COLORECTAL CANCER

Colorectal cancer is a potentially fatal gastrointestinal disease andhas been studied extensively. In an effort to decrease the morbidity and mortality associatedwith this disease, studies have been performed to gain insight into the anatomic distribution,average age at presentation, mean age at presentation for different segments of colon involvedand intersex differences. Objective: The objective of this study is to determine the frequencyof sites of colorectal cancer involvement. Material and methods: Study design: Study wasdescriptive case series. Setting: General surgical department post graduate Lady ReadingHospital Peshawar. Period: From 01/01/2011 to 30/06/2012. Sample size: Sample size was416 using 3.57% proportion of descending colon5, 95% confidence level and 1.785% margin oferror under WHO software for sample size determination. Sampling technique: Consecutivenon probability sampling. Results: This study was carried out in 416 consecutive patients.These patients included 233 men (56 %) and 183 women (44%). Age varied from twelve yearsto seventy years. The commonest age group in the study at the time of presentation was63-72 years. Commonest site involved was rectum (26%) followed by sigmoid colon (16%).Bleeding per rectum was the commonest symptom (62.05%) followed by altered bowel habits(35.71%). Twelve patients (21.43%) presented with intestinal obstruction. Histopathologically,twenty patients had well differentiated adeno-carcinoma (35.72%) whereas eighteen patientshad anaplastic tumour (32.14%) and mucinous adeno-carcinoma was found in five patients(8.92%).Conclusion: Rectum is the most common site of tumour followed by left, right andtransverse colon respectively. The site of involvement affects the surgical procedure required.In conclusion the symptoms of colorectal cancer may not be representative of any anatomicalsite, by the time symptoms appear the lesion may have become invasive.