Colorectal cancer in patients from Uganda: A histopathological study
Abstract
Background: Approximately one million people are diagnosed with colorectal cancer (CRC) globally each year. Uganda is a developing country with an estimated total population of 32.9 million. The incidence of colorectal cancer is reported to be low. The clinical impression is that it occurs predominantly in young people who live in rural areas This study was aimed at determining the demographic and morphological features of a cohort of patients withc olorectal cancer from in Mulago and Mbarara hospitals in Uganda.
Methods: Histopathologicalspecimens of 81 Ugandan patientswith CRC (2006-2010) wereretrospectivelyreviewed. Demographic data was retrievedfrom the medical records. Tumourswereexaminedtodeterminehistological features suggestive of mismatchrepair gene mutations (accordingto the revisedBethesdaguidelinesformicrosatelliteinstabilitytesting).
Results: The medianage of thosewith CRC was 55 years (range 20-89) at diagnosis. 30.6% and 6.9% of the patientswere< 50 and< 30 yearsoldrespectively. 94,9% of the tumourswerelocated in the left side of the colon. Mucinous adenocarcinoma was significantly more common in patientsunder the age of 50. Based on the histologicalanddemographic features, 22/81 (27.3%) patients met at leastone of the criteria of the revisedBethesdaGuidelinesfor MSI testing.
Conclusions: Histologicalanddemographic features suggestive of the geneticpathwaytypicallyseen in HNPCC wereidentified in 27.3% of patients. These features appeartobequite different frompublished data from first worldcountries. The limited availability of flexiblecolonoscopy, maycontributeto the greatpreponderance of left-sidedneoplasms (especiallylocated in the rectum) andunderdiagnoses of right sidedtumours
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