Rozhgar Rashid Ali a, Hazha Abdulla Mohammed Ameen b, Sara Jamil Nidhamalddin a, Mohammed Abdalwahab Hassan a, and Azhin Ali Qadir a  

a Hiwa Hospital, Sulaimani. Ministry of Health Kurdistan Region, Iraq. 

b College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 9/7/2021; Accepted: 15/3/2022; Published: 21/6/2022

DOI Link: https://doi.org/10.17656/jsmc.10359 



Colorectal cancer is the third most common malignancy. However, there is a shifting paradigm and clinical manifestation related to the early presentation.


To know the incidence and evaluate the demographic manifestations of colorectal cancers in Sulaimani.

Patients and Methods

A retrospective cross-sectional study was performed on 516 patients admitted to Hiwa Hospital from January 2015 to December 2019. Data of patients were retrieved from the hospital database. Inclusion criteria were patients aged ≥18 years who had colorectal cancers. Demographic features, including ages and gender, clinical manifestations, abdominal pain, bleeding per rectum, constipation, and personal and family history of malignancy, were recorded. Also, the location, stages, and histopathological features of cancer were recorded.


The incidence of colorectal cancers was 40.3 per 100000 persons per year. There was no significant shifting of colorectal cancer incidence toward younger ages (p-value = 0.605). The majority of patients were aged >50 years, and the male: female ratio was (1.1:1). Most patients were presented with abdominal pain, bleeding per rectum, and constipation; 64.5%, 57.2%, and 41.9%, respectively. A significant association was found between grades and presentations. There was a significant association of polyp findings on colonoscopy with their staging. 


The incidence of colorectal cancers in Sulaimani did not significantly shift toward younger ages but slightly increased. Colorectal cancer had near-the-same gender distribution, and most patients had abdominal pain and bleeding per rectum.


Colorectal cancer; Colorectal epidemiology; Colorectal incidence; Demographic features.


1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394–424. 

2. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017; 66(4):683–91. 

3. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2095–128. 

4. Graham A, Adeloye D, Grant L, Theodoratou E, Campbell H. Estimating the incidence of colorectal cancer in Sub-Saharan Africa: A systematic analysis. J Glob Health. 2012; 2(2):020404. 

5. Walker ARP, Segal I. Colorectal cancer in an African city population in transition. Eur J Cancer Prev. 2002; 11(2):187–91. 

6. Yoshihara M, Hiyama T, Tanaka S. Epidemiology of colorectal cancer. Nihon Naika Gakkai Zasshi. 2007; 96(2):200–6. 

7. Haggar FA, Boushey RP. Colorectal cancer epidemiology: Incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009; 22(4):191–7. 

8.  Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136(5): E359–86. 

9. Medhin LB, Achila OO, Abrham AT, Efrem B, Hailu K, Abraha DM, et al. incidence of colorectal cancer in Eritrea: Data from the National Health Laboratory, 2011-2017. PLoS One. 2019; 14(11):2011–7. 

10. Khil H, Kim SM, Hong SE, Gil HM, Cheon E, Lee DH, et al. Time trends of colorectal cancer incidence and associated lifestyle factors in South Korea. Sci Rep. 2021;11(1):1–12. 

11. Fedewa SA, Anderson JC, Siegel RL. Colorectal Cancer Incidence in Canada : What Do Rates at Age 50 Years Reflect ? JNCI J Natl Cancer Inst. 2021; 113(7):805-7. 

12. Ngeow J, Eng C. editorial Rectal Cancer : Age Matters in the Affairs of Stage. JNCI J Natl Cancer Inst. 2016; 108(1): djv325. 

13. Irabor DO, Afuwape OO, Ayandipo OO. The Present Status of the Management of Colon and Rectal Cancer in Nigeria. J Cancer Res. 2014; 2014(Article ID 267190):1–7. 

14. Feletto E, Yu XQ, Lew J Bin, St John DJB, Jenkins MA, Macrae FA, et al. Trends in the colon and rectal cancer incidence in Australia from 1982 to 2014: Analysis of data on over 375,000 cases. Cancer Epidemiol Biomarkers Prev. 2019; 28(1):83–90. 

15. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors. Prz Gastroenterol. 2019; 14(2):89–103. 

16. Song M, Emilsson L, Bozorg SR, Nguyen LH, Joshi AD, Staller K, et al. Risk of colorectal cancer incidence and mortality after polypectomy: a Swedish record-linkage study. Lancet Gastroenterol Hepatol. 2020; 5(6):537–47.

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.