Adenocarcinoma of the large bowel in nigerians

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Abstract
Cases (320) of colorectal adenocarcinoma at the University College Hospital, Ibadan, Nigeria, over a period of 18 yr were analyzed. The sex ratio was 1.5:1 in favor of males: the average age when first seen was 44 yr. The symptom complex was weight loss, bloody mucoid stool, altered bowel habit and abdominal mass; 80% of rectal cases were in the lower 3rd of the rectum. Most cases were very advanced at the time they were first seen. The association of infective granuloma, notably schistosomiasis and amebiasis, occurred in 11 cases. This probably had diagnostic and prognostic significance, but the etiologic significance is still conjectural; 80% of the tumors were well-differentiated adenocarcinoma, while 20% were of other histologic variants. In spite of advanced disease, resection was possible in 66% of colonic and 45% of rectal cases. Although the number of cases of colorectal cancers treated yearly in the hospital has increased significantly in the last few years, the hitherto low treatment rate may probably be attributable to social unacceptability of a permanent colostomy.