms: a cohort study in primary care. Br J
Cancer 2006; 95: 1321–1325. doi: 10.1038/
sj.bjc.6603439.
Lee GH, Malietzis G, Askari A, et al. Is rightsided Colon cancer different to left-sided
colorectal Cancer? - a systematic review. Eur J
Surg Oncol 2015 ; 41: 300-308. doi: 10.1016/
j.ejso.2014.11.001
Nawa T, Kato J, Kawamoto H, et al. Differences
between right- and left-sided colon cancer in
patient characteristics, cancer morphology and
histology. J Gastroenterol Hepatol.
;23(3):418-423. doi: 10.1111/j.1440-
2007.04923.x
AO Oluyemi, E Odeghe and O Owoseni
Oribabor FO, Adebayo BO, Aladesanmi T, and
Akinola DO. Anatomical sites of colorectal
cancer in a semi-urban Nigerian hospital: is there
a true rightward shift. East Afr Med J 2013; 90(8):
-52. PMID: 26866111
Anyanwu SN. Colorectal adenocarcinoma in
Eastern Nigeria: Subsite distribution and surgical
treatment patterns. J Clin Oncol 2012;
(Suppl;abstr e1 4III)