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Simon EG, Dhus U, Rao AS, M K, Yedupati KR, George JT, K P, Swarna A, Somasundaram A, Ramakrishnan A, L V, Thomas D, V A, S P AM, M S R, Jha R, S J, Devakumar S, Pl A, Gade SV, Manickavasagam K, Agarwal D, V G MP, Prasad M, B M, Abirami D, T S C, B J G, Natrayan R, Sampathkumar HM, B S R, Chand N, S JJB, Ashokan S, S A, Srinivasan K, A A, N L, R S A, Kumar AEP, A R, N A R, A C A, Balaji G, P P, Verma S, V J. Clinical profile of 1208 newly diagnosed colorectal cancer patients in Tamil Nadu-A multi-centric survey. Indian J Gastroenterol 2024:10.1007/s12664-023-01496-9. [PMID: 38372944 DOI: 10.1007/s12664-023-01496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/28/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND An increasing incidence of colorectal cancer (CRC) is being reported in developing countries, including India. Most Indian studies on CRC are retrospective and single-centered. The present study is an attempt to understand the current clinical profile and stage of newly diagnosed CRCs across multiple centers in Tamil Nadu, India. METHODS A multi-centric observational survey was conducted between September 1, 2021, and August 31, 2022, under the aegis of the Indian Society of Gastroenterology - Tamil Nadu chapter. Patients 18 years of age and older with a recent diagnosis of CRC fulfilling the inclusion criteria were prospectively recruited at the participating centers. Their demographic, clinical, biochemical, endoscopic, histopathologic, radiologic and risk factor details were systematically collected and analyzed. RESULTS Across 23 centers in Tamil Nadu, 1208 patients were recruited. The male:female ratio was 1.49:1, while mean (SD) age was 57.7 (13.5) years. A majority (81.9%) were Tamils and 78.5% belonged to lower socioeconomic classes. The predominant symptoms were hematochezia (30.2%) and a change in bowel habits (27.5%). The most common locations were the rectum (34.3%) and rectosigmoid (15.1%). Synchronous CRCs were seen in 3.3% and synchronous colorectal polyps in 12.8%. Predisposing factors for CRC were seen in 2%. A past history of any cancer among CRC patients was obtained in 3.1% and a family history of any cancer was found in 7.6%. Patients who were either overweight or obese constituted 46.4% of the study population. At presentation, the predominant stages were stage III (44.7%) and stage IV (20.8%). CONCLUSIONS A majority of patients with newly diagnosed CRC in Tamil Nadu belonged to the lower socioeconomic classes. About 60% had CRCs located within the reach of the flexible sigmoidoscope. Two-thirds of the patients exceeded stage II disease at presentation. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Ebby George Simon
- Department of Medical Gastroenterology, Christian Medical College, Vellore, 632 004, India.
| | - Ubal Dhus
- Department of Medical Gastroenterology, Apollo Hospitals, Chennai, 600 006, India
| | - Amara Sadguna Rao
- Department of Medical Gastroenterology, Apollo Hospitals, Chennai, 600 006, India
| | - Kannan M
- Department of Medical Gastroenterology, Madurai Medical College, Madurai, 625 020, India
| | - Kondala Rao Yedupati
- Department of Medical Gastroenterology, Madurai Medical College, Madurai, 625 020, India
| | - John Titus George
- Department of Medical Gastroenterology, Christian Medical College, Vellore, 632 004, India
| | - Premkumar K
- Institute of Medical Gastroenterology, Madras Medical College, Chennai, 600 003, India
| | - Anupama Swarna
- Institute of Medical Gastroenterology, Madras Medical College, Chennai, 600 003, India
| | | | - Arulraj Ramakrishnan
- GI and Liver Unit, Kovai Medical Center and Hospital, Coimbatore, 641 014, India
| | - Venkatakrishnan L
- Department of Gastroenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India
| | - Dhanush Thomas
- Department of Gastroenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India
| | - Arulselvan V
- Department of Medical Gastroenterology, Coimbatore Medical College, Coimbatore, 641 018, India
| | - Arshiya Mubin S P
- Department of Medical Gastroenterology, Coimbatore Medical College, Coimbatore, 641 018, India
| | - Revathy M S
- Department of Medical Gastroenterology, Stanley Medical College, Chennai, 600 001, India
| | - Rakesh Jha
- Department of Medical Gastroenterology, Stanley Medical College, Chennai, 600 001, India
| | - Jeswanth S
- Department of Surgical Gastroenterology, Stanley Medical College, Chennai, 600 001, India
| | - Satish Devakumar
- Department of Surgical Gastroenterology, Stanley Medical College, Chennai, 600 001, India
| | - Alagammai Pl
- Department of Gastroenterology, Meenakshi Mission Hospital and Research Centre, Madurai, 625 107, India
| | - Sujata V Gade
- Department of Gastroenterology, Meenakshi Mission Hospital and Research Centre, Madurai, 625 107, India
| | - Kanagavel Manickavasagam
- Department of General, GI and Minimal Access Surgery, St. Isabel's Hospital, Chennai, 600 004, India
| | - Deepak Agarwal
- Department of General, GI and Minimal Access Surgery, St. Isabel's Hospital, Chennai, 600 004, India
| | - Mohan Prasad V G
- Department of Medical Gastroenterology, VGM Hospital, Coimbatore, 641 005, India
| | - Madhura Prasad
- Department of Medical Gastroenterology, VGM Hospital, Coimbatore, 641 005, India
| | - Mahadevan B
- Department of Medical Gastroenterology, Gleneagles Global Health City, Chennai, 600 100, India
| | - Dinu Abirami
- Department of Medical Gastroenterology, Gleneagles Global Health City, Chennai, 600 100, India
| | - Chandrasekar T S
- Department of Medical Gastroenterology, MedIndia Hospitals, Chennai, 600 034, India
| | - Gokul B J
- Department of Medical Gastroenterology, MedIndia Hospitals, Chennai, 600 034, India
| | - Rajesh Natrayan
- Department of Medical Gastroenterology, Sri Gokulam Hospital, Salem, 636 004, India
| | | | - Ramakrishna B S
- Department of Medical Gastroenterology, SRM Institutes for Medical Science, Chennai, 600 083, India
| | - Naveen Chand
- Department of Medical Gastroenterology, SRM Institutes for Medical Science, Chennai, 600 083, India
| | | | - Sindhu Ashokan
- Department of Gastroenterology, Annai Arul Hospital, Chennai, 600 063, India
| | - Arulprakash S
- Department of Gastroenterology and Hepatology, MGM Healthcare, Chennai, 560 070, India
| | - Karishma Srinivasan
- Department of Gastroenterology and Hepatology, MGM Healthcare, Chennai, 560 070, India
| | - Aravind A
- Department of Digestive Health and Diseases, Govt. Kilpauk Medical College, Chennai, 600 010, India
| | - Lavanya N
- Department of Digestive Health and Diseases, Govt. Kilpauk Medical College, Chennai, 600 010, India
| | - Arun R S
- Department of Medical Gastroenterology, Madras Medical Mission, Chennai, 600 037, India
| | | | - Rathnaswami A
- Department of Surgical Gastroenterology, SRM Medical College Hospital and Research Centre, Chennai, 603 211, India
| | - Rajesh N A
- Department of Medical Gastroenterology, SRM Medical College Hospital and Research Centre, Chennai, 603 211, India
| | - Arun A C
- Department of Medical Gastroenterology, Velammal Medical College Hospital and Research Institute, Madurai, 625 009, India
| | - Ganga Balaji
- Department of Medical Gastroenterology, Velammal Medical College Hospital and Research Institute, Madurai, 625 009, India
| | - Padmanabhan P
- Department of Medical Gastroenterology, Meenakshi Medical College Hospital and Research Institute, Kancheepuram, 631 552, India
| | - Somnath Verma
- Department of Medical Gastroenterology, Meenakshi Medical College Hospital and Research Institute, Kancheepuram, 631 552, India
| | - Jayanthi V
- Department of Hepatology, Gleneagles Global Health City, Chennai, 600 100, India
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