Epidemiological and histopathological features of colorectal adenocarcinoma in the Western Cape public health sector between 2018 and 2020

Abstract

Background: There is a paucity of epidemiological colorectal adenocarcinoma data in sub-Saharan Africa. This deficiency coupled with the rising trends of colorectal cancer (CRC) incidence and mortality necessitated the need for an epidemiological colorectal adenocarcinoma study to be conducted in the South African setting.

Methods: A retrospective analysis of demographic and histopathological data of colorectal adenocarcinoma patients diagnosed in the Western Cape public health sector was performed through the utilisation of the National Health Laboratory Services (NHLS) Academic Affairs and Research Management System (AARMS) database.

Results: A total of 612 patients were diagnosed with colorectal carcinoma in the Western Cape during the study period. 595/612 (97.2%) were diagnosed with adenocarcinoma, of these 284 (48%) of patients with primary rectal adenocarcinoma, 304 (51%) with primary colon adenocarcinoma and 7 (1%) with synchronous colorectal adenocarcinoma or a lesion involving both the colon and the rectum. Rectal adenocarcinoma most commonly occurred in 99/284 (34.9%), in the > 60–70 age group, while colon adenocarcinoma occurred most commonly in the > 50–60 age group, 78/304 (25.7%). The commonest stage of rectal adenocarcinoma patients was IIA 35/119 (29.4%), whereas stage IIIB was the commonest colon adenocarcinoma stage comprising 66/212 (31.3%) patients. Forty patients had mutations of mismatch repair genes, 7 of which had a positive BRAF mutation.

Conclusion: The study showed an even distribution of colorectal adenocarcinoma incidence between males and females, with the highest rates of diagnosis in patients aged more than 50 years. Patients with stage III and IV disease had a higher rate of serum CEA elevation as compared to stage I and II.