شاخص های اپیدمیولوژیک و کلینیکو پاتولوژیک سرطانهای کولورکتال در ساری 1386-1378

Background and Purpose: Each year, about 50,000 new cases of cancer occur in Iran and the most common being the gastrointestinal (GI) tract (38%). Colorectal cancers account for the 3rd and 4th most prevalent cancers in Iranian men and women, respectively. Since genetic and environmental factors lead to differences in colorectal cancer occurrence in different geographic regions and races, we designed a study to assess characteristics of this cancer, in the Guilak race of Mazandaranian people. Materials and methods: The records of all colorectal cancer patients who were referred to in a private GI clinic or admitted in hospitals and were studied during 1999 to 2007. Data was analyzed using SPSS software, Chi- Square and T-Tests. Results: 296 cases of colorectal cancers (CRCs) were enrolled in the study. There were 2 cases of colon lymphoma and 1 case of cervical cancer with metastasis to colon. The remaining 293 patients had colorectal Aden carcinoma, of which 152 were males and 141 were females. The mean age of patients was 52.6 ± 15.2 years. 98 patients (33.5%) were under 45 years of age. A total of 70 cases (24%) had familial history of CRC. Moreover, 47% of patients under 45 years had positive familial history for CRC , of whom 43 patients (14.6%) were classified as having Hereditary Non- Polyposis Colorectal Cancer (HNPCC). 125 patients had rectal, while 168 cases had colon cancers. Right- sided colon cancers were 2 times more prevalent than the left- sided involvements. In addition, right- sided colon cancers were relatively more prevalent in those with positive familial history of CRC. Importantly, about half of all patients showed advanced stages of the disease (Lymph node involvement or distal metastases) at the time of diagnosis. Conclusion: Regarding the younger age of involvement, the significant positive familial history, the more prevalent proximal colon cancers and advanced stages of the disease at the time of diagnosis, we recommend to design screening programs for earlier detection of CRCs in this geographic region.