Published July 13, 2023 | Version v1
Journal article Open

Incidence and Imaging of Colorectal Cancer Between 2015-2020 in Somalia: A Review of 585 Colonoscopy

Creators

  • 1. Department of General Surgery, Ankara City Hospital (Bilkent), Ankara, Türkiye.
  • 2. Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.
  • 3. Department of Radiology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye.

Description

Abstract

©Copyright LMS. Licensed by Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).

The aim of the study is to determine the frequency and distribution of all colonoscopic pathologies, especially colorectal cancer (CRC), in Somalia between 2015 and 2020. For this retrospective and descriptive study, a total of 760 colonoscopy results were analyzed from the medical records of Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital. We excluded 175 patients with incomplete colonoscopy findings and medical records. Patient characteristics, presence of normal mucosa, presence, characteristics, localization, and histopathology of the lesion were recorded. Abdomino-pelvic computed tomography (CT) scans were evaluated. The median age of 585 patients (male; n=384, 65.6%) included in the study was 44 years (range; 19-94). 20.5% (n=120) had normal colonoscopy findings and 31.8% (n=186) had benign perianal pathologies (most common hemorrhoids; n=139, 23.8%). In 40.9% (n=239/585) of patients, lesions were detected in the colorectum and biopsy was performed. The number of cases with CRC on colonoscopy was 50 (8.5%), the most common histopathological type was adenocarcinoma (n=40/50; 80%) and the most common localization was rectosigmoid colon (n=37/50; 74%). The median age of CRC cases was 53 years (range, 29-85) and 72% (n=36) were male. The most common morphologic type of adenocarcinoma on CT image was mass-forming (n=35/40; 87.5%). In all patients, the tumor had invaded the bowel wall and periintestinal fat infiltration was present. Lymph node metastases were present in 38% (n=19/50) and distant organ metastases in 18% (n=9/50) of patients with CRC. Our study reveals that colonoscopies in Somalia mostly find perianal lesions (most commonly hemorrhoids), the incidence of CRCs is 8.5%, all CRCs are diagnosed at an advanced stage and require neoadjuvant chemoradiotherapy. Community education and screening programs should be developed to detect CRCs early in the precancerous stage and reduce mortality.

Özet

Çalışmanın amacı 2015-2020 yılları arasında Somali'de başta kolorektal kanser (colorectal cancer, CRC) olmak üzere tüm kolonoskopik patolojilerin sıklığını ve dağılımını belirlemektir. Retrospektif ve tanımlayıcı nitelikteki bu çalışma için Somali Türkiye Recep Tayyip Erdoğan Eğitim ve Araştırma Hastanesi'nin tıbbi kayıtlarından toplam 760 kolonoskopi sonucu analiz edildi. Kolonoskopi bulguları ve tıbbi kayıtları eksik olan 175 hasta çalışma dışı bırakıldı. Hasta özellikleri, normal mukoza varlığı, lezyonun varlığı, özellikleri, lokalizasyonu ve histopatolojisi kaydedildi. Abdomino-pelvik bilgisayarlı tomografi (computed tomography, CT) çekimleri değerlendirildi. Çalışmaya dahil edilen 585 hastanın (erkek; n=384, %65.6) ortanca yaşı 44 yıl (yaş aralığı, 19-94) idi. Hastaların %20.5'inde (n=120) normal kolonoskopi bulguları ve %31.8'sinde (n=186) benign perianal patolojiler (en sık hemoroid; n=139, %23.8) mevcuttu. Hastaların %40.9'unda (n=239/585) kolorektumda lezyon tespit edildi ve biyopsi yapıldı. Kolonoskopide CRC'li olgu sayısı 50 (%8.5) olup, en sık histopatolojik tip adenokarsinom (n=40/50; %80) ve en sık lokalizasyon yeri rektosigmoid kolon (n=37/50; %74) idi. CRC olgularının ortanca yaşı 53 (yaş aralığı, 29-85) olup, %72'si (n=36) erkekti. CT görüntülerinde en sık görülen morfolojik adenokarsinom tipi kitle oluşturan (mass-forming) tipti (n=35/40; %87.5) Tüm hastalarda tümör bağırsak duvarını invaze etmişti ve periintestinal fat infiltrasyonu mevcuttu. CRC'li hastaların %38'inde (n=19/50) lenf nodu metastazı ve %18'inde (n=9/50) uzak organ metastazı vardı. Çalışmamız Somali'deki kolonoskopilerde çoğunlukla perianal lezyonların (en sık hemoroid olmak üzere) tespit edildiğini, CRC insidansının %8.5 olduğunu, CRC'lerin tümünün ileri evrede teşhis edildiğini ve neoadjuvan kemoradyoterapi gerektirdiğini ortaya koymaktadır. CRC'leri prekanseröz aşamada erken tespit edip mortaliteyi azaltmak adına toplum eğitilmeli ve tarama programları geliştirilmelidir.

Notes

Somali'de 2015-2020 Yılları Arasında Kolorektal Kanser İnsidansı ve Görüntüleme: 585 Kolonoskopinin İncelenmesi

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