Colorectal Cancer in India: A Comprehensive Analysis from a Tertiary Care Center.

Abstract:  

Background: Colorectal cancer (CRC) is prevalent worldwide, with most cases occurring in developed countries, while India has a relatively low prevalence in comparison to the western world. . Limited cancer registry coverage in India suggests possible under-reporting, but CRC incidence is rising due to rapid socio-economic development. The purpose of this study is to investigate and evaluate various treatment modalities employed and explore recent advancements in the management of colorectal carcinoma.

Methods: This was an observational single-center study combined both prospective and retrospective analyses involving 82 patients diagnosed with colorectal cancer conducted in the Department of Surgery at Gandhi Medical College and Hamidia Hospital, Bhopal, a tertiary referral center in Madhya Pradesh. Following institutional ethics committee approval, a three-year descriptive study was performed, consisting of a one-year retrospective analysis of case files from September 2021 to September 2022, and a two-year prospective analysis of patients from October 2022 to June 2024.

Results:The study reviewed 82 CRC patients, with a male-to-female ratio of 1.05:1 and reveals that 8 (10%) of the patient were strict vegetarians, suggesting a possible protective effect. Tobacco use was prevalent, correlating with CRC risk factors. Most cancerous lesions were located on the left side of the colon, primarily in the rectum 40 (48%) and ascending colon 25 (31%). Our analysis revealed that most tumors were moderately differentiated adenocarcinoma and the most patients presented with the Stage II disease. Notably, the median age of diagnosis was 46.87 years, with 29 (35.36%) of cases occurring before age 40.

Conclusion: This study highlights distinct demographic and histological features of CRC in India, including younger age at diagnosis, a higher rate of signet ring cell tumors, left-sided tumor predominance, advanced stages at presentation, and widespread malnutrition among patients. The younger age structure likely contributes to the higher incidence in younger patients, emphasizing the need for thorough family histories and nutritional interventions. Limited access to advanced treatment adds to the healthcare burden, underscoring the need for research on emerging risk factors like dietary shifts that may influence CRC patterns in India. Survival data will further illuminate the evolving landscape of CRC.

Categories: Oncology, General Surgery, Pathology/Radiology

Keywords: Colorectal cancer, Neoadjuvant Chemoradiotherapy, TNM staging, Hemicolectomy, Low Anterior Resection, Abdominoperineal Resection.