BACKGROUND: CRC (CRC) rates are low but increasing in Africa. Data on detection, treatment, and outcome are scarce. OBJECTIVE: The aim of this study was to evaluate the presentation, treatment, and outcome pattern of CRC and to compare the care processes for two time periods. SETTING: The setting was Kenyatta National Hospital (KNH), a teaching and referral center. PATIENTS AND METHODS: A total of 259 patients seen over two time periods (1993-1998 and 1999-2005) were analyzed for admission date, sex, subsite involvement, diagnostic process, treatment, follow-up, and outcome. The distribution of variables between the time periods were analyzed using Student's t-test and chi2 as appropriate. Survival trends were generated using Kaplan Meier method; p<0.05 was statistically significant. RESULTS: The average number of CRC diagnoses showed a 2.7-fold increase during the study periods. The mean age at presentation was 49.7 years. The mean duration of symptoms was 29.6 weeks; and the commonest subsite was the rectum (55.3%). The overall resection rate was 67.7%. For rectal tumors the abdominoperineal rate was 51.4%. Mortality was higher for poorly differentiated cancer, advanced disease, age>50 years, and emergency surgery. There was no change in the age, duration of symptoms, proportion of patients<40 years, or the colon/rectal ratios of the cancer site. The second time period saw more adjuncts for diagnosis, less in-hospital mortality, and better staging data. CONCLUSION: CRC peaks during the fifth decade of life in Kenyans. The disease is characterized by late presentation, rectal preponderance, and inadequate pathology data. Improved patient follow-up will unravel the true pattern of disease outcome.
BACKGROUND: CRC (CRC) rates are low but increasing in Africa. Data on detection, treatment, and outcome are scarce. OBJECTIVE: The aim of this study was to evaluate the presentation, treatment, and outcome pattern of CRC and to compare the care processes for two time periods. SETTING: The setting was Kenyatta National Hospital (KNH), a teaching and referral center. PATIENTS AND METHODS: A total of 259 patients seen over two time periods (1993-1998 and 1999-2005) were analyzed for admission date, sex, subsite involvement, diagnostic process, treatment, follow-up, and outcome. The distribution of variables between the time periods were analyzed using Student's t-test and chi2 as appropriate. Survival trends were generated using Kaplan Meier method; p<0.05 was statistically significant. RESULTS: The average number of CRC diagnoses showed a 2.7-fold increase during the study periods. The mean age at presentation was 49.7 years. The mean duration of symptoms was 29.6 weeks; and the commonest subsite was the rectum (55.3%). The overall resection rate was 67.7%. For rectal tumors the abdominoperineal rate was 51.4%. Mortality was higher for poorly differentiated cancer, advanced disease, age>50 years, and emergency surgery. There was no change in the age, duration of symptoms, proportion of patients<40 years, or the colon/rectal ratios of the cancer site. The second time period saw more adjuncts for diagnosis, less in-hospital mortality, and better staging data. CONCLUSION: CRC peaks during the fifth decade of life in Kenyans. The disease is characterized by late presentation, rectal preponderance, and inadequate pathology data. Improved patient follow-up will unravel the true pattern of disease outcome.
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Authors: Ahmed A Abou-Zeid; Wael Khafagy; Deya M Marzouk; Ahmed Alaa; I Mostafa; M Aboul Ela Journal: Dis Colon Rectum Date: 2002-09 Impact factor: 4.585
Authors: Mrunal V Kesari; Vandana L Gaopande; Avinash R Joshi; Shreedhar V Babanagare; Bageshree P Gogate; Ameya V Khadilkar Journal: Indian J Gastroenterol Date: 2015-03-04
Authors: Gregory C Knapp; Olusegun I Alatise; Olalekan O Olasehinde; Ademola Adeyeye; Omobolaji O Ayandipo; Martin R Weiser; T Peter Kingham Journal: J Glob Oncol Date: 2019-06
Authors: Phillipo L Chalya; Mabula D McHembe; Joseph B Mabula; Peter F Rambau; Hyasinta Jaka; Mheta Koy; Eliasa Mkongo; Nestory Masalu Journal: World J Surg Oncol Date: 2013-04-18 Impact factor: 2.754
Authors: Brendan Bebington; Elvira Singh; June Fabian; Christine Jan Kruger; Leanne Prodehl; Daniel Surridge; Clem Penny; Lynne McNamara; Paul Ruff Journal: JGH Open Date: 2018-06-06