Makmun D, Simadibrata M, Abdullah M, Syam AF, Shatri H, Fauzi A, Renaldi K, Maulahela H, Utari AP, Pribadi RR, Muzellina VN, Nursyirwan SA. Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors. World J Clin Cases 2021; 9(32): 9804-9814 [PMID: PMC8610908 DOI: 10.12998/wjcc.v9.i32.9804]
Corresponding Author of This Article
Dadang Makmun, FACG, MD, PhD, Attending Doctor, Professor, Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jl. Pangeran Diponegoro No. 71, Jakarta 10430, Indonesia. hdmakmun@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2021; 9(32): 9804-9814 Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9804
Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors
Dadang Makmun, Marcellus Simadibrata, Murdani Abdullah, Ari F Syam, Hamzah Shatri, Achmad Fauzi, Kaka Renaldi, Hasan Maulahela, Amanda P Utari, Rabbinu R Pribadi, Virly N Muzellina, Saskia A Nursyirwan
Dadang Makmun, Marcellus Simadibrata, Murdani Abdullah, Ari F Syam, Achmad Fauzi, Kaka Renaldi, Hasan Maulahela, Amanda P Utari, Rabbinu R Pribadi, Virly N Muzellina, Saskia A Nursyirwan, Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
Hamzah Shatri, Clinical Epidemiology Unit, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
Author contributions: Makmun D designed and performed the research, conducted the analysis, and wrote the manuscript; Simadibrata M supervised the report and provided clinical advice; Shatri H contributed to the statistical analysis; and Makmun D, Simadibrata M, Abdullah M, Syam AF, Fauzi A, Renaldi K, Maulahela H, Utari AP, Pribadi RR, Muzellina VN and Nursyirwan SA performed the colonoscopy examination and provided clinical advice.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Faculty of Medicine Universitas Indonesia (Protocol No. 19-06-0751).
Informed consent statement: As this was a retrospective study and only existing data from medical records were collected, patients were not required to give informed consent to the study. However, all patients agreed by written consent to the medical treatment provided in the healthcare setting.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dadang Makmun, FACG, MD, PhD, Attending Doctor, Professor, Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jl. Pangeran Diponegoro No. 71, Jakarta 10430, Indonesia. hdmakmun@yahoo.com
Received: June 21, 2021 Peer-review started: June 21, 2021 First decision: July 18, 2021 Revised: August 15, 2021 Accepted: September 22, 2021 Article in press: September 22, 2021 Published online: November 16, 2021 Processing time: 141 Days and 22.7 Hours
ARTICLE HIGHLIGHTS
Research background
The incidence of early-onset colorectal cancer (CRC) has been increasing worldwide. Determining the population at-risk for early-onset CRC, who will most benefit from screening, is important.
Research motivation
The reports of clinical characteristics as well as potential risk factors associated with early-onset CRC, especially in developing countries, are still lacking.
Research objectives
The objective of this study was to evaluate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia.
Research methods
In this study, patients who underwent colonoscopy examination between 2008 and 2019 and were diagnosed with CRC based on histopathological findings were identified from medical records. The subjects were classified into two groups, according to their age at diagnosis: Early onset (18-49 years old) and late onset (≥ 50 years old). Demographic data, characteristics, and risk factors of both age groups were evaluated using the chi-square and Fisher’s exact tests.
Research results
Among the total 495 patients assessed, 205 (41.4%) were classified as early-onset CRC. Most subjects in the early-onset age group were male (53.7%), had adenocarcinoma histopathology (89.8%), and presented with left-sided tumors (78%). Abdominal pain was the most frequent symptom in the early-onset age group (55.6%), a significantly higher proportion than that in late-onset age group (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight compared to late-onset CRC cases (34.6% vs 20.0%, P < 0.001). The proportion of subjects suspected with hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset age group than in the late-onset age group (9.3% vs 4.1%, P < 0.05).
Research conclusions
Most patients with early-onset CRC were male, had left-sided tumors, and histopathologically displayed adenocarcinoma. A higher proportion of early-onset CRC cases presented with abdominal pain. The early-onset CRC patients were more likely to be underweight and suspected of having HNPCC compared with the late-onset CRC patients.
Research perspectives
Further multicenter research involving a larger sample size is required to better assess the clinical demographics of early-onset CRC patients and the potential risk factors associated with early-onset CRC; these data will help to redefine the most appropriate cutoff age and the populations at-risk for CRC who will most benefit from screening.
