High Magnitude Advanced Colorectal Cancer at Diagnosis in Ethiopian Patients: Imaging Pattern and Associated Factors.

BACKGROUND: Colorectal cancer (CRC) is one of the most prevalent and incident cancers worldwide with an Increasing prevalence in a younger age in developing countries. The aim of the study was to determine the staging and imaging pattern of CRC at diagnosis.

METHODS: This is a descriptive cross-sectional study including all consecutive cases of CRC found in the departments of radiology and oncology during the study period from March 2016 - February 2017.

RESULTS: A total of 132 CRC cases were studied with M: F = 2.4:1, mean age of 46yrs and 67.4% </= 50yrs. Left-sided tumors were associated with rectal bleeding (p = 0.001) and bowel habit change (p =0.045) whereas right-side tumors were associated with weight loss (p = 0.02) and abdominal pain (p = 0.004). 84.5% of CRC presented at an advanced stage, and 32% had distant metastasis. Young age was associated with the advanced stage (P=0.006) whereas family history was associated with the lower stage (P=0.008). Distance metastasis was associated with Colonic lesions (P=0.003) and emergent presentation (P=0.008). Asymmetric wall thickening with luminal narrowing was significantly associated with left side tumor (95% vs 21.4%) whereas large mass with necrosis was significantly associated with right side tumor (50% vs 5%) (P= 0.004).

CONCLUSIONS: CRC is presented at a younger age and at an advanced stage. The majority of CRCs were left-sided and rectal. Increasing the index of suspicion for CRC in patients with rectal bleeding and, bowel habit change is recommended.