Brief Article
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World J Gastroenterol. Aug 14, 2012; 18(30): 3997-4003
Published online Aug 14, 2012. doi: 10.3748/wjg.v18.i30.3997
Age distribution, polyps and rectal cancer in the Egyptian population-based cancer registry
Darlene Veruttipong, Amr S Soliman, Samuel F Gilbert, Taylor S Blachley, Ahmed Hablas, Mohamed Ramadan, Laura S Rozek, Ibrahim A Seifeldin
Darlene Veruttipong, Amr S Soliman, Samuel F Gilbert, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
Taylor S Blachley, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
Ahmed Hablas, Mohamed Ramadan, Ibrahim A Seifeldin, Tanta Cancer Center and the Gharbiah Population-Based Cancer Registry, Tanta 31512, Egypt
Laura S Rozek, Department of Environmental Health Science, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
Author contributions: Soliman AS, Hablas A, Ramadan M, Rozek LS and Seifeldin IA designed the study; Veruttipong D and Ramadan M performed the data collection and retrieval of clinical and research materials; Veruttipong D, Gilbert SF and Blachley TS performed the data management and data analysis; Veruttipong D and Gilbert SF wrote the first versions of the manuscript; Soliman AS, Hablas A, Ramadan M, Rozek LS and Seifeldin IA participated in data interpretation and writing of the different versions of the manuscript.
Supported by The National Cancer Institute Grant, No. R25 CA112383 (to Veruttipong D and Gilbert SF); and the University of Michigan Center for Global Health
Correspondence to: Amr S Soliman, MD, PhD, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. asoliman@umich.edu
Telephone: +1-734-7645469 Fax: +1-734-7643192
Received: January 24, 2012
Revised: March 23, 2012
Accepted: April 12, 2012
Published online: August 14, 2012
Abstract

AIM: To describe the clinical and epidemiologic profiles of the disease and to compare the findings with those generated from the previous hospital-based studies.

METHODS: The Gharbiah cancer registry is the only population-based cancer registry in Egypt since 1998. We analyzed the data of all colorectal cancer patients included in the registry for the period of 1999-2007. All medical records of the 1364 patients diagnosed in Gharbiah during the study period were retrieved and the following information abstracted: age, residence, diagnosis date, grade, stage, topology, clinical characteristics, and histology variables. Egyptian census data for 1996 and 2006 were used to provide the general population’s statistics on age, sex, residence and other related demographic factors. In addition to age- and sex-specific incidence rate analyses, we analyze the data to explore the incidence distribution by rural-urban differences among the 8 districts of the province. We also compared the incidence rates of Gharbiah to the rates of the Surveillance Epidemiology and End Results (SEER) data of the United States.

RESULTS: Over the 9 year-period, 1364 colorectal cancer cases were included. The disease incidence under age 40 years was relatively high (1.3/105) while the incidence in the age groups 40 and over was very low (12.0/105, 19.4/105 and 21.2/105 in the age groups 40-59 years, 60-69 years and > 70 years, respectively). The vast majority of tumors (97.2%) had no polyps and 37.2% of the patients presented with primary lesions in the rectum. Colorectal cancer was more common in patients from urban (55%) than rural (45%) areas. Regional differences in colon and rectal cancer incidence in the 8 districts of the study province may reflect different etiologic patterns in this population. The registry data of Egypt shows a slightly higher incidence of colorectal cancer than the United States in subjects under age 40 years. The results also shows significantly lower incidence of colorectal cancer in subjects over age 40 years compared to the same age group in the United States SEER.

CONCLUSION: Low rate of polyps, low incidence in older subjects, and high rate of rectal cancer in Egypt. Future studies should explore clinical and molecular disease patterns.

Keywords: Colorectal cancer, Young-onset, Polyps, Developing countries, Egypt