Cancer of the lower gastrointestinal tract: a five year experience in Ethiopia

To provide the pattern and outcome, 131 patients admitted to Tikur Anbessa Hospital, Department of Surgery, between 1992 and 1996 with a diagnosis of lower gastrointestinal tract (colo-anorectal and small bowel) cancer were analysed. Lower gastrointestinal tract cancer accounted for 30% of all gastrointestinal tract malignancies, excluding hepatic cancer, seen in the Department during the study period. The female to male ratio was 1.0:1.8. The mean age was 47.1 +/- 15.7 (range 17-85) years. Among the 131 cases, 52.7% and 16% were under 50 and 30 years of age, respectively. The mean duration of symptoms on admission was 11.2 +/- 8.9 (range 0.2-43) months. The most frequent clinical features included weight loss (93%), pain (86%), rectal bleeding (79%), tenesmus (74%) and anorectal lesion (62%). Adenocarcinoma accounted for 92% of the pathology. Among 94 surgically staged cases, 63 had Dukes' C and D lesions. The most common site of primary tumours was the rectum (61.1%). Ninety per cent of the cases were operable and of these, 63 had resections with curative intent. Twenty patients refused surgery. There were fifteen postoperative hospital-stay deaths. The mean follow up was 5.7 +/- 3.1 (range 0.2-48) months. Cancer of the lower gastointestinal tract seemed to occur in rather younger age and diagnosis was late.