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Incidence and mortality rates of colorectal cancer in Malaysia
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Muhammad Radzi Abu Hassan, Ibtisam Ismail, Mohd Azri Mohd Suan, Faizah Ahmad, Wan Khamizar Wan Khazim, Zabedah Othman, Rosaida Mat Said, Wei Leong Tan, Siti Rahmah @ Noor Syahireen Mohammed, Shahrul Aiman Soelar, Nik Raihan Nik Mustapha
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Epidemiol Health. 2016;38:e2016007. Published online March 9, 2016
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DOI: https://doi.org/10.4178/epih.e2016007
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Abstract
OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity.
METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution.
RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05).
CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
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Summary
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Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
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Mohd Azri Mohd Suan, Wei Leong Tan, Shahrul Aiman Soelar, Ibtisam Ismail, Muhammad Radzi Abu Hassan
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Epidemiol Health. 2015;37:e2015017. Published online March 30, 2015
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DOI: https://doi.org/10.4178/epih/e2015017
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62,034
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188
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Abstract
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Abstract
OBJECTIVES The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma.
METHODS Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer.
RESULTS Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008).
CONCLUSIONS The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
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