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. 2021 Oct 7:13:7697-7707.
doi: 10.2147/CMAR.S334226. eCollection 2021.

Colorectal Cancer in Uganda: A 10-Year, Facility-Based, Retrospective Study

Godfrey Wekha  1 , Nelson Ssewante  1 , Angelique Iradukunda  1 , Micheal Jurua  1 , Shadia Nalwoga  1 , Sharon Lanyero  1 , Ronald Olum  1 , Felix Bongomin  2   3
Affiliations

Colorectal Cancer in Uganda: A 10-Year, Facility-Based, Retrospective Study

Godfrey Wekha et al. Cancer Manag Res. .

Abstract

Introduction: Colorectal cancer (CRC) is the most common type of gastrointestinal malignancies and the third leading cause of cancer-related deaths for both sexes worldwide. Although the burden of CRC is highest in developed countries, reports are indicating a rise in the incidence of early-onset CRC in developing countries. In this study, we aimed to determine the prevalence of CRC among patients hospitalized with lower gastrointestinal complaints at a tertiary health facility in Uganda.

Methods: We conducted a 10-year retrospective chart review of patients admitted to Mulago National Referral Hospital in Kampala, Uganda, between 1st January 2010 and 31st December 2020. We reviewed all charts of patients admitted to the lower gastrointestinal tract (GIT) ward. Charts with grossly missing data, pediatric patients, and those from other non-lower GIT specialties were excluded.

Results: Data of 1476 unique eligible patients were analyzed. Of these,138 had a diagnosis of CRC (prevalence: 9.3%, 95% confidence interval (95% CI): 6.5-11.7%). Among patients with CRC, the female:male ratio was 1:1. The most common site for CRC was the rectum (59.8%, n= 79). For the 138 participants with CRC, 44 had staging data with 72.8% (n=32) having advanced disease, that is, stage 3 or 4. Factors independently associated with CRC were age ≥50 years (adjusted odds ratio (aOR): 4.3, 95% CI: 2.6-7.1, p < 0.001), female sex (aOR: 1.8, 95% CI: 1.2 -2.8, p = 0.005), being widowed (aOR: 2.5, 95% CI: 1.3-5.0, p = 0.006), and presence of any risk factor for CRC (aOR: 5.3, 95% CI: 2.9-9.9, p < 0.001).

Conclusion: CRC is relatively common among patients hospitalized with lower GIT complaints, particularly among women and those with known risk factors for CRC. Awareness creation and screening programs should be instituted to allow early diagnosis of CRC in our setting.

Keywords: GIT malignancy; colon; colorectal cancer; rectum.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Comparison of median age between CRC and Non-CRC patients.
Figure 3
Figure 3
Map of Uganda showing distribution of CRC cases.
Figure 4
Figure 4
Risk factors associated with CRC.
Figure 5
Figure 5
The trend of CRC cases recorded from 2010 to 2020.
See this image and copyright information in PMC

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