Ankouane Andoulo¹*, Kowo Mathurin¹, Atenguena Obalemba Etienne¹, Ndjitoyap Ndam Antonin William¹, Bekolo Winnie², Dontsi Donrielle¹, Eloumou Bagnaka Servais Fiacre²

¹Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde Central Hospital, Cameroon
²Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala Gynaecological-Obstetric and Paediatric Hospital, Cameroon

*Corresponding Author: Ankouane Andoulo, Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde Central Hospital, Cameroon.

Received: August 17, 2021; Published: August 27, 2021

Abstract

Introduction: In sub-Saharan Africa, colorectal cancer (CRC) affects nearly 39.2% of young people aged 20-45 years. Epidemiological data are scarce. The aim was to describe the clinico-pathological characteristics of CRC in young subjects aged 30 years and under.

Patients and Methods: Retrospective study, conducted from January 1 to May 15, 2020, on a collection of data from the records of patients who were under patient care for histologically confirmed CRC in the hepato-gastroenterology, digestive surgery and medical oncology departments of ten hospitals in the cities of Yaounde and Douala-Cameroon, from January 1, 2009 to December 31, 2019. Patients were divided into two groups for comparison: the group comprising subjects aged 30 years and under at the time of diagnosis and the group including subjects aged over 30 years.

Results: A total of 153 patients followed for histologically confirmed CRC were included, of which 67 were 30 years old and under (43.8%) and 86 were older than 30 years (56.2%). The average age of those 30 years and under was 25.5 ± 4.2 years (10 - 30 years). Anaemia (65.7% vs. 48.8%; OR: 2.0 [1.0 - 4.1]; p = 0.03), abdominal mass (29.9% vs. 17.4%; OR: 2.0 [0.9 - 4.6]; p = 0.07), and occlusive syndrome (16.4% vs. 7.0%; OR: 2.6 [0.8 - 8.5]; p = 0.06) were more prevalent in the 30 years and under group. The general condition was impaired (WHO stage II to IV) in 92.5% of those 30 years and under (OR: 16.4 [5.6 - 51.7; p < 10^-5). Risk factors for CRC were rare in those aged 30 years and under, notably alcoholism (7.5% vs 43.0%; OR: 0.1 [0.0 - 0.3]; p < 10^-5) and smoking (3.0% vs 10.5%; OR: 0.3 [0.0 - 1.4]; p = 0.06). The average time from symptom onset to diagnosis was 8.6 ± 4.4 months for those 30 years and under vs. 9.4 ± 5.2 months (p < 10^-5). The left colon was the specific site in those 30 years and under (16.4% vs. 4.7%; OR: 4.0 [1.1 - 16.0]; p = 0.03). Ulcerated adenocarcinoma (86.6%) was more frequent in those aged 30 years and under 43.3% vs. 27.9% (OR: 2.0 [1.0 - 4.1]; p = 0.04). Well- and moderately-differentiated forms were unfrequently found in patients aged 30 years and under (19.4% vs. 34.9%; OR: 0.5 [0.2 - 1.0]; p = 0.03 and 11.9% vs. 38.4%; OR: 0.2 [0.0 - 0.5]; p < 10^-5, respectively). TNM stage II was the most common in both groups. Liver and lung metastases were found approximately equally in both groups.

Conclusion: CRC in young subjects aged 30 years and under is very common in the tropical areas. Some well-known risk factors do not appear too involved. The alteration of the general state seems to be present at the time of diagnosis. Anaemia, abdominal mass and occlusive syndrome are quite common. The left colon is involved in more than 80% of cases. The adenocarcinoma is ulcerated and of variable differentiation.

Keywords: Colorectal Cancer; Adenocarcinoma; Young Subject; Cameroon

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Citation

Citation: Ankouane Andoulo., et al. “Clinico-Pathological Characteristics of Colorectal Cancer among Young Subjects Aged 30 and Under in Tropical Areas: Retrospective Comparative Study Over Ten Years of Clinical Practice in Cameroon”. Acta Scientific Gastrointestinal Disorders 4.9 (2021): 65-69.

Copyright

Copyright: © 2021 Ankouane Andoulo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.