Adenocarcinoma of the large bowel in Nigerians: a clinicopathologic study

This paper analyzes 320 cases of colorectal adenocarcinoma at the University College Hospital, Ibadan, Nigeria over a period of 18 years. The sex ratio was 1.5:1 in favor of males; the average age when first seen was 44 years. The symptom complex was weight loss, bloody mucoid stool, altered bowel habit, and abdominal mass. Eighty per cent of rectal cases were in the lower third of the rectum. Most cases were very advanced at the time they were first seen. The association of infective granuloma, notably schistosomiasis and amebiasis, occurred in 11 cases. This probably had diagnostic significance but the etiologic significance is still conjectural. Eighty per cent of the tumors were well-differentiated adenocarcinoma, while 20 per cent were of other histologic variants. In spite of advanced disease, resection was possible in 66 per cent of colonic and 45 per cent of rectal cases. Although the number of cases of colorectal cancers treated yearly in the hospital has increased significantly in the last few years, it is suggested that the hitherto low treatment rate may be attributable to social unacceptability of a permanent colostomy.