Colorectal cancer at Kenyatta National Hospital from 2014 to 2018: clinicopathological characteristics, outcomes & correlates

Abstract

Background: Colorectal cancer is one of the most common cancers diagnosed amongst males and females worldwide. The incidence has stabilised in the developed world but seems to be rising in developing countries. It is likely that after various government programmes and guidelines targeting cancer being established since 2011, there is improved awareness of colorectal cancer, better access to healthcare, earlier diagnosis of the disease and more widespread availability of better treatment over time. It is thus expected that the presentation and outcome of the disease at Kenyatta National Hospital has changed since 2011. The study was done to determine the clinicopathological characteristics and outcomes of colorectal cancer at Kenyatta National Hospital over a five-year period from 2014 to 2018 and the data generated can be used to delineate the trends. Objective: To describe the clinicopathological characteristics and outcomes of colorectal cancer at Kenyatta National Hospital and correlate mortality with the clinicopathological characteristics. Design: Retrospective chart review. Setting & Duration: Kenyatta National Hospital cancer treatment centre and Kenyatta National Hospital records department. The study covered a 5-year period from 1st January 2014 to 31st December 2018. Population: All patients with biopsy proven colorectal cancer diagnosed between January 2014 and December 2018 and having records at the aforementioned centres. Methods: Chart reviews of patients with histologically proven colorectal cancer between January 2014 and December 2018 were done. Clinico-pathologic and socio-demographic data were retrieved from the patient’s files and entered into a study proforma.1 year outcomes of treatment of colorectal cancer were also determined from the files. Results: A total of 478 patient charts were reviewed, 248 were males and 230 were females. The mean age of patients with colorectal cancer was 53. The most common clinical manifestations were abdominal pain, hematochezia, altered bowel habits and anemia. Most cancers occurred on the left side. Metastatic disease was present in 37.5% of patients at presentation. The most common treatment modality was chemotherapy. The one year mortality rate was 18%. Conclusion: Colorectal cancer occurs in a relatively young population in our country and most patients present with advanced disease. Young patients have a more aggressive histology. Folinic acid, fluorouracil, plus oxaliplatin is now the most common chemotherapy prescribed. The one year mortality of colorectal cancer still remains high compared to developed countries.