Clinical and demographic profile of lower gastrointestinal malignancies: A retrospective observational study from Eastern India

Abstract

ABSTRACT Background: Lower gastrointestinal (GI) cancers including colorectal and anal cancers are less common in India than in the rest of the world. Literature regarding these malignancies from Eastern India is scarce. Objectives: Our primary objective was to determine the clinical and demographic profile of patients with lower GI malignancies reporting to our center. Materials and Methods: This observational study was conducted in the Department of Radiation Oncology at State Cancer Institute, Indira Gandhi Institute of Medical Sciences in Patna (Bihar), a tertiary care center in Eastern India. The details of 1191 patients with lower GI cancers were extracted retrospectively from the Hospital-Based Cancer Registry from 2014 to 2021 and analyzed for basic clinical and demographic parameters. The total number of lower GI cancer cases over these consecutive calendar years was calculated. Calculation of annual percentage change (APC) and analysis of the time trend was done using Joinpoint regression software (4.0.1). Results: There were 1028 patients with colorectal cancer and 163 patients with anal cancer. The median ages at presentation were 49.5 (range, 12–92) years for colorectal cancer, and 48 (range, 12–85) years for anal cancer, with a male predominance (M:F ratio 1.7 [or 1.7:1 for colorectal cancer] and 2.7 [or 2.7:1 for anal cancer]) patients with colorectal cancer who were younger than 39 years (young colorectal cancer). The rectum (n = 594, 50%) was the commonest site involved. Nearly three-quarter patients (562 with colorectal cancer [74.7%] and 84 with anal cancer [73%]) presented with advanced disease (Stages III and IV). Chemotherapy was the most commonly administered treatment modality (colorectal cancer [n = 383, 37.1%] and anal cancer [n = 70, 43.1%]). There was a rising trend observed in the number of lower GI cancer cases with a significant APC (P < 0.01). Conclusion: The number of lower GI cancers is increasing as per the data from our hospital-based cancer registry in Eastern India. Greater frequency of advanced disease coupled with early age at presentation are causes concern. Measures to increase awareness and facilitate early diagnosis are urgently required. Population-based studies are required to validate these findings.