Clinicopathological patterns of colorectal cancer in Tunisia

Introduction: Colorectal cancer is the third most commonly diagnosed cancer worldwide. Design: In order to review the clinical and pathological features of colorectal cancer in Tunisia, a retrospective study was carried out on 1,443 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital of Sousse, for a 15-year period (1993-2007). Results: The median age was 61 years. Adenocarcinoma was the most frequent (90.9%) with moderately differentiated tumors accounting for 76.7% of cases. Only eighty patients were identified as being in early stages (0 and A) and 85.8% in advanced stages (B-D). Over time, we observed a significant decrease of stage B (p=0.02) and a significant increase of stage D (p=0.002). The tumor size was larger than 5 cm in 67.5% of cases. Conclusion: The large proportion of patients presented at advanced stages, compared to only 5.5% of patients at early stages, emphasizes the need to plan and develop a screening program for the early detection of this cancer and its precursor lesions in Tunisia.