A Two- year review of Colorectal Cancer at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Background: Colorectal Cancer is the third most common cause of admission and death in the West; and till recently it was thought to be an uncommon disease in Africa and Asia. Although data from Ethiopia is unavailable, a recent report from Global cancer statistics center shows an increasing incidence in the sub-Saharan Africa which is also our observation. The objective of this study was to assess the hospital prevalence, common presenting symptoms, common presenting signs, site, stage and histology of colorectal cancer.
Methods: A retrospective cross-sectional study design, by reviewing of patient records collected from 2010 to 2011was used. Patient card numbers with colorectal and anal cancer were retrieved from registry log book in the department of surgery. Individual patient card was retrieved from the hospital record office. A total of 120 out of 142 patient cards were included in the study. Data were entered using epi-data, version 3.0 and was analyzed using SPSS for windows version 21, and descriptive data analysis using frequency was made to answer the research question.
Results: The mean age of the study subjects was 47 ± 16 years, ranging between 18 and 83 years. A third was below the age of 40 years, 58% were men, nearly half came from Addis Ababa, and 20% presented as an emergency. Study subjects presented with rectal bleeding (63.0%), abdominal pain (54.3%), weight loss (44.9%), tenesmus (39.4%), change in bowel habit (48.0%) and symptoms of obstruction (17.3%). The study revealed mass on Digital Rectal Examination in 50%, anemia in 24.4%, abdominal mass in 22.8% and signs of obstruction among 11.8% of patients. The common sites of cancer were the rectum in 48.3% of cases followed by caecum (12.5%), sigmoid colon (11.5%) and recto-sigmoid junction (10.8%). More than half of the study subjects had stage III to IV disease. More than 94% of the patients had histologically proven adenocarcinoma. Thirty four percent of the cases had either inoperable or unresectable tumor indicative of delayed presentation. The hospital mortality was 8.0%.
Recommendation: Colorectal Cancer is a problem of significant magnitude and as the outcome of treatment depends largely on the early detection of cases a detailed research should be done to see the factors which hamper early detection and referral of cases to the tertiary health facilities where multidisciplinary management is available.