Chandrasinghe P C, Ediriweera D S, Hewavisenthi J, Kumarage S K, Fernando F R, Deen K I
Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
BMC Res Notes. 2017 Oct 30;10(1):535. doi: 10.1186/s13104-017-2869-1.
Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka.
Analyzing 679 patients, it is observed that both colon and rectal cancers have significantly increased over time (pre 2000-61, 2000 to 2004-178, 2005 to 2009-190, 2010 to 2014-250; P < 0.05). Majority of the cancers were left sided (82%) while 77% were rectosigmoid. Over 25% of all CRC were diagnosed in patients less than 50 years and the median age at diagnosis is < 62 years. Increasing trend is seen in the stage at presentation while 33% of the rectal cancers received neoadjuvant chemoradiation. Left sided preponderance, younger age at presentation and advanced stage at presentation was observed. CRC disease pattern in the South Asian population may vary from that observed in the western population which has implications on disease surveillance and treatment.
由于社会经济格局和人口结构的变化,南亚地区的结直肠癌(CRC)负担正在增加。该地区缺乏可靠的高质量数据来评估疾病模式和进行比较。作者使用假设泊松分布的广义线性模型和模型拟合,描述了自1997年以来斯里兰卡一家地区三级护理中心CRC负担情况随时间的变化。
分析679例患者后发现,结肠癌和直肠癌的发病率均随时间显著增加(2000年前为61例,2000年至2004年为178例,2005年至2009年为190例,2010年至2014年为250例;P<0.05)。大多数癌症位于左侧(82%),而77%位于直肠乙状结肠交界处。超过25%的CRC患者诊断时年龄小于50岁,诊断时的中位年龄<62岁。就诊时的分期呈上升趋势,33%的直肠癌接受了新辅助放化疗。观察到左侧优势、就诊时年龄较轻和就诊时处于晚期。南亚人群的CRC疾病模式可能与西方人群不同,这对疾病监测和治疗有影响。