Epidemiologic and clinical profiles of colorectal cancer in Southern Egypt

To calculate the incidence of colorectal cancer in Southern Egypt and to describe the epidemiological profiles of people with colorectal cancer in this region.

Colorectal cancer (CRC) is one of the common cancers in high income countries but historically CRC has been uncommon in low- and middle-income countries (LMICs). Egypt was among the first countries to report higher incidence of early-onset CRC under age 40. While previous studies on CRC in Egypt over the past 3 decades have focused on Cairo and the northern Nile delta regions, this study focused on CRC in the Southern Egypt, an underserved region with distinct socioeconomic and patient constitutional characteristics.

We identified 613 CRC patients who received care during 2018-2022 at the Shefa Al-Orman Cancer Hospital (SOH), the main cancer hospital in the Luxor province in Southern Egypt. Data retrieved from the medical records included demographic, clinical, and family history of all patients managed at SOH. We calculated the incidence by two age groups, under age 45 vs. 45 + years, the incidence rate (IR), age- and sex-specific rates, and distribution of clinical characteristics.

Twenty-three percent of patients were diagnosed under age 45. The 5-year incidence was 4.5 per 100,000, and the incidence rate (IR) of early-onset was 1.3 vs 18.3 per 100,000 for those 45 + years. Distant metastasis was identified in 28% of patients, and 38% of patients had rectal cancers and 58% of the patients were alive at last follow-up.

The incidence of early-onset and late-onset CRC is lower in Southern Egypt than the reported incidence from other regions of the country. Future etiologic studies should focus on investigating the socioeconomic and lifestyle factors of Southern Egypt. Clinical studies should also explore factors related to late-stage presentation and low survival in this population. The study may have global implications for the etiology and management of colorectal cancer.