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Clinical profile of 1208 newly diagnosed colorectal cancer patients in Tamil Nadu—A multi-centric survey

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

An increasing incidence of colorectal cancer (CRC) is being reported in developing countries, including India. Most Indian studies on CRC are retrospective and single-centered. The present study is an attempt to understand the current clinical profile and stage of newly diagnosed CRCs across multiple centers in Tamil Nadu, India.

Methods

A multi-centric observational survey was conducted between September 1, 2021, and August 31, 2022, under the aegis of the Indian Society of Gastroenterology - Tamil Nadu chapter. Patients 18 years of age and older with a recent diagnosis of CRC fulfilling the inclusion criteria were prospectively recruited at the participating centers. Their demographic, clinical, biochemical, endoscopic, histopathologic, radiologic and risk factor details were systematically collected and analyzed.

Results

Across 23 centers in Tamil Nadu, 1208 patients were recruited. The male:female ratio was 1.49:1, while mean (SD) age was 57.7 (13.5) years. A majority (81.9%) were Tamils and 78.5% belonged to lower socioeconomic classes. The predominant symptoms were hematochezia (30.2%) and a change in bowel habits (27.5%). The most common locations were the rectum (34.3%) and rectosigmoid (15.1%). Synchronous CRCs were seen in 3.3% and synchronous colorectal polyps in 12.8%. Predisposing factors for CRC were seen in 2%. A past history of any cancer among CRC patients was obtained in 3.1% and a family history of any cancer was found in 7.6%. Patients who were either overweight or obese constituted 46.4% of the study population. At presentation, the predominant stages were stage III (44.7%) and stage IV (20.8%).

Conclusions

A majority of patients with newly diagnosed CRC in Tamil Nadu belonged to the lower socioeconomic classes. About 60% had CRCs located within the reach of the flexible sigmoidoscope. Two-thirds of the patients exceeded stage II disease at presentation.

Trial registration

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References

  1. 10_8_9-Colorectum-fact-sheet.pdf [Internet]. [cited 2021 February 4]. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/10_8_9-Colorectum-fact-sheet.pdf.

  2. 356-india-fact-sheets.pdf [Internet]. [cited 2023 January 26]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/356-india-fact-sheets.pdf.

  3. Chapter 5 Comparison of cancer incidence and patterns of all Population Based Cancer Registries.pdf [Internet]. [cited 2021 February 7]. Available from: https://www.ncdirindia.org/All_Reports/Report_2020/resources/Chapter5ComparisonofcancerincidenceandpatternsofallPopulationBasedCancerRegistries.pdf.

  4. Report of National Cancer Registry Programme 2020 [Internet]. [cited 2021 February 7]. Available from: https://www.ncdirindia.org/All_Reports/Report_2020/default.aspx.

  5. Mathew Thomas V, Baby B, Wang K, et al. Trends in colorectal cancer incidence in India. J Clin Oncol. 2020;38 15_suppl:e16084.

  6. Demb J, Earles A, Martínez ME, et al. Risk factors for colorectal cancer significantly vary by anatomic site. BMJ Open Gastroenterol. 2019;6:e000313.

  7. Saleem SM. Modified Kuppuswamy socioeconomic scale updated for the year 2020. Indian J Forensic Community Med. 2020;7:1–3.

  8. AJCC Cancer Staging Manual [Internet]. [cited 2023 October 19]. Available from: https://link.springer.com/book/9783319406176.

  9. Bassett J. The Asia-Pacific perspective: redefining obesity and its treatment. Australia: Health Communications Australia; 2000. p. 56.

  10. Wong MCS, Huang J, Lok V, et al. Differences in incidence and mortality trends of colorectal cancer worldwide based on sex, age, and anatomic location. Clin Gastroenterol Hepatol. 2021;19:955–66.e61.

  11. Navarro M, Nicolas A, Ferrandez A, Lanas A. Colorectal cancer population screening programs worldwide in 2016: an update. World J Gastroenterol. 2017;23:3632–42.

  12. Sudarshan V, Hussain N, Gahine R, Mourya J. Colorectal cancer in young adults in a tertiary care hospital in Chhattisgarh, Raipur. Indian J Cancer. 2013;50:337–40.

  13. Patra T, Mandal S, Alam N, Murmu N. Clinicopathological trends of colorectal carcinoma patients in a tertiary cancer centre in Eastern India. Clin Epidemiol Glob Health. 2018;6:39–43.

  14. Peedikayil MC, Nair P, Seena SM, et al. Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy. Indian J Gastroenterol. 2009;28:212–5.

  15. Javid G, Zargar SA, Rather S, et al. Incidence of colorectal cancer in Kashmir valley, India. Indian J Gastroenterol. 2011;30:7–11.

  16. Deo SVS, Kumar S, Bhoriwal S, et al. Colorectal cancers in low- and middle-income countries-demographic pattern and clinical profile of 970 patients treated at a tertiary care cancer center in India. JCO Glob Oncol. 2021;7:1110–5.

  17. Patil PS, Saklani A, Gambhire P, et al. Colorectal cancer in India: an audit from a tertiary center in a low prevalence area. Indian J Surg Oncol. 2017;8:484–90.

  18. Kumari P, Sharma N, Khatri PK, et al. Age wise distribution of colorectal cancer: an institutional observational study. IOSR J Dent Med Sci. 2017;16:01–5.

  19. Street W. Colorectal Cancer Facts & Figures 2020-2022. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-andstatistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf.

  20. CROCODILE study group. Catastrophic expenditure and treatment attrition in patients seeking comprehensive colorectal cancer treatment in India: A prospective multicentre study. Lancet Reg Health Southeast Asia. 2022:None. https://doi.org/10.1016/j.lansea.2022.100058.

  21. Moreno CC, Mittal PK, Sullivan PS, et al. Colorectal cancer initial diagnosis: screening colonoscopy, diagnostic colonoscopy, or emergent surgery, and tumor stage and size at initial presentation. Clin Colorectal Cancer. 2016;15:67–73.

  22. Suryadevara S, Kumar KV, Pampanagouda SKM, Arjun R, Deshmani V, Mukherjee G. Colorectal cancer profile in a tertiary care centre, Bangalore, India. Online J Health Allied Sci. 2014;1:13.

    Google Scholar 

  23. Jasperson KW, Tuohy TM, Neklason DW, Burt RW. Hereditary and familial colon cancer. Gastroenterology. 2010;138:2044–58.

  24. Ferreira AM, Chodankar SU, Vaz FS, D’souza DB, Kulkarni MS. Risk factors for colorectal cancer in Goa, India: a hospital-based case-control study. Indian J Community Med. 2021;46:474–8.

  25. Ganesh B, Talole SD, Dikshit R. A case–control study on diet and colorectal cancer from Mumbai, India. Cancer Epidemiol. 2009;33:189–93.

  26. Bhattacharya S, Bhattacharya S, Basu R, Bera P, Halder A. Colorectal cancer: a study of risk factors in a tertiary care hospital of North Bengal. J Clin Diagn Res JCDR. 2014;8:FC08–10.

  27. FR375.pdf [Internet]. [cited 2023 May 1]. Available from: https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf.

  28. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70:3–21.

  29. Mauri G, Sartore-Bianchi A, Russo AG, Marsoni S, Bardelli A, Siena S. Early-onset colorectal cancer in young individuals. Mol Oncol. 2019;13:109–31.

  30. Gupta S, Bhattacharya D, Acharya AN, Majumdar S, Ranjan P, Das S. Colorectal carcinoma in young adults: a retrospective study on Indian patients: 2000-2008. Colorectal Dis. 2010;12:e182–9.

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Acknowledgements

We would like to acknowledge Dr. Bijesh Yadav, Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, for help with statistical analyses and the Indian Society of Gastroenterology — Tamil Nadu chapter — for the kind support and encouragement received.

Funding

The study was supported by the institutional Fluid Research Grant, Christian Medical College, Vellore (IRB No. 13925 [OBSERVE] dated 28.04.2021).

Author information

Authors and Affiliations

  1. Department of Medical Gastroenterology, Christian Medical College, Vellore, 632 004, India

    Ebby George Simon & John Titus George

  2. Department of Medical Gastroenterology, Apollo Hospitals, Chennai, 600 006, India

    Ubal Dhus & Amara Sadguna Rao

  3. Department of Medical Gastroenterology, Madurai Medical College, Madurai, 625 020, India

    Kannan M. & Kondala Rao Yedupati

  4. Institute of Medical Gastroenterology, Madras Medical College, Chennai, 600 003, India

    Premkumar K. & Anupama Swarna

  5. GI and Liver Unit, Kovai Medical Center and Hospital, Coimbatore, 641 014, India

    Aravindh Somasundaram & Arulraj Ramakrishnan

  6. Department of Gastroenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India

    Venkatakrishnan L. & Dhanush Thomas

  7. Department of Medical Gastroenterology, Coimbatore Medical College, Coimbatore, 641 018, India

    Arulselvan V. & Arshiya Mubin S.P.

  8. Department of Medical Gastroenterology, Stanley Medical College, Chennai, 600 001, India

    Revathy M.S. & Rakesh Jha

  9. Department of Surgical Gastroenterology, Stanley Medical College, Chennai, 600 001, India

    Jeswanth S. & Satish Devakumar

  10. Department of Gastroenterology, Meenakshi Mission Hospital and Research Centre, Madurai, 625 107, India

    Alagammai PL. & Sujata V. Gade

  11. Department of General, GI and Minimal Access Surgery, St. Isabel’s Hospital, Chennai, 600 004, India

    Kanagavel Manickavasagam & Deepak Agarwal

  12. Department of Medical Gastroenterology, VGM Hospital, Coimbatore, 641 005, India

    Mohan Prasad V.G. & Madhura Prasad

  13. Department of Medical Gastroenterology, Gleneagles Global Health City, Chennai, 600 100, India

    Mahadevan B. & Dinu Abirami

  14. Department of Medical Gastroenterology, MedIndia Hospitals, Chennai, 600 034, India

    Chandrasekar T.S. & Gokul B.J.

  15. Department of Medical Gastroenterology, Sri Gokulam Hospital, Salem, 636 004, India

    Rajesh Natrayan & Harshini Manonmani Sampathkumar

  16. Department of Medical Gastroenterology, SRM Institutes for Medical Science, Chennai, 600 083, India

    Ramakrishna B.S. & Naveen Chand

  17. Department of Gastroenterology, Annai Arul Hospital, Chennai, 600 063, India

    Joseph Jensingh Babu S. & Sindhu Ashokan

  18. Department of Gastroenterology and Hepatology, MGM Healthcare, Chennai, 560 070, India

    Arulprakash S. & Karishma Srinivasan

  19. Department of Digestive Health and Diseases, Govt. Kilpauk Medical College, Chennai, 600 010, India

    Aravind A. & Lavanya N.

  20. Department of Medical Gastroenterology, Madras Medical Mission, Chennai, 600 037, India

    Arun R.S. & Asher Edward Prem Kumar

  21. Department of Surgical Gastroenterology, SRM Medical College Hospital and Research Centre, Chennai, 603 211, India

    Rathnaswami A.

  22. Department of Medical Gastroenterology, SRM Medical College Hospital and Research Centre, Chennai, 603 211, India

    Rajesh N.A.

  23. Department of Medical Gastroenterology, Velammal Medical College Hospital and Research Institute, Madurai, 625 009, India

    Arun A.C. & Ganga Balaji

  24. Department of Medical Gastroenterology, Meenakshi Medical College Hospital and Research Institute, Kancheepuram, 631 552, India

    Padmanabhan P. & Somnath Verma

  25. Department of Hepatology, Gleneagles Global Health City, Chennai, 600 100, India

    Jayanthi V.

Authors
  1. Ebby George Simon
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  2. Ubal Dhus
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  3. Amara Sadguna Rao
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  4. Kannan M.
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  5. Kondala Rao Yedupati
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  6. John Titus George
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  7. Premkumar K.
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  9. Aravindh Somasundaram
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  14. Arshiya Mubin S.P.
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  18. Satish Devakumar
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  19. Alagammai PL.
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  20. Sujata V. Gade
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  21. Kanagavel Manickavasagam
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  28. Gokul B.J.
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  29. Rajesh Natrayan
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  30. Harshini Manonmani Sampathkumar
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  31. Ramakrishna B.S.
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  32. Naveen Chand
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  33. Joseph Jensingh Babu S.
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  34. Sindhu Ashokan
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  35. Arulprakash S.
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  36. Karishma Srinivasan
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  37. Aravind A.
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  38. Lavanya N.
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  39. Arun R.S.
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  40. Asher Edward Prem Kumar
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  41. Rathnaswami A.
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  42. Rajesh N.A.
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  43. Arun A.C.
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  44. Ganga Balaji
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  45. Padmanabhan P.
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  46. Somnath Verma
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  47. Jayanthi V.
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Contributions

EGS: Study conception and design, data collection, data analysis, preparation of manuscript, overall coordination. JV: Study conception and design, critical revision of the manuscript for important intellectual content. UD, PK, VL, JS, RBS: Study design, data collection, critical revision of the manuscript for important intellectual content. Rest of the authors: data collection and critical revision of the manuscript for important intellectual content. All authors approve the final submitted version of the manuscript and are accountable for all aspects of the work.

Corresponding author

Correspondence to Ebby George Simon.

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Conflict of interest

EGS, UD, ASR, MK, KRY, JTG, PK, AnS. AS, AR, VL, DT, AV, AMSP, RMS, RJ, JS, SD, APL, SVG, KM, DA, MPVG, MP, MB, DA, CTS, GBJ, RN, HMS, RBS, NC, JJBS, SA, ArS, KS, AA, LN, ARS, AEPK, RA, RNA, AAC, GB, PP, SV and JV declare no competing interests.

Ethics approval

The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institution Review Board (Silver, Research and Ethics Committee), Christian Medical College, Vellore, Tamil Nadu (IRB No. 13925 [OBSERVE] dated 28.04.2021).

Consent to participate and for publication

Informed consent was obtained from all individual participants in the study including for publishing their data so long as it was being used for research purpose without revealing any identifying details.

Disclaimer

The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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This work was presented at the 12th Annual Research Day at Christian Medical College, Vellore, Tamil Nadu, as an oral presentation on October 6, 2022.

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Simon, E.G., Dhus, U., Rao, A.S. et al. Clinical profile of 1208 newly diagnosed colorectal cancer patients in Tamil Nadu—A multi-centric survey. Indian J Gastroenterol (2024). https://doi.org/10.1007/s12664-023-01496-9

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