By Dr. Prabhat Pradhan
Abstract:
Introduction:
Globally, colorectal cancer is the third most
common cancer and the third leading cause of cancer-related
deaths. This study describes the epidemiological and clinical
profile of patients with colorectal cancer diagnosed in Bhutan.
Methods: This was a cross-sectional study based on the review
of records of patients diagnosed with colorectal cancer at the
National Referral Hospital, the only hospital with onco-surgery
services, between 2018 and 2024.
Results: There were 182 patients diagnosed with colorectal
cancers. The crude incidence of colorectal cancer was 3.58 per
100,000 population and the overall prevalence was 25.03 per
100,000 population. The overall age-standardized incidence
rate was 206.43 per 100,000 population. The highest crude
prevalence rates were observed in the Pema Gatshel (63.47),
Lhuentse (62.34) and Trashigang (61.51) districts. The mean
age at diagnosis was 61.51 ±15.64 years; almost half were
males (52.20%) and a higher age-standardized incidence rate
was noted among those aged ≥70 years. The common
presenting symptoms were abdominal pain (59.26%), altered
bowel habits (43.21%) and per rectal bleeding (40.74%). The
predominant location of the tumour was in the middle/lower
rectum (35.54%) and the right colon (33.06%). The majority of
the patients were diagnosed with stage III (71.08%) and stage
IV (19.28%) diseases. The dominant histology pattern was
adenocarcinoma (86.36%). The common form of treatment
offered was surgery with chemotherapy.
Conclusion:
This study provides the baseline prevalence and age-standardized incidence rates of colorectal cancer in
Bhutan. The country will benefit from improving oncology
diagnostic and treatment facilities and the adoption of a
dedicated screening program for colorectal cancer for high risk
population.