COLORECTAL ADENOCARCINOMA IN A DEFINED JORDANIAN POPULATION FROM 1990TO 1995

PURPOSE: This study aims to evaluate cancer of the large bowel as it o ccurred in a defined Jordanian population, with special reference to i ts epidemiologic aspects. Second, this study was undertaken to compare these results with those of other countries and those previously repo rted from Jordan. METHODS: Records of patients diagnosed as having col orectal adenocarcinoma during a six-year period in Irbid province, Jor dan, were reviewed. The material was analyzed retrospectively with res pect to various epidemiologic features, and the results were compared with those of other countries and those previously published about the Jordanian population. RESULTS: Between January 1990 and December 1995 , 109 new patients with colorectal adenocarcinoma were managed, an inc idence of 3.8/100,000/year. Male to female ratio was 1:1.05 for coloni c cancer and 1.36:1 for rectal cancer. The maximum incidence was seen in the sixth and seventh decades. A total of 12.8 percent of the patie nts were younger than 40 years of age. The rectum was the most common site involved in 30.3 percent of the patients, followed by the sigmoid , right colon, and the rest of the colon. When compared with previous Jordanian figures, a shift toward the western figures was noted. The d elay in diagnosis was noted from the 8.2 months of delay before diagno sis and the advanced stage of the disease at the time of diagnosis. A total of 49.5 percent of the cases were in Dukes B stage, 30.3 percent in Dukes C, and 19.3 percent in Dukes D. Only one patient was in Duke s A stage. A total of 13.8 percent of the cases were mucinous adenocar cinoma. A total of 26.5 percent of the patients presented with complic ations. CONCLUSIONS: As for colorectal adenocarcinoma, rye still share the epidemiologic characteristics of developing countries, but there is a shift toward those of western communities. Flexible sigmoidoscopy is encouraged for evaluation of lower gastrointestinal symptoms, and education of the public and medical staff about colorectal diseases is needed to improve the outcome.