Anatomical Sites of Colorectal Cancer in a Semi-urban Nigerian Hospital: Is There a True Rightward Shift.

BACKGROUND Recent report on colorectal tumours in Nigeria and Africa sub-region from big urban cities have shown that the incidence of colorectal cancer is rising and with a proportionate right-ward shift. OBJECTIVE To assess the sub-site distribution and surgical treatmentpatterns of colorectal cancer in a semi-urban tertiary Nigerian hospital. DESIGN A retrospective descriptive study. SETTING Tertiary health institution in a semi-urban (rural) community. SUBJECTS All consecutive in-patients, admitted and managed for acute intestinal obstruction due to colorectal cancer. MAIN OUTCOME The right colon was the site of predilection (60.6%) while the left colon was only (6.06%). Young adults were mostly affected. RESULT A total of thirty three (33) cases of colorectal cancer (CRC) were seen during the study period. There were 20 (60.6%) males and 13 (39.4%) females. The male:female ratio was 1.5:1. The age range was between 22-87 years (mean 57.09 years). The peak age of occurrence was the 6th decade. All patients'were symptomatic at presentation. The caccum (36.365) was the predominant site affected; followed by the rectum (24.24%) and the hepatic flexure (21.21%). Of the colonic tumours, 60.6% were on the right colon while only 6.06% were on the left colon. Tumours of the descending and sigmoid colon were conspicuously absent. Fifteen patients (45.5%) had curative resection and 33.3% had palliative surgery. Twenty one point two percent mortality was recorded, while 21.2% refused surgery and opted for alternative care. CONCLUSION Colorectal cancers are seen among rural dwellers in Nigeria. Presentations are often late. The right colon is the dominant site affected; this calls for a change in strategy for formulating a preventive policy for the country.