The Study of Epidemiology, Clinicopathology and Current Management in Patients of Colorectal Malignancies in Northern India

Background: Colorectal malignancy is the third most common malignancy worldwide and the incidence in India is showing an increasing trend. Rapidly increasing incidence rates could result from epidemiological factors including age , race, diet, environmental exposures, and acquisition of modern lifestyle. This study was conducted to describe the epidemiological trends, clinicopathologic characteristics and management of CRC in our settings.

Methods: This prospective study was carried out from November 2020 to November 2022 in the Department of Surgery, at Jawaharlal Nehru Medical College, Aligarh. All histologically confirmed cases of colorectal cancer were included. The data was collected and analysed using IBM SPSS Statistics for windows, version 25.

Results: A total of 54 patients with colorectal malignancy were in the study. Males outnumbered females with a Ratio of 1.24.Most of the patients were below 40years of age (42.8%) and the mean age was 45.27±14.208 years. 32 patients (57.1%) were non-vegetarian and 24 patients (42.8%) were vegetarian (P value >0.05). 19.6% of patients had a smoking addiction, 5.3% used tobacco and 3.5% of patients were alcohol drinkers (P value <0.0001). 3 patients(5.3%) had a positive family history of carcinoma or polyposis in their first-degree or second-degree relatives(P value <0.0001). Bleeding per rectum was the commonest presentation (33.9% followed by pain abdomen (26.7%). The highest number of lesion was seen in the rectum alone (46.4%), followed by ascending colon alone (19.6%).On endoscopy, 29(51.7%) patients had circumferential annular growth, 21(37.5%) patients had exophytic mass, 3(5.3%) patients had polyposis masses and 3(5.3%) ulcero-infiltrating mass. Non-mucin-secreting adenocarcinoma was the commonest pathological finding (62.5%), followed by mucin-secreting Adenocarcinoma (30.3% ) and signet ring cell carcinoma (7.1%). 32 (57.1%) patients had well-differentiated lesions, 17(30.3%) had moderately differentiated lesions and 7(12.5%) patients had poorly differentiated lesions. The majority (60.7%) of the participants have lymph node involvement. 51 patients (91.1%) underwent surgeries and 5 patients (8.9%) were given neoadjuvant chemo-radiation therapy. There was no mortality during the study period.

Conclusion: Colorectal malignancies are common in our settings and shows a trend towards younger age groups. We recommend screening high-risk groups for early diagnosis and better management.