Publication:

Clinical presentations of colorectal cancer at initial presentation to hospital and its site specific correlation

Background Colorectal cancer is one of the leading cause of death all over the world. It progresses slowly and may be asymptomatic for as many as 5 years. Aim of this study was to find the incidence and the initial clinical presentations of patients with colorectal cancer and its site specific correlationMethods: This was a prospective hospital-based study conducted over a period of two years from August 2015 to September 2017 in the postgraduate department of surgery, Government medical college, Srinagar. Total of fifty three patients in the age group of 10 years to 80 years were included in the study. Colorectal tumors were divided into right colon growths (caecum, ascending colon and hepatic flexure), left colon growths (splenic flexure, descending colon and sigmoid colon) and rectal growths. Data was collected from their hospital records and analysed using SPSS computer program.

Results In present study incidence of colorectal cancer was 0.2 per 100,000 people. Thirty percent of our patients were found to be in the sixth decade of their life with male preponderance in almost every age group. Mean age of presentation being 46.44 years (males= 48.5years, females= 43.76years). Out of 53 patients, rectal growths constituted 36%, left colonic growths 36% followed by 28% cases of right colonic growths. More than one symptom was present in several patients. Maximum number of patients (43%) presented with anemia (microcytic hypochromic) with Hb of <9gm% followed by constipation 38% and bleeding per rectum 28%. Pain abdomen was present in 23% of patients. Loss of weight and diarrhoea was equally seen in 19% of patients. Diarrhoea was seen in 6 males and 4 females and was statistically significant (p<0.05).

Conclusions Colorectal cancer was found to affect the Kashmiri patients at younger age (38% were 40 years or less) with peak incidence at sixth decade. Males were affected more than females. Anaemia, constipation and bleeding per rectum were the most common predominant clinical features in right colon, left colon and rectal growths respectively.