Colorectal cancer in Egypt is commoner in young people: Is this cause for alarm?

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer worldwide after lung and breast cancers with two-thirds of all CRCs occurring in the more developed regions of the world. CRC affects men and women of all racial and ethnic groups, and is most often found in those aged 50 years or older. 
Aim: The aim of the study was to determine the prevalence of CRC among patients undergoing colonoscopy in Egypt.
Materials and methods: This was a descriptive cross-sectional hospital-based study. A total of 412 consecutive patients who underwent planned pancolonoscopy from January 2000 to January 2012 at our institution were assessed. All endoscopic examinations leading to a diagnosis of CRC were evaluated. The following parameters were analyzed: frequency of CRC, patient characteristics, indication for endoscopic examination, endoscopic findings, localization of CRC and histopathology. 
Results: CRC was diagnosed in 57 patients (14% of all colonoscopies). Fifty-six percent were female. The mean age was 51± 15 years (age range: 16–80 years). Twenty-five percent of cancers occurred in patients aged less than 40 years. The most frequent indication for colonoscopy was rectal bleeding (39%). The most common colonoscopy finding was mass (96%). Sixty-eight percent of CRC were located in the left colon and rectum. Ninety-one percent of CRC wereAdenocarcinoma. 
Conclusions: CRC is not uncommon among Egyptian patients subjected to colonoscopy. Thereare relatively higher CRC rates in patients under 40 years of age than reported in the West. This has implications relating to future epidemiological trends in Egypt. Physicians must have a greater awareness of the potential for CRC in young people in the Middle East.

Keywords: Colorectal cancer; Birth cohort; Egypt