Authors:

Abstract

Introduction: The incidence of colorectal cancers is increasing in developed countries as well as in developing countries. A similar pattern was noted in Sri Lanka over the past decade.

 

Objectives: To determine the incidence trends of colorectal cancer in Sri Lanka from 2005 to 2019.

 

Methods: Data from 2005 to 2019 on all newly diagnosed patients with colorectal cancers in Sri Lanka included in the National Cancer Control Programme (NCCP) Database were analysed to determine trends in incidence using Joinpoint regression program.

 

Results: This study analysed 24 263 patients with newly diagnosed colorectal carcinomas over the 15-years study period from 2005 to 2019. Approximately 52% (n= l2 592) were females and 48% (n= l l 835) were males. Female to male ratio was 1.06: 1. The increasing trend of age standardized incidence rates of colorectal cancer for both males and females over the study period was statistically significant. Annual percentage change (APC) was 8.4 for males (95% CI: 6.9, 9.9; p<0.001) and 7.9 for females (95% CI: 6.5, 9.4; p<0.001). Age specific rates of colorectal cancers were calculated for different age groups. The majority of cases were in the 70 to 74 years age group at the time of diagnosis, although there were cases presenting as early as 35 to 39 years. Men 49 years and less showed two times higher annual percentage increase (APC= 15 .15) than 50 years and above males (APC=7. 7). Similarly, females showed a higher APC among 49 years and less age group (APC= 11.86) when compared with 50 years and above female group (APC=7 .87).

 

Conclusions & Recommendations: There is a statistically significant increase in the incidence of colorectal cancer in both males and females. The age at diagnosis in the majority was between 70-74 years. Annual percentage changes of age specific rates were higher in both males and females in the 49 years and less age group. A possible cause is the presence of modifiable risk factors related to lifestyle changes. Increase in trend is also affected by improvement of diagnostic and surveillance facilities. Considering a screening programme is timely.

Keywords: Colorectal cancer, Age standardized rates, Cancer incidence, National Cancer Registry, Sri Lanka

How to Cite: Kariyawasam, C.J., Wickramatunga, T.A., Munas, M. and Perera, S., 2022. The surge of colorectal cancer in Sri Lanka. Journal of the College of Community Physicians of Sri Lanka, 27(5), pp.63–70. DOI: http://doi.org/10.4038/jccpsl.v27i5.8433