Hospital frequency of large bowel cancer: factors thought to influence outcome

One of the leading causes of death from malignancies is cancer of the large gut. Elsewhere in the developed world, the disease severity and operative mortality are falling due to increased use of screening, earlier diagnosis and improvement in surgical techniques.

To report our experience with this disease at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.

This is an 8-year retrospective analysis (January 1998 December 2005) of all established cases of large bowel cancer managed at the surgical services of the Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto.

A total of 40 cases of colorectal cancer were seen in this centre during the study period. There were 21 (52.5%) males and 19 (47.5%) females, representing a male: female ratio of approximately 1:1. The modal age was the 5th decade. The youngest patient was 15 years old. Forty-two percent of patients were below 40 years of age. All were symptomatic at time of detection. There was no patient in Dukes' stage A category. Nineteen (47.5%) were stage D at presentation. Potentially curative resection was performed in 5 (12.5%) patients. Another 22 (55.0%) cases had palliative surgical treatment. The remainder were either inoperable (n= 3; 7.5%), refused colostomy (9; 22.5%) or died before surgical treatment (1; 2.5%). Among those who were surgically treated, 6 (22.2%) died within 30 days of operation. The mean duration of post-operative follow up was 16 months (5 67 months).

Cancers of the large intestine are not uncommon in this part of the world. A rising frequency of colorectal cancers in our locality is observed. Presentation to hospital is usually late. A significant number of patients are below 40 years of age.