Abstract

ABSTRACT

EPIDEMIOLOGY OF COLON & RECTAL CANCER IN IRAQ. Z. AL-BAHRAINI, MB, CH.B, FRCS, FACS, FACG, BAGHDAD, IRAQ: and A. H. AL-HUMADI, MB, CH.B, MD, FACS, OLEAN, NY, USA.

PURPOSE: This study evaluates the descriptive epidemiology and clinical aspects of colorectal cancer (CRC) in the Iraqi population.

METHOD: Records of patients diagnosed with colorectal cancer for a period of thirty years from 1965 to 1994 in Baghdad Medical City Teaching Hospital and two private hospitals (Alousi and AlMustansuria) in Baghdad were reviewed. The material was analyzed retrospectively to study the epidemiological increase of cancer of the colon and rectum.

RESULTS: There were 511 patients diagnosed with colorectal cancer from 1965-1994. The male/female incidence was 1.4/1 for colon cancer and 1.1/1.0 for rectal cancer. The highest incidence was seen at the median age of 50. A total of 21.1 percent of patients were younger than 40 years of age. The population of Iraq in 1993 was 19 million composed of 15.5 million Arabs and 2.5 million Kurds with the incidence ratio of 6/1 for colon cancer and 5.3/1 for rectal cancer. The most common symptom was change in bowel habits with obstruction for colon cancer (51%), rectal bleeding and change in bowel habits for rectal cancer (71.5%). The rectum was the most common site 47% followed by the left colon and sigmoid colon 27% and the right colon at 26%. The predisposing factors related to adenomatous polyps 3%, familial polyps 5%, ulcerative colitis 3%. Pathological classification was Duke’s D lesion 56.9%, Duke’s C lesion 71.3%, Duke’s B and Duke’s A 7%.

DISCUSSION: Comparative studies in the Iraqi Cancer Registry during the 30 year period (65-94) showed an increased incidence of colorectal cancer from 25% to 50% and a decrease of gastric cancer from 78% to 50%. The incidence of colorectal cancer in Iraq is 2.6% compared to 6-13% in the developed countries and 17-51.1% in the industrialized nations.

CONCLUSION: Iraq shares the epidemiology characters of developing countries in the Middle East. There is a shift towards the western-style of living that has probably leaded to the increase of colon and rectal cancer in the Iraqi population. This increased incidence in colon and rectal cancer coincides with the decreased incidence in gastric cancer. The expected change in pattern of this disease in Iraqi is probably related to the rapid change in dietary habits. In addition, there may be possible effects of environmental and chemical hazards of the Iraqi/Iranian War and the Gulf War that remain to be seen.

Recommended Citation

Adil H. Al-Humadi (2008) "Epidemiology of Colon & Rectal Cancer In Iraq," World Journal of Colorectal Surgery: Vol. 1 : Iss. 1, Article 15.
Available at: http://services.bepress.com/wjcs/vol1/iss1/art15