Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution. Issue 3 (30th September 2019)

• Record Type: Journal Article
• Authors: McCabe, Michelle; Perner, Yvonne; Magobo, Rindidzani; Mirza, Sheefa; Penny, Clement
• Is Part Of: JGH open. Volume 4:Issue 3(2020)
• Page Start: 360
• Page End: 367
• Publication Date: 2019-09-30
• Subjects: colorectal cancer -- descriptive epidemiology -- race -- South Africa
• DOI: 10.1002/jgh3.12248
• Languages: English
• ISSNs: 2397-9070

Abstract

Abstract : Background and Aim: Epidemiological studies of colorectal cancer (CRC) in South Africa (SA) have been poorly characterized. Black and white SA population groups have demonstrated distinct CRC clinical presentations, suggesting that black SA patients follow a different carcinogenic pathway than their white counterparts. Thus, the aim of this study was to identify unique demographic and histopathological features associated with black SA patients to facilitate earlier diagnosis and to improve disease management. Methods: This preliminary descriptive epidemiological study included 665 retrospective CRC cases diagnosed between the period 2011 and 2015 at the Charlotte Maxeke Johannesburg Academic Hospital. Demographic and histopathological features in black versus other race groups (ORG) were compared, and Student's t ‐test, Chi‐square, and Fischer's exact tests were used for statistical analysis. Results: Statistical analysis demonstrated that patients with left‐sided tumors of invasive adenocarcinoma were predominantly black and male. These patients were considerably younger when compared to ORG (median 56 vs 62 years, respectively), P < 0.0001. However, no significant propensity for other histological features was illustrated. Polyps were mostly tubular adenomas (51%) and tubulovillous adenomas (TVAs) (44%). TVAs were mostly high‐grade lesions ( P < 0.0001) and associated with left‐sided CRC ( P = 0.0325). Conclusion: These findings verify that black SA CRC patients have an earlier disease onset in comparison to ORG; however, no increased tendency for tumor site, precursor lesion, stage of disease, or gender was evident. Thus, a deeper molecular characterization of CRC is required to understand the underlying causes associated with earlier disease onset in black SA CRC patients. Abstract : This study demonstrated that black South Africa (SA) colorectal cancer (CRC) patients present at a significantly younger age in comparison to other SA race groups; however, no increased tendency for tumor site, precursor lesion, stage of disease, or gender was shown with regard to race. CRC in black SA patients also appears to be distinct from African American patients, illustrating a different mechanism of disease and characterization at the molecular level required to understand the underlying pathology.