Colorectal cancer pathology at Muhimbili national hospital, Dar es Salaam, Tanzania.

Abstract

Background: Colorectal cancer (CRC) is among the most common cancers worldwide especially in the Western world. An increase of CRC in resource- limited countries has been noted with presentation in the younger age group and advanced stages. It was therefore against this background that we sought to describe the clinicopathological characteristics of CRC at Muhimbili National Hospital in Tanzania. Objectives: Our broad objective was to describe the clinicopathological features of CRC at Muhimbili National Hospital (MNH). Methodology: The study was conducted in pathology department, histopathology unit at MNH, Dar es salaam, Tanzania. It was a descriptive cross-sectional study. Paraffin embedded blocks of colorectal cancer patients diagnosed between January 2011 and December 2014, were retrieved in departmental archive, resectioned, and stained by routine H&E and immunohistochemistry. More information pertaining to study participants was retrieved in hospital medical records. Microscopic examination was done for typing, grading, pathological staging using TNM-7 system and Dukes‘ system. Results: A total of 201 colorectal cancer patients were enrolled in our study, males slightly outnumbered females, with sex ratio of 1.1:1, mean age was 50.2 (SD±16.9), age range of 12-92, with a peak in 45-59 year age group and mode of 45 years. The rectum was the most commonly involved site (63.7%), usual adenocarcinoma was the most common histologic type (77.6%). Sixty one (30%) patients presented with high grade cancer and 88.2 % had advanced stages. Mucinous adenocarcinoma and signet ring cell carcinoma were found to correlate with young age (below 40 years), p=0.002. HIV/AIDS was the most common comorbidity associated with CRC (38%). Conclusion: Colorectal cancer is not rare in Tanzania; poor prognostic entities are relatively common at younger age associated with advanced stage at diagnosis. There is a need for initiating a country wide screening program and through improved awareness and early detection and diagnosis it will enable curative interventions of CRC.