Colorectal cancer: incidence and trend in Brunei Darussalam

Chong VH, Abdullah MS, Telisinghe PU, Jalihal A 
Correspondence: Dr Chong Vui Heng, chongvuih@yahoo.co.uk
 

ABSTRACT
Introduction The incidence of colorectal cancer (CRC) is reported to be increasing. This study assessed the incidence and trend of CRCs in Brunei Darussalam, a developing nation.
Methods All histologically-confirmed CRCs over a 22-year period (1986–2007) were identified from the National Cancer and the Department of Pathology registries and retrospectively reviewed.
Results There was a total of 576 (male 59.0 percent, mean age 59.6 +/- 14.8 years, adenocarcinoma 97.6 percent, rectum 31.4 percent) CRCs diagnosed during this period. There was an increasing trend in the mean age at diagnosis, 55.2 +/- 17.5 years in 1986 to 62.0 +/- 13.0 years in 2007, but this was not significant (p-value equals 0.150, ANOVA). 18.8 percent were diagnosed in patients aged 45 years or below. There was no difference in the age at diagnosis between the genders (p-value equals to 0.432) and tumour sites, colon vs. rectum (p-value equals to 0.279). Overall, there was an increase in the age standardised rate (ASR) from 10.36 (1986–90) to 13.75 (1991–95), 15.90 (1996–2000), 16.87 (2001–05) and 24.31 per 100,000 (2006–07). Among the ethnic groups, the Chinese had higher ASRs (41.44) compared to the Malays (including the indigenous groups) with 15.46 per 100,000. The mean age of the Chinese (62.6 +/- 14.0 years) was significantly higher than that of the Malays (58.2 +/-14.9 years, p-value equals to 0.001) at diagnosis. The age-specific incidence rates for the genders were comparable, except for the age groups of older than 55–59 years, where the rate for males was higher.
Conclusion The incidence of CRC is increasing in our local setting with differences observed among the ethnic groups. The Chinese had a higher incidence but developed CRC at a later age. These have important implications if screening for CRC is to be considered in our local setting.