Clinicopathological Evaluation of Colorectal Growth in a Tertiary Level Hospital in Bangladesh: A Series of Hundred Cases

Author(s): Syeda Rumman Aktar Siddiqui, Md. Ariful Islam, Ratim Mir, Mohammad Zillur Rahman.

Introduction: Colorectal cancer (CRC) ranks as the third most commonly diagnosed cancer worldwide, with incidence and mortality rates of 6.1% and 9.2%, respectively. In 2020, CRC accounted for an estimated 10 million deaths globally, with 6 million occurring in low-income countries. Despite being less prevalent in Bangladesh compared to other underdeveloped nations, it poses a significant health burden. Methods: This retrospective cross-sectional study, conducted at the Department of Histopathology in Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh, from July to December 2023, aimed to assess the clinicopathological characteristics of colorectal growth among patients undergoing colonoscopic biopsy and excision procedures. A purposive sampling technique was employed, enrolling 100 cases irrespective of age and sex. Results: Of the study participants, 50% underwent colonoscopic biopsy, with 52% being malignant and 48% non-malignant. All patients (50%) undergoing excision procedures had malignant cases. Female patients comprised the majority (60.5%) of malignant cases, with the ascending colon being the most frequent site (31.0%) of colorectal carcinoma. Adenocarcinoma, NOS, was the predominant histopathological type (63.2%). Most cases were diagnosed at an advanced stage, with Grade II being the most frequent (54, 71.1%). PT2 was the most common T stage (18, 51.4%), while PN0 dominated among N stages (19, 52.8%), with the highest lymph node involvement observed in N1b (18.0%). Conclusion: Colorectal carcinoma predominantly affects middle-aged individuals, with a notable female predominance. Adenocarcinoma, NOS, represents the most frequent histopathological subtype, primarily affecting the ascending colon. The advanced stage at diagnosis underscores the necessity for screening programs to facilitate early detection in Bangladesh.