Clinical &Pathological Presentation of Colorectal Cancer Among Young Sudanese Adults in Khartoum State Hospitals (2019-2021)

Background: Colorectal cancer is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries, probably due to the acquisition of western lifestyle. Objectives:The study aimed to identify the clinical and pathological presentation of colorectal cancer among Sudanese adults aged 50 years and below versus those above 50 years of age. Methods:A prospective and retrospective comparative study of histological confirmed cases of colorectal cancer.Retrospective from June/ 2019 to November/ 2020 and prospective from December/2020 to December/2021.The study was multicenter conducted within the main three colorectal services units in Khartoum state; Ibrahim Malik teaching hospital, Ibn Sina hospital, and Soba university hospital.Data had been collected by the researcher using administered questionnaire which included all the variables.Either by direct interview or through phone call with the colorectal cancer confirmed patients.Consents were obtained from all patients included in the study.It was cross-sectional collection and age independent.Prospective follow up for three to six months has been conducted for the new cases that presented during 2020-2021.The patients who presented during 2019 had been contacted by the researcher and their data and history of presentation were documented retrospectively.The total numbers of cases include in this study were 120 cases.They had been divided into two groups, group A (50 years and below) and group B (>50 years).Results: A total of 120 colorectal cancer patients were enrolled in the study.The mean age of patients at presentation was 51.2 years (SD=15).Sixty-one cases (50.8%) belonged to age group B (>50 years) and 59 cases (49.2%) belonged to group A (50 years and below).Male: female ratio in group A was 1.5:1 and in group B was 1.3:1.A significant number; 65 patients (54.3%) presented with rectal cancer, 35 patients (60%) were young adults and 30 patients (54.2%) were elderly.CRC was most frequently misdiagnosed with dysentery which counted 25 young patients (42.4%) and 17 elderly patients (27.9%).The most dominating presenting symptom among young adults was bleeding per rectum which occurred in 48 patients (81.4%), while weight loss was the most common presenting symptom in elderly which was found in 48 patients (78.8%).The adenocarcinoma was the most common histopathological type reported in 115 patients (95.8%).Both groups at presentation had advance radiological stage.Stage IIIB was reported in 13 patients (29.5%) among group A and in 14 patients (32.6%) of group B. The commonest postoperative histopathological TNM stage in group A was IIA which was reported in 15 cases (34.9%).In group B Stage IIIB and IIA were reported in 13 cases (26.5%).One hundred and six patients (88.3%) underwent surgical procedures for colorectal cancer.Eighty-nine patients (84%) underwent elective curative resections after preoperative full workup and staging.Five patients (4.7%) underwent emergency resections and 12 patients (11.3%) had palliative procedures.Postoperative complications and morbidity rates were 64.6% and 58.2% for group A and B respectively.One hundred and five out of 120 were alive (96.6%) and available for follow-up at the end of 2 years.Cancer recurrence was reported in 3 cases from group B (2.9%) and metachronous tumor also was detected in two cases from group B. Conclusion:In this study we identified that young Sudanese adults has different remarkable presentations.They presented ijclinmedcasereports.com