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Time intervals from presentation to treatment of colorectal cancer in Libya: A study of cases referred to medical oncology at Tripoli University Hospital, Tripoli, Libya in 2021
Background
Colorectal cancer is the second most common cancer in Libya with increasing trends faster than other countries and a high mortality rate. Reports indicate that a delay in diagnosis and treatment could affect survival. This study is done to study the different time intervals from presentation to treatment initiation.
Methods
A retrospective review of the hospital records of colorectal cancer patients referred to the department of medical oncology of Tripoli University Hospital in one year (2021). Data abstraction for demographics, clinical and pathological presentations and dates in relation to presentation, diagnosis and treatment. Dates of the biopsy report (date of diagnosis) was missing in many records, the biopsy date was used instead. Splenic flexure cancer was counted as left sided. Time intervals are calculated from records with the required dates reported, the number of records retrieved is denoted with each time interval.
Results
A total of 159 patient records were registered in 2021. Ninety-three (58%) were males. The mean age was 58.2 (± 12.2) years. Seventy patients (44%) presented with left colonic cancer and 41 (26%) with rectal cancer. The main histopathology was Adenocarcinoma (85%) and 11 (7%) cases were mucinous adenocarcinoma. The common presenting symptoms were abdominal pain (23%), bleeding per rectum (18%) and constipation (18%). Stage IV (44%) was the most common followed by stage III (27%) and stage II (26%). The median duration of symptoms from onset to presentation was 59 days (n =95). The median time from presentation to biopsy was 9 days (n =75). The median time from biopsy to the first therapeutic intervention was 28 days (n =97); the median time from biopsy to surgery was 26 days (n =74), from biopsy to neoadjuvant chemoradiation of rectal cancer was 44 days (n =9) and from biopsy to initiation of chemotherapy in metastatic disease was 34 days (n =14). The median time from surgery to start of adjuvant chemotherapy in colon cancer was 35 days (n =42). The turnaround time of pathology reports for surgical resection cases was 10 days (n =90).
Conclusions
Colorectal cancer presents in advanced stages in Libya. The different time intervals from presentation to treatment didn’t show any significant delay. This suggests that more effort is primarily required to focus on patient awareness and early detection programs for colorectal cancer to promote presentations in earlier stage.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
