Shahabi Fatemeh, Abdollahi Abbas, Zarif-Sadeghian Mahdieh, Ziyaie Dorin, Rahimpour Ehsan, Ansari Majid, Davoudi-Monfared Esmat
Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Surgery, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
BMC Cancer. 2025 Mar 27;25(1):553. doi: 10.1186/s12885-025-13924-4.
Colorectal cancer rising incidence still pose a public health challenge. In the present systematic review, we aimed to study the colorectal cancer patients with initial presentation of rectal prolapse.
The study protocol was developed (PROSPERO CRD42017060473). We searched Web of Science, PubMed and Scopus to identify case reports of rectal Prolapse as a chief compliant of colorectal cancer. The Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) guidelines were used for screening and data extraction.
Thirty-one case reports were included in this review. More than half of the patients were females over 65 years old and mean ± SD age of the cases were 64 ± 17.9 years and, the female gender were mentioned in 17 (56%) case reports. The majority (64.5%) of the identified cancer belong to rectum and recto-sigmoid origin's location. In the history retained from the cases, rectal bleeding and constipation were the most frequent reported accompanied symptoms in colorectal cancer cases with initial presentation of rectal prolapse. 67.7% of all identified cases in this review published at 2015 and later.
Rectal prolapse can be an initial presentation of colorectal cancer, which is more prevalent in female more than 65 years old. The most common symptoms accompanied rectal prolapse were rectal bleeding and constipation. According to rising published case reports on colorectal cancer patients with initial presentation of rectal prolapse in recent years, further work-up is recommended for patients without predisposing factors for a concomitant tumor.
结直肠癌发病率不断上升，仍然是一项公共卫生挑战。在本系统评价中，我们旨在研究以直肠脱垂为首发表现的结直肠癌患者。
制定了研究方案（PROSPERO CRD42017060473）。我们检索了Web of Science、PubMed和Scopus，以确定以直肠脱垂为主要主诉的结直肠癌病例报告。系统评价和Meta分析的首选报告项目（PRISMA）指南用于筛选和数据提取。
本评价纳入了31例病例报告。超过一半的患者为65岁以上女性，病例的平均年龄±标准差为64±17.9岁，17份（56%）病例报告中提到了女性。大多数（64.5%）确诊的癌症起源于直肠和直肠乙状结肠。在病例记录中，直肠出血和便秘是结直肠癌以直肠脱垂为首发表现时最常报告的伴随症状。本评价中所有确诊病例的67.7%发表于2015年及以后。
直肠脱垂可能是结直肠癌的首发表现，在65岁以上女性中更为普遍。直肠脱垂最常见的伴随症状是直肠出血和便秘。根据近年来发表的关于以直肠脱垂为首发表现的结直肠癌患者的病例报告不断增加的情况，建议对无伴随肿瘤易感因素的患者进行进一步检查。
