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  • br Cigarette smoking has been linked to a

    2019-09-24


    Cigarette smoking has been linked to a two to threefold increase in CRC risk, most noticeably after a prolonged latency AWD 131-138 of at least three decades. Emerging data suggest that cigarette smoking may be differentially associated with CRCs
    that exhibit microsatellite instability.17 The aim of this study is to describe the main characteristics of CRC regarding age, gender, and anatomical sub-site distribution, as well as the main presenting symptoms, in Iraqi patients.
    Patients and methods
    Over a two years since January 2017 we reviewed all the colonoscopy reports of patients diagnosed with CRC who had their diagnostic colonoscopy performed in the Gastroenterol-ogy and hepatic center-Baghdad. This study was approved by the ethics committee of Alkindy college of Medicine — University of Baghdad. Patients were excluded if they had recurrent cancer and only patients with newly-diagnosed CRC were studied. In all patients, diagnosis was initially sus-pected on endoscopic findings and subsequently confirmed by the results of histopathological examination of endoscopic colonic biopsies. For all of the patients studied, the diagnosis was adenocarcinoma of varying degrees of differentiation.
    Aspects included in the study were the patients’ demo-graphic and the clinical symptoms for which they have been referred for colonoscopy as well as the anatomical location of the tumor mass as described in the colonoscopy report. Five symptoms and their total duration including bleeding per rectum, diarrhea, constipation, abdominal pain, and weight loss were recorded. This descriptive statistics, correlation, and regression were used to analyze the data.
    Results
    Sixty three cases with a newly-diagnosed CRC and were included in this study.
    The most common symptom reported was fresh bleeding per rectum which occurred in 48 (76.2%) patients; while the least common was weight loss, reported in 12 (19%) patients. Patients’ demographic and clinical characteristics are summa-rized in Table 1.
    The shortest duration of symptoms before referral for diag-nostic colonoscopy was 10 days; while the longest was 6 years. The mean duration of symptoms before referral was 7.3 ± 12.6 months. Twenty-five percent of patients had symp-toms for one month or less, 50% for 2 months or less, 75% for 8 months or less, and 25% for more than 8 months (p < 0.05). Fig. 2 illustrates the relative frequencies of patients’ duration of symptoms before referral for diagnostic colonoscopy.
    A summary of the distribution of anatomical location of the tumors for the study patients is B memory cells demonstrated in Fig. 3. By far the most common location was the rectum which was reported in 37 (58.7%) patients; followed by the sigmoid colon, in 12 (19%) patients; and the cecum, in 7 (11.1%) patients,
    Age in years
    Fig. 1 – Age distribution of patients with newly diagnosed CRC.
    Table 1 – Demographic and clinical characteristics of patients.
    Characteristic Valuesa
    b Duration of symptoms measured in months.
    Duration of symptoms (months)
    Fig. 2 – Percentage of patients by their average duration of symptoms.
    ARTICLE IN PRESS
    Abdominal
    pain
    Rectum
    No
    Yes
    Sigmoid
    Cecum
    Descending
    Ascending
    Multiple
    0% Descending Cecum
    Rectum
    Sigmoid Ascending
    Fig. 3 – Anatomical distribution of patients’ CRCs. Fig. 5 – Correlation between tumor site and abdominal
    pain.
    Bleeding
    per
    rectum
    Yes
    No
    Cecum
    Rectum Descending
    Sigmoid Ascending
    Fig. 4 – Correlation between frequency of bleeding per rectum and tumor site.
    whereas the least common single site was the ascending colon, found in 2 (3.2%) patients. Tumors of the rectum and AWD 131-138 sigmoid region were significantly more common than tumors at other sites of the colon being present in 77.8% of all CRCs diagnosed (p < 0.05).