title: Epidemiology and clinical findings of colorectal carcinoma in two tertiary care hospitals in Benghazi, Libya.
abstract: OBJECTIVE
  The aim is to determine the pattern of patients with colorectal cancer (CRC) seen in two tertiary hospitals in Benghazi, Libya.
  
  
  METHODS
  The cohort includes all patients of CRC who were presented between January 2007 and December 2009 to the Oncology Department, Aljomhoria Hospital and 7(th) October Hospital, Benghazi. Patient's age, gender, clinical presentation, location of cancer involvement, and histopathologic diagnosis were reviewed. Tumor staging was carried out according to Astler Coller modification of Duke's system, dividing it into stage A to C depending upon the extent of local involvement and regional node spread. Stage D was added to account for distant metastasis in accordance with Turnbull modification.
  
  
  RESULTS
  A total of 152 patients with CRC were included, 84 males (55%) and 68 females (45%) with a male to female ratio of 1.2:1.0. The mean age was 57.4 ± 12.92 years (range 21-87 years). 18 (11.8%) patients were below 40 years of age. The most common presenting symptoms were rectal bleeding and abdominal pain and were together present in 71% of the patients. The majority (67.8%) of tumors arise from rectum and sigmoid colon. More than one-third of the patients had poorly differentiated adenocarcinoma. Sixty patients (39.5%) presented in stage D, whereas 30.9% (47/152) and 29.6% (45/152) of patients were in stage B and stage C, respectively. None of the patients had stage A at presentation. The radiological evaluation showed presence of liver metastasis in 14 patients (9.2%) and pulmonary metastasis in two patients (1.3%). Anemia was found in 56 patients (36.8%). It was more common in females (P = 0.01) and in the right sided tumors (66.7%) than left sided tumors (29.5%) (P = 0.001).
  
  
  CONCLUSIONS
  The majority of CRC patients in Benghazi were diagnosed in locally advanced or metastatic stage. In order to achieve early detection of CRC, a comprehensive cancer education program and screening of high risk population for CRC should be considered in this part of Libya.
authors.affiliation: Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Abdel-Naser
authors.initials: AN
authors.lastname: Elzouki
authors.affiliation: Department of Surgery, Faculty of Medicine, Omar Almokhtar University, Al Bayda, Libya.
authors.forename: Salah
authors.initials: S
authors.lastname: Habel
authors.affiliation: Department of Surgery, Faculty of Medicine, Al-Arab Medical University, Benghazi, Libya.
authors.forename: Saeid
authors.initials: S
authors.lastname: Alsoaeiti
authors.affiliation: Department of Surgery, Faculty of Medicine, Al-Arab Medical University, Benghazi, Libya.
authors.forename: Adam
authors.initials: A
authors.lastname: Abosedra
authors.affiliation: Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Fahmi
authors.initials: F
authors.lastname: Khan
keywords: Colon cancer; Libya; colorectal carcinoma; epidemiology