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Try out PMC Labs and tell us what you think. Learn More. One hundred and thirty-two patients were randomised in this study.

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It actively collects information on all cancer cases in the province from 3 main cancer hospitals; Tanta Cancer Center, the Gharbiah Cancer Society Hospital, and the Tanta University Hospital. These rates were ificantly lower than the colorectal cancer incidence rates seen in the United States of While incidence rate of colorectal cancer for those under age 40 years in Gharbiah was slightly higher than the United States incidence rate for the same age group, the incidence rates for subjects 40 years and older in the United States were ificantly higher than the corresponding rates for the same age groups in Egypt.

While our studies showed no familial aggregation among young patients to suggest HNPCC or similar syndromes[ 71617 ], more recent studies of possible mismatch repair gene defects[ 18 - 21 ] or autosomal recessive inheritance[ 22 ] are warranted in this population, especially in absence of a strong family history and lack of distinct molecular characteristics among young-colorectal cancer patients in Egypt[ 717 ].

Second, high proportion of tumors located in the rectum. Published online Aug Weaknesses included inherent nature of population-based cancer registries of limited information on potential risk factors for colorectal cancer, such as diet and lifestyle habits, pesticide exposure, and family history because of lack of interviewing of patients. The Gharbiah population-based cancer registry, the only population-based registry in Egypt was founded in [ 9 ].

Compared to the low rates of the Zefta district, living in Tanta and Basyoon districts was ificantly associated with increased risk of developing colorectal cancer for both young and old subjects.

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It has a male:female ratio of 1. Incidence rate of colorectal cancer was 5. National Center for Biotechnology InformationU. Journal List World J Gastroenterol v. The very low rate of polyps reported in this study is unique.

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It is important to note that pathologists in this population in Egypt report very few polyps in other segments of the resected colon not only in the cancer site. Regional differences in disease incidence in colon and rectal cancers in the region may reflect different etiologic patterns in this population.

Colorectal cancer is a common cancer worldwide. Incidence rates of colorectal cancer for men range from 4. Our studies also revealed low rate of polyps, high proportion of rectal cancers among the colorectal cancer tumors, and lack of molecular characteristics of hereditary non-polyposis colorectal cancer HNPCC or young-onset or sporadic colorectal cancer in the United States[ 5 - 7 ].

Studies should also explore clinical and molecular pathways for the district age and polyp distribution of colorectal cancer. Future analytical studies should focus on further understanding of the etiology and pathogenesis of the disease in this population with extensive environmental exposures and possible genetic factors that may modulate the disease risk. hospital-based studies in Egypt showed low incidence of colorectal cancer and high proportion of young-onset disease. The disease incidence under age 40 years was relatively high 1.

The relatively high rate in subjects under age 40 years was reported by the MECC report in which Egypt had the highest incidence for both genders combined 1. Our studies have also shown intense environmental exposures such as organochlorine pesticide levels, however, these environmental and genetic factors were not related to the young or old onset of the disease[ 8 ].

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Older urban men were more likely to develop rectal cancer while young urban men were more likely to develop colon cancer. The also demonstrate the differences in colorectal cancer incidence between the population-based registry of Gharbiah and the SEER registry of the United States.

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Learn More. In addition to age- and sex-specific incidence rate analyses, we analyze the data to explore the incidence distribution by rural-urban differences among the 8 districts of the province. There is a wide variability in the incidence rates of colorectal cancer, with most incident cases occurring in developed countries[ 1 ]. This profile sheds some lights on the epidemiologic, clinical, and geographic distribution of colorectal cancer in this population.

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The main occupation in the Gharbiah province is agriculture. Fruit and vegetable-deficient diet, calorie-dense foods, physical inactivity, obesity, and smoking increase the risk for developing colorectal cancer[ 2 ]. Future studies should explore clinical and molecular disease patterns. This study confirms that patients over age 40 years in Egypt have ificantly lower incidence of colorectal cancer than subjects in the same age group in the United States. While developing countries historically have a low rate of colorectal cancer, the transition to a more Western diet has been associated with increasing rates of disease[ 34 ].

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The high proportion of rectal cancers and the vast majority of tumors without polyps are also interesting findings of the study. However, the proportion of primary rectal colorectal cancers in this study is still high compared to Western countries, where only It is worth noting that recent studies in the United States showed increasing incidence of both young-onset colorectal cancer as well as the proportions of rectal cancers[ 24 ].

The quality of the egyptian set is very important, especially in the population-based cancer registry. The low rate of polyps was also reported in our hospital-based studies[ 67 ]. Other causes of the low polyp rate may be related to the intake of aspirin or aspirin- like compounds[ 29 - 32 ] which is also common in this population because of self-medication[ 3334 ] or other molecular pathways that do man include polyps in the colorectal carcinogenesis in this population. The registry data for the period of was used to examine epidemiologic, clinical and incidence rates of colorectal cancer in this population and to compare that with the of the United States Surveillance Epidemiology and End Program SEER.

The Tanta district of the Gharbiah province had the most cases Characteristics of study population and cancer patterns in Gharbiah, Egypt Age and tumor site distribution of cases showed that The majority of tumors were grade II moderately-differentiated tumors About The vast majority of patients did not present with polyps Mucinous carcinomas were present in only Adenocarcinoma was the most common histopathologic type of tumors For both men and women, living in an urban area ificantly increased the risk of developing colorectal cancer either in the colon or the rectum.

World J Gastroenterol. Technical support, training, and quality control of data are periodically conducted by Rollins School of Public Health, the International Agency for Research on Cancer, and NCI to ensure the high quality of the registry data[ 911 ].

Similar low rates of colorectal cancer in this population in Egypt 6. The also shows dating lower incidence of colorectal cancer in subjects over age 40 years compared to the same age group in the United States SEER. The registry data Cary Egypt shows a slightly higher incidence of colorectal cancer than the United States in subjects under age 40 years.

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In women, incidence rates range from 3. Future clinical and epidemiologic studies should investigate the etiologic factors related to the regional differences of colorectal cancer in this population in Egypt. The vast majority of tumors Regional differences in colon and rectal cancer incidence in the 8 districts of the study province may reflect different etiologic patterns in this population. Medical records of patients were retrieved and the following information abstracted: age, residence, diagnosis date, grade, stage, topology, clinical characteristics and histology variables.

In summary this study showed a relatively high incidence of colorectal cancer under age 40 years and a ificantly low incidence in the age group of 40 years and older in this population in Egypt. Try out PMC Labs and tell us what you think. Limitations of the studies on colorectal cancer in Egypt included their hospital-based nature and relatively small sample size.

The high proportion of cancers that are located in the rectum in this study The high proportion of rectal cancer was reported in our hospital based studies[ 5 - 7 ]. We analyzed the data of all colorectal cancer patients included in the registry for the period of All medical records of the patients diagnosed in Gharbiah during the study period were retrieved and the following information abstracted: age, residence, diagnosis date, grade, stage, topology, clinical characteristics, and histology variables.

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Comparison of incidence rates for colorectal cancer patients in the 8 districts of Gharbiah Compared to the low rates of colon or rectal cancers in the Zefta district, living in Tanta and Basyoon districts was associated with ificantly increased risk of developing both primary colon and rectal cancers.

Rates for the United States are Westernization is often associated with higher incidence rates of colorectal cancer.

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Causes of the very low rate of polyps may be related to diet rich in high fiber, legumes, and green vegetables[ 2526 ] which is common in this population[ 2728 ]. Further, pesticide manufacturing in Kafr El Zayat City and textile production in El Mehalla City are also important industries in the province.

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Our hospital-based studies in Egypt showed low incidence of colorectal cancer and high proportion of young-onset disease[ 5 ]. Peer reviewer: Dr. NOS: Not otherwise specified. Fourth, living in an urban area was associated with higher rates of colorectal cancer, with variability in rates across the region. Analysis of the cases of colorectal cancer collected at the Gharbiah population-based cancer registry from revealed the following important findings: First, a relatively high incidence of colorectal cancer in young subjects under age 40 years and ificantly low incidence in subjects 40 years and older.

As there is a fairly reliable access to medical care for diagnosis and no screening facilities are available in the province of the registry[ 38 ], differences in risk factors across the region is most likely the cause of the variation in incidence rates.

The same trend was present looking only at primary lesions in the colon and less pronounced for rectal cancers. Egypt has a new reliable resource of a population-based registry in the Gharbiah region of the Nile Delta. The low rates were also reported from the Gharbiah cancer registry for the period ofwhere the age-standardized incidence rates for colorectal cancer was 6. Living in El Mehalla and Kafr El Zayat was associated with ificantly increased risk of developing colorectal cancer for subjects over 40 years only.

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This is the first study on a population-based scale to show the limited proportions of polyps in colorectal cancer patients in Egypt. This study had the following strengths: 1 the population-based data from the Gharbiah population-based cancer registry and the large sample size give an accurate picture of the state of colorectal cancer in Egypt; 2 the inclusion of key demographic and clinical data allowed for characterization of the clinical profile and suggestions of possible risk factors for colorectal cancer in this population; and 3 studies in the same population using hospital-based data were comparable to from the population-based cancer registry.

All colorectal cancers diagnosed from to were included in the study. The of the study provide a comprehensive profile of colorectal cancer in this population. The Gharbiah province is in in the center of the Nile delta region about 90 km north of Cairo with a population of about 4 million individuals[ 9 ]. SAS version 9. A total of cases of colorectal cancer were included in registry from Patients deated as residing in an urban area constituted In any given year, between new cases of colorectal cancer were included in the registry.

In addition, information on cancer patients is collected from all private clinics and laboratories throughout the province[ 9 ]. AIM: To describe the clinical and epidemiologic profiles of the disease and to compare the findings with those generated from the hospital-based studies. Diet and lifestyle factors are implicated risk factors for the disease.