Colorectal cancer is the most common cancer in Saudi men and the second commonest in Saudi women


Colorectal cancer in Saudi Arabia: incidence, survival, demographics and implications for national policies

Nasser Alsanea,a Alaa S. Abduljabbar,a Samar Alhomoud,a Luai H. Ashari,a Denise Hibbert,b Shouki Bazarbashic

From the aFellow, Saudi Society of Colon & Rectal Surgery, Member Scienti c Committee, Consultant Colorectal Surgeon, King Faisal Specialist Hospital & Research Centre-Riyadh, Saudi Arabia; bChair, Saudi Enterostomal Therapy Chapter of SSCRS, Colorectal Clinical Specialist Director, Nursing Affairs, KFSH&RC-Riyadh, cEx-Chairman Saudi Cancer Registry Head Section, Medical Oncology, King Faisal Specialist Hospital & Research Center-Riyadh, Saudi Arabia

Correspondence: Nasser Alsanea · President of the Saudi Society of Colon & Rectal Surgery, Head Section, Colon & Rectal Surgery, King Faisal Specialist Hospital & Research Center- Riyadh, (MBC-40) PO Box 3354 Riyadh 11211, Saudi Arabia · [email protected]

Ann Saudi Med 2015; 35(3): 196-202 DOI: 10.5144/0256-4947.2015.196

Background and oBjectives: The national data on colorectal cancer in Saudi Arabia has not been ana- lyzed. The objective of this study is to describe the demographics, incidence and survival rates for colorectal cancer in Saudi Arabia for the period 1994-2010.
design: Retrospective analysis of the Saudi Cancer Registry data for the period 1994-2010.

setting: Data from the Saudi Cancer Registry was analyzed by stage at presentation (local, regional, distal, unknown) and survival rates were calculated using the Kaplan-Meier method.
Patients: From 9889 colorectal cancer cases, a sample of 549 (5.6%) patients was selected and their living status ascertained to assess survival.

results: Colorectal cancer has been the most common cancer among men and the third commonest among women since 2002 in Saudi Arabia. There has been a slight predominance among men with an average ratio of 116:100 over the years (range: 99:100-132:100). The overall age-standardized rate (ASR) approached a plateau of 9.6/100 000 in 2010. The incidence of the disease has been highest in the capital, Riyadh, where it reached 14.5/100 000 in 2010. Median age at presentation has been stable at around 60 years (95% confidence Interval (CI): 57-61 years) for men and 55 years (95% CI: 53-58 years) for women. Distant metastasis was diagnosed in 28.4% of patients at the time of presentation and rectal cancer represented 41% of all colorectal cancers diagnosed in 2010. The overall 5-year survival was 44.6% for the period 1994-2004. The ASR for all age groups below 45 years of age was lower than that for the United States.

limitations: The study was retrospective with a possibility of bias from inaccurate staging of patients, and inaccurate survival information and patient demographics due to the underdeveloped census system prior to 2001. Survival data for the period 2005-2010 are lacking.
conclusion: Colorectal cancer presents at a younger age in Saudis, especially in women. This has a major implication for decisions about the threshold age for screening. The ASR has increased, but is still much lower than in developed countries. The lower overall 5-year survival compared with developed countries is due to lack of screening, a higher proportion of advanced stage cancer at presentation, lack of specialized care outside the major cities and a higher proportion of rectal cancer cases.


Colorectal cancer is the most common cancer in Saudi men and the second commonest in Saudi women