Rectal prolapse as an initial presentation of colorectal cancer: a systematic review

Colorectal cancer rising incidence still pose a public health challenge. In the present systematic review, we aimed to study the colorectal cancer patients with initial presentation of rectal prolapse.

The study protocol was developed (PROSPERO CRD42017060473). We searched Web of Science, PubMed and Scopus to identify case reports of rectal Prolapse as a chief compliant of colorectal cancer. The Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) guidelines were used for screening and data extraction.

Thirty-one case reports were included in this review. More than half of the patients were females over 65 years old and mean ± SD age of the cases were 64 ± 17.9 years and, the female gender were mentioned in 17 (56%) case reports. The majority (64.5%) of the identified cancer belong to rectum and recto-sigmoid origin's location. In the history retained from the cases, rectal bleeding and constipation were the most frequent reported accompanied symptoms in colorectal cancer cases with initial presentation of rectal prolapse. 67.7% of all identified cases in this review published at 2015 and later.

Rectal prolapse can be an initial presentation of colorectal cancer, which is more prevalent in female more than 65 years old. The most common symptoms accompanied rectal prolapse were rectal bleeding and constipation. According to rising published case reports on colorectal cancer patients with initial presentation of rectal prolapse in recent years, further work-up is recommended for patients without predisposing factors for a concomitant tumor.