Table of Contents
Journal of Cancer Research
Volume 2014 (2014), Article ID 267190, 7 pages
http://dx.doi.org/10.1155/2014/267190
Research Article

The Present Status of the Management of Colon and Rectal Cancer in Nigeria

1Gastrointestinal Surgery Division, Department of Surgery, College of Medicine, University of Ibadan, Oyo State, Nigeria
2Gastrointestinal Surgery Division, College of Medicine, University of Ibadan, Ibadan, Nigeria
3Hepatobiliary and Endocrine Surgery Division, College of Medicine, University of Ibadan, Ibadan, Nigeria

Received 26 May 2014; Revised 8 July 2014; Accepted 24 July 2014; Published 21 August 2014

Academic Editor: Shoji Natsugoe

Copyright © 2014 David O. Irabor et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To demonstrate the possibility of the uniqueness of colorectal cancer (CRC) in the native Nigerian by looking at the different facets of the challenges that management of this disease presents in a tertiary-care hospital in Ibadan, Nigeria. Method. A cohort study starting in 2009 where patients were seen in the out-patient’s clinic. All patients who presented with features suggestive of colon or rectal cancer were studied. Biopsies were performed to confirm CRC (especially rectal cancer); patients were then booked for admission and subsequent operation. Patients were excluded if the histopathology of a resected or biopsied mass turned out to be noncancerous or inflammatory. Demographic data like age and sex were recorded. The type of operation done, findings at surgery, and the histopathology of the resected specimen were all recorded. The time taken for the pathology department to process the biopsy and resected specimens was also recorded. Results. 120 patients with CRC were seen over the study period of 5 years (2009–2013) giving an average of 24 patients per annum. The male : female ratio was 1 : 1.14. 86 (71.7%) patients had rectal cancer while the remaining 34 (28.3%) had colon cancer. Most of the colon cancer cases were in the 51–60 age group. The rectum : colon ratio was 2.5 : 1.31% of the patients were 40 years and below. 37% of those with rectal cancer were 40 years and below. 50% of resected specimens were Duke’s B and above. 45% of patients had tumors with unfavorable grade or biology (mucinous 21.7%, signet ring 8.3%, and poorly differentiated 15%). Only 24% of patients below 40 years and 41% of those above 40 years with confirmed rectal carcinoma presented for operation. Conclusion. Advanced tumors at presentation may not always be as a result of late presentation. Unusual aggressiveness of the tumors may lead to rapid progression of the disease. Increasing incidence in younger patients makes abdominoperineal excision of the rectum difficult for such patients to accept.