Histological analysis of colorectal cancer specimen in a tertiary hospital in Ghana: A retrospective study

Abstract

Background: There are few publications on the histopathological spectrum of cancer arising from the colon and rectum in this country. Knowledge of the spectrum of findings from colorectal cancer (CRC) biopsies will help reveal the type of cancers, the most common grade and the most prevalent anatomical distribution, the demographical distribution as well as the association of clinical symptoms with various conditions. This will inform interventions to be made. Methodology: The study employed a retrospective design with data and archived slides extracted from the Department of Pathology, Komfo Anokye Teaching Hospital, January 2009–September 2018. The slides were reviewed to establish diagnoses on colorectal biopsies. Results: A total of 237 CRC cases were reviewed, and the mean age was 54.61 ± 17.62 years, with the modal age being 75 years. The age ranges from 5 to 91 years, with the age group of 50–59 years recording the most with 22.36%. The male-to-female ratio is 1:1.09. Rectal cancers were relatively more common constituting 48.10% of the cases compared to colonic cancers, which contributed 45.57% of the cases, and rectoanal cancers recorded 6.33% of the cases. Adenocarcinoma was the most common cancer type constituting 209 (88.19%) cases and squamous cell carcinoma accounting for 21 (8.86%) cases. There were 4 neuroendocrine cancers representing 1.62% of the cases and 2 non-Hodgkin's lymphomas contributing to 0.84% of the cases, with sarcoma contributing a single case (0.42%) of the total number of cancers. Conclusion: CRC incidence is on the ascendency and continues to pose major health risk in this sub-Sahara African population. Females were at slightly increased risk and frequently located in the rectum, with most being high-grade CRCs.