Colorectal cancers in tropical environment

The main goal of our work was to study the epidemiological, clinical and prognostic aspects of colorectal cancers in a hospital environment This case-control transversal survey was conducted in the hospitals of the "G point" and Gabriel Tour, and in Farako clinic of Bamako (Mali). All patients presenting a tumour histologically confirmed have been collected. The patients with normal low digestive endoscopy have been compared to the previous. An investigation about the life habits of the patients has been carried out in both groups. During the period of survey, we collected 19 CCR representing 0.1% of all low digestive endoscopies and 19% of the cancers of the digestive tract. The sex-ratio of 0.4 was in favour of women. The average age of patients with cancer was of 43.7 +/- 16,9 years. The more represented social and professional groups were the housewives and the farmers with 52.5% (p = 0.001). The frequent consumption of dried and smoked fish, to with potash, of naturally preserved meat, of cola and tobacco smoking was significantly associated to CCR (p = 0.001). The more observed clinical signs were pain, weight loss and rectal bleeding. Adenocarcinoma represented 89.5% of the histological aspects. Diagnostic delay in most cases negatively influenced the therapeutic management with only 57.9% of palliative surgery and 15.8% of curative surgery. Surgery which is the only therapeutic option for the CCR is unfortunately not possible in the majority of the cases because of the delay in diagnosis. The improvement of the prognosis requires an early diagnosis and management.