Colorectal cancer in Saudi Arabia: incidence, survival, demographics and implications for national policies (original) (raw)
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Colorectal cancer patients in western Saudi Arabia
Saudi Medical Journal, 2019
Objectives: To determine the survival outcomes and to describe the epidemiological characteristics of patients with colorectal cancer (CRC) in western Saudi Arabia. Methods: Our study is a retrospective analysis of patients with CRC diagnosed between 2002 and 2014. We recruited 279 patients who were selected randomly and followed until the end of July 2017. A Kaplan-Meier curve was used to estimate the survival rate for CRC patients according to gender, histopathological pattern, tumor site, and mutation type, taking into consideration time factor, dropouts, and loss to follow-up. Results: The mean age of CRC patients was 57±13 years, and most of them were Saudi (87.5%). Regarding tumor epidemiology, 32.4% of the patients at Best American Joint Committee on Cancer (Best AJCC) stage 4; 28.9% were at stage 3; and 1.2% were at stage zero. The most frequent pathological variant was adenocarcinoma (77.4%); the most affected site was the rectum (40.5%). By Cox regression analysis, age at diagnosis, tumor stage, Kirsten Ras (KRAS) mutation, and lymphovascular invasion were significant prognostic factors for survival in CRC patients. Conclusion: Colorectal cancer patients presented to the hospital late in the disease course. This may call for lowering the screening age, increasing awareness programs, and establishing a national screening program.
First national survival data for colorectal cancer among Saudis between 1994 and 2004: what's next?
2013
Background: Colorectal cancer (CRC) is the second most common malignancy in the Saudi population. This study aimed to review CRC data from the Saudi Cancer Registry (SCR) in order to evaluate the prognostic factors for CRC survival in Saudi patients. Methods: This study was a retrospective censored overall survival (OS) analysis of CRC data for the period 1994-2004 obtained from the SCR. Data were collected from all 13 administrative regions of the Kingdom of Saudi Arabia (KSA) by the SCR in collaboration with the National Information Center of the Ministry of Interior. The Kaplan-Meier method was used to calculate the cumulative survival rate, which was then stratified by gender and by period (1994-1999 versus 2000-2004). The clinico-pathological variables that might affect CRC survival were analyzed by Cox regression analysis. Results: Between 1994 and 2004, 549 CRC cases were diagnosed (363 [66.1%] in males and 186 [33.9%] in females). The OS for CRC during this period was 44.6% (44.7% for 1994-1999 and 44.3% for 2000-2004 [p=0.7]). There was a significant (p=0.003) discrepancy of 9.6% between the male five-year OS (41.0%) and the female five-year OS (50.6%). The five-year OS was 63.3% for patients with localized disease, 50.2% for those with regional disease, and 14.7% for patients with metastases. By Cox regression analysis, age and extent were significant prognostic factors of survival in patients with colon cancer; the risk was higher in patients with distant metastasis (hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.17-5.45; p=0.01). In patients with rectal cancer, the risk was lower in males (HR, 0.66; CI, p=0.04), but higher in patients with unknown tumor extent (HR, 3.70; 95% CI, 1.66-8.24; p=0.01). Conclusions: The five-year OS for 1994-2004 was 44.6% for patients with CRC. More so, five-year OS based on CRC stage was generally lower than the typically reported survival rates. The establishment of a national screening program and increased access to specialized medical faculties may be necessary to improve CRC survival in the KSA.
Colorectal cancer in the Kingdom of Saudi Arabia: need for screening
Asian Pacific Journal of Cancer Prevention, 2012
Colorectal cancer (CRC) is a major health problem in the Kingdom of Saudi Arabia (KSA). Our aim was to characterize the epidemiology of CRC in the Saudi population. Retrospective analysis of all cases of CRC recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2006 amongst Saudi citizens in KSA. Data were retrieved from the database of the SCR. Descriptive statistics was performed using SPSS. A total of 4,201 cases of CRC were registered in the SCR. The incidence of CRC increased between 2001 and 2006. The mean age of patients at the time of diagnosis was 58 years; most patients were above 45 years of age (n=3322; 79.1%). At the time of diagnosis, 977 patients (23.0%) presented with localized disease and 1,018 (24.0%) had distant metastasis. The most frequent pathological variant was adenocarcinoma (73%), with grade 2 (moderately differentiated) being the most common grade among all variants (61%). For all cancer grades, the frequency of CRC was significantl...
Past, present and future of colorectal cancer in the Kingdom of Saudi Arabia
Saudi Journal of Gastroenterology, 2008
Background/Aims: The crude frequency of colorectal cancer (CRC) is second to breast cancer in the Kingdom of Saudi Arabia (KSA). To assess the future burden of CRC in the country, we designed a model that takes into consideration the recent lifestyle pattern and the growth and aging of the population. Methods: We compared CRC statistics for KSA (using data from the National Cancer Registry) with that from the Surveillance, Epidemiology and End Results (SEER) databases of the United States of America (USA). We used the Joinpoint regression program to identify changes in secular trends, while the GLOBOCAN 2002 software was used to project future incidence and mortality. Results: Between 1994 and 2003, agestandardized rates (ASRs) for CRC in KSA almost doubled, as compared to a nonsignifi cant decline in USA. Between 2001 and 2003, while the annual percent change (APC) of CRC incidence in the USA showed a nonsignifi cant decrease in females, APC in Saudi females showed a nonsignifi cant rise of six percent. On the other hand, the rising incidence among Saudi males, during the years 1999 to 2003, was signifi cant, with an APC of 20.5%. The projection model suggested that the incidence of CRC in KSA could increase fourfold in both genders by the year 2030. Conclusions: In KSA, the present and expected increase in CRC rates is alarming. Pragmatic recommendations to face that challenge are discussed. The present work could serve as a model to study other prevalent types of cancer, particularly in developing countries.
Journal of Cancer Prevention & Current Research, 2017
Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths worldwide. There are different histopathological variants of CRC that differ in behavior and means of management. Therefore, the aim of this study was to determine the different types CRC in relation to age and gender in Northern KSA. Methodology: A retrospective cohort study was carried out over a five year period in different referral hospitals. In this study 120 files were retrieved from departments of Surgery from different hospitals in Northern KSA. Results: Most patients presented with colonic site tumors constituting 67/120(55.8%), followed by Recto-sigmoid, and Rectum representing 31/120(25.8%) and 13/120(10.8%) respectively. Adenocarcinoma (AD) was diagnosed in 105/120(87.5%).The great majority of patients were categorized with moderately differentiated carcinoma representing 76/120(63.3%), followed by well differentiated and poorly differentiated carcinomas constituting 35/120(29.2%) and 9/120(7.5%), respectively. Conclusion: Saudi patients with CRC were more expected to present with more advanced stages of the disease and at younger ages compared to Western populations, which presents more frequently in an extra advanced stage and poorly differentiated type than in older patients.
Colorectal Cancer in Jordan: Survival Rate and Its Related Factors
Journal of Oncology, 2017
Objectives. To estimate the survival rate of colorectal cancer (CRC) and determine its predictors among Jordanian patients who were diagnosed in the period of 2005–2010. Methods. This study was based on Jordan cancer registry. All CRC cases that were registered in cancer registry during 2005–2010 were analyzed using the survival analysis. The last date for follow-up was 1st Oct 2016. Results. A total of 3005 patients with CRC were registered during 2005–2010. The overall 5-year and 10-year survival rates for patients with CRC were 58.2% and 51.8%, respectively. The 5-year survival rate decreased significantly from 60.4% for the age <50 years to 49.3% for the age ≥70 years (p<0.005). The 5-year survival rate was 72.1% for the localized stage, 53.8% for the regional stage, and 22.6% for the distant metastasis. In the multivariate analysis, the only factors that were significantly associated with survival were age, grade, stage, and location of tumor. Conclusions. The overall 5-y...
Clinicopathological pattern of colorectal cancer in the United Arab Emirates
Saudi medical journal, 2003
The aim of this study is to define the epidemiology of the colorectal cancer in the United Arab Emirates and compare it with the other Gulf States and developed countries. This study is a retrospective descriptive study that includes 114 patients who underwent surgeries for colorectal carcinoma at Al-Ain and Tawam Hospitals in the United Arab Emirates during the period 1985 through to 1998. These patients were under medical follow up for a mean period of 24 months (range 6-120 months) Both univariate and multivariate analyses were performed to assess predictors of recurrence and survival. The survival curves were computed by using Kaplan-Meier method. Mean annual incidence was 12 patients/year. There were 77 males (67.5%) and 37 females (32.5%). The mean age at the time of diagnosis was 46.6 11.8 years with the median age of 47 years. The mean overall survival time was 63.7 7.7 months. The survival time was shorter for younger patients, those with palliative resection, lymph node me...
Colorectal Cancer in Saudi Population
The Professional Medical Journal, 2018
Background: The aim of study was to investigate differences inclinicopathological (CPC) features of colorectal cancer (CRC) patients between both genders.Setting and Design: We did a retrospective chart review of CRC patients confirmed byhistopathology. Materials and Methods: 414 patients were included in study from King AbdulAzizmedical city Jeddah. Charts of patients were reviewed; data was analyzed on SPSS version20. Results: Majority of patients were males (58.7%) who were slightly older than females (meanage 57.7 versus 54.6 years) (p value 0.033). The most common age group was fifty to eighty yearsin both genders (64% patients). Abdominal pain was reported more in females (57% vs. 41.5% pvalue 0.002) while there was no difference in reporting bleeding per rectum between bothgenders (50.2% vs. 49.3% p value 0.953). History of diabetes mellitus (DM), smoking and colonicpolyps) was more common in males (67 versus 34 patients), (21 versus 3 patients) and (10 versus1 patient respec...
Colorectal Cancer in Saudi Arabia: The Way Forward
Asian Pacific Journal of Cancer Prevention, 2023
Australia/New Zealand (ASR 36.4 and 27.7 per 100,000 for males and females respectively). The incidence of CRC tends to be low in most regions of Western Africa (ASR 7.0 and 5.1 per 100,000 for males and females respectively), and in South Central Asia (ASR 6.2 and 4.0 per 100,000 for males and females respectively) (Sung et al., 2021). In general, the incidence of CRC in high/very high Human Development Index (HDI) countries is higher (ASR 29.0 and 7.4 per 100,000 for males and females respectively) than in the low-and middle HDI countries (ASR 20.0 and 5.4 per 100,000 for males and females respectively) (Sung et al., 2021; Arnold et al., 2020). According to Saudi cancer incidence report in 2018, CRC is the most common cancer among men (15.3%) and third among women (9.8%) (Table 1). Despite the high
Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study
Epidemiology and Health, 2013
We aimed to investigate factors associated with colorectal cancer survival in Golestan, Iran. METHODS: We used a population based cancer registry to recruit study subjects. All patients registered since 2004 were contacted and data were collected using structured questionnaires and trained interviewers. All the existing evidences to determine the stage of the cancer were also collected. The time from first diagnosis to death was compared in patients according to their stage of cancer using the Kaplan-Meir method. A Cox proportional hazard model was built to examine their survival experience by taking into account other covariates. RESULTS: Out of a total of 345 subjects, 227 were traced. Median age of the subjects was 54 and more than 42% were under 50 years old. We found 132 deaths among these patients, 5 of which were non-colorectal related deaths. The median survival time for the entire cohort was 3.56 years. A borderline significant difference in survival experience was detected for ethnicity (log rank test, p= 0.053). Using Cox proportional hazard modeling, only cancer stage remained significantly associated with time of death in the final model. CONCLUSIONS: Colorectal cancer occurs at a younger age among people living in Golestan province. A very young age at presentation and what appears to be a high proportion of patients presenting with late stage in this area suggest this population might benefit substantially from early diagnoses by introducing age adapted screening programs.