Publication:

Prospective observational study on etiological factors, clinical profile and pattern of metastases of colorectal cancer: in a rural population of Central India – a tertiary cancer centre study

Background Colorectal cancer (CRC) incidence has increased in Asian countries with 2-4 times surge in colorectal cancer incidence and mortality. There is a significant interaction between lifestyle changes and genetic predispositions. This study, involving 332 patients from central India, investigates the demographic patterns, epidemiological aspects, pattern of metastases, and clinical profiles of patients from the rural central India.

Methods A prospective observational study was performed at State Cancer Institute, NSCB Medical College in Jabalpur, focussed on all cases of colorectal carcinoma registered at our institution from 2017 to 2023. Staging followed the recent AJCC 8th edition and treatment as per the recent NCCN guidelines.

Results Among 332 CRC patients (24.09% aged 0–39 years (mean 29.2), 75.91% >40 years (overall mean 48.3)), abdominal pain (50%, n=166) and tobacco use (45.18%, n=150) predominated. Stage III/IV (68.38%, n=227), liver metastases (n=78), and rectal tumours (49.72%, n=165). Rural residents (62.65%, n=208) and illiteracy (29.52%, n=98) were common. Right-sided CRC correlated with females (55%) and mucinous histology (23.1%). Young cases rose 3–5% annually, peaking post-COVID.

Conclusion This tertiary cancer hospital study (2017-2023) highlights that 68.38 % of patients presented with Stage III/IV disease mostly from rural population. Most cases were sporadic, with no significant family history. Rectum was the most common site, and liver the predominant site of metastasis. Dietary habits indicate low fibre and high red meat intake may contribute to CRC risk. These findings highlight the need for early screening, public awareness, and targeted interventions to address modifiable risk factors in rural populations.