Distribution and Determinants of Colorectal Cancer, Kingdom of Saudi Arabia, 2004 - 2010 Open Access

Abstract

Background: Colorectal cancer (CRC) is the fastest growing cause of cancer-related illnesses and deaths globally and (in particular) in the Kingdom of Saudi Arabia (KSA). The purposes of this study were to investigate trends in CRC incidence rates (IRs) from 2004 - 2010 in KSA; make recommendations for further investigation; and offer options for policy change.

Methods: We estimated the IRs and 95% confidence Intervals (CIs) of CRC in KSA from 2004 - 2010. The CRC IRs were stratified by nationality, gender, and the 13 administrative regions. IRs were estimated using the number of cases per year over the total population per 100,000 individuals.

Results: We observed a consistent increase of CRC IRs over the time period of the study. This increase of was statistically significant from 2004 (IR=4.06; 95%CI=3.79-4.32) to 2010 (IR=5.62; 95%CI=5.34-5.9), with a substantially high IR in 2009. Among Saudis, a significant increase was observed in IR from 2004 (IR=4.05; 95%CI=3.74-4.36) to 2010 (IR=6.01; 95%CI=5.66-6.36). Among non-Saudis, a similar trend was also observed in IR from 2004 (IR=3.64; 95% CI=3.17-4.12) to 2010 (IR=4.07; 95%CI=4.24-5.16). Among males, the IR increased significantly from 2004 - 2010, from 4.26 in 2004 (95%CI=3.9-4.62) to 5.68 in 2010 (95%CI=5.31-6.06). A similarly significant increase in IR was also observed among females, from 3.8 in 2004 (95%CI=3.42-4.18), to 5.55 in 2010 (95%CI=5.13-5.97). The differences in IRs by gender were not statistically significant except in the years 2005 and 2009.

Conclusion: The incidence and mortality rates can be significantly diminished through early screening and detection, healthier diet, increased amounts of physical activity, and the elimination of harmful lifestyle habits. Recommendations for further study include probing into the reasons behind the higher rates of CRC in men versus women and possibly a separate study that includes the records of patients who have been seen by private doctors. Future studies should build on the conclusions from this research in order to narrow down the individuals for whom CRC poses a higher threat and determine additional common factors between them. It is the responsibility of public health departments to ensure the health and wellbeing of the KSA residents to the best of their ability.

Table of Contents

Acknowledgement...6

Introduction...7

Literature review...11

Abstract...21

Introduction...22

Methods...22

Results...23

Discussion...24

References...26

Tables and Figures...27

Conclusion...30

References...33

Appendix...34

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	incidence rate Distribution and Determinants 2004 - 2010 saudi arabia Colorectal cancer
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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