Correlating Between Demographic Distribution and Hematological Parameters in Samples of Iraqi Patients with Colorectal Cancer

Authors

Rasha Abbas Azeez Department of Basic Science, College of Dentistry, University of Baghdad, Baghdad, Iraq. https://orcid.org/0000-0002-2761-8228
Suha Abdul-Khaliq Al-Jowari Department of Biology, College of Science, University of Baghdad, Baghdad, https://orcid.org/0000-0001-8364-7755
Hayder Jamal Mahmood Endoscopy Department at the Gastroenterology and Hepatology Teaching Hospital Medical City, https://orcid.org/0009-0008-8047-341X

DOI:

https://doi.org/10.30526/38.4.3577

Keywords:

Colorectal Cancer, Demographic Distribution, WBC, RBC, Hb

Abstract

The current study found no statistically significant difference in gender or age values between the colorectal cancer (n = 41), colitis (n = 19), or control groups (n = 20), despite the fact that the incidence rate of Colorectal Cancer (CRC) increased significantly with age. In addition, the data showed that alcohol raises the risk by 60.98% in the colorectal adenocarcinoma group who drank alcohol, and the male: female ratio indicated that the majority of patients with early-onset CRC were male patients compared to females. Statistically significant (P≤0.05) differences were found between CRC patients, colitis patients, and control participants who smoked. Furthermore, no significant variations in occupational exposures linked to an elevated risk of CRC were seen between study groups. One of the most fundamental peripheral blood biochemical tests, Hemoglobin (Hb) (g/dL), Red blood cell count (RBC) (×10⁶ cells/µL), and White blood cell count (WBC) (×10³ cells/µL), were used to effectively indicate abnormalities of infection and anemia and improve the accuracy of CRC detection. There were significant differences (P≤0.05) between males and females in W.B.C. count, RBC, and Hb in all types of research groups when compared with the conventional pathological test of tumor lesions. Student's t-test, Fisher's exact test, one-way ANOVA with Hochberg GT2 and Games-Howell tests, and chi-square tests were among the statistical tests used. The diagnostic prediction for CRC early screening was constructed using a panel of commonly used hematological markers, which may serve as useful adjuncts in CRC screening.

Author Biographies

Rasha Abbas Azeez, Department of Basic Science, College of Dentistry, University of Baghdad, Baghdad, Iraq.

Department of Basic Science, College of Dentistry, University of Baghdad, Baghdad, Iraq.
Suha Abdul-Khaliq Al-Jowari, Department of Biology, College of Science, University of Baghdad, Baghdad,

Department of Biology, College of Science, University of Baghdad, Baghdad,
Hayder Jamal Mahmood, Endoscopy Department at the Gastroenterology and Hepatology Teaching Hospital Medical City,

Endoscopy Department at the Gastroenterology and Hepatology Teaching Hospital Medical City,

References

1. Haria PD, Baheti AD, Palsetia D, Ankathi S K, Choudhari A, Guha A, Sinha R. Follow-up of Colorectal Cancer and Patterns of Recurrence. Clin Radiol. 2021; 76:908-915.‏ http://dx.doi.org/10.1016/j.crad.2021.09.003

2. Ibrahem S, Ahmed H, Zangana S. Trends in Colorectal Cancer in Iraq over Two Decades: Incidence, Mortality, Topography and Morphology. Ann Saudi Med 2022; 4 (24): 252-261. https://doi: 10.5144/0256-4947.2022.252

3. McCulloch SM, Aziz I, Polster AV, Pischel AB, Stalsmeden H, Shafazand M, et al. The Diagnostic Value of a Change in Bowel Habit for Colorectal Cancer within Different Age Groups. United Eur Gastroent. 2020; 8: 209-211. https://doi.org/10.1177/2050640619888040

4. Cancer Facts & Figures 2023. American Cancer Society, Inc. No. 500822. cancer.org .1.800.227.2345.

5. Virdee PS, Marian IR, Mansouri A, Elhussein L, Kirtley S, Holt T. The Full Blood Count Blood Test for Colorectal Cancer Detection: A Systematic Review, Meta-Analysis, and Critical Appraisal. Birks J. Cancers (Basel) 2020; 12: 23-48. https://doi.org/10.3390/cancers12092348

6. Li Y, Wu H, Xing C, Hu X, Zhang F, Peng Y, Li Z, Lu T. Prognostic Evaluation of Colorectal Cancer using Three New Comprehensive Indexes Related to Infection, Anemia and Coagulation derived from Peripheral Blood. J Cancer 2020; 11: 3834-3845. https://www.jcancer.org/v11p3834.htm

7. NaNa K, Edward G. Global Burden of Colorectal Cancer: Emerging Trends, Risk Factors and Prevention Strategies. Nat Rev Gastroenterol Hepatol. 2020; 16: 713–732. https://doi.org/10.1038/s41575-019-0189-8

8. Ahmed, M. Colon Cancer: A Clinician’s Perspective in 2019. Gastroenterol Res. 2020;13:1-10. https://doi.org/10.14740/gr1239

9. Wu J, Ge XX, Zhu W, Zhi Q, Xu MD, Duan W, Chen K, Gong FR, Tao M, Shou LM, Wu MY, Wang WJ. Values of Applying White Blood Cell Counts in the Prognostic Evaluation of Resect Able Colorectal Cancer. Mol Med Rep. 2019; 19: 2330-2340. PMID: 30664202. https://doi.org/10.3892/mmr.2019.9844

10. Siegel RL, Miller KD, Goding –Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal Cancer Statistics, 2020. CA: A Cancer J Clin. 2020; 70: 145-164. Doi: http://dx.doi.org/10.14715/cmb/2024.70.8.29

11. Saad El Din K, Loree JM, Sayre EC, Gill Sh, Brown CJ, Dau H, Mary A, Vera D. Trends in the Epidemiology of Young-Onset Colorectal Cancer: A Worldwide Systematic Review, BMC Cancer 2020; 20: 288. https://doi.org/10.1186/s12885-020-06766-9

12. Abualkhair WH, Zhou MS, Ahnen D, Yu Q, We XC, Karlitz JJ. Trends in Incidence of Early-Onset Colorectal Cancer in the United States Among Those Approaching Screening Age. JAMA Network Open. 2020; 3(1): e1920407-e1920407 http://doi:10.1001/jamanetworkopen.2019.20407

13. Huang J, Xu P, Chen Y. A Retrospective Study from a Single Center to Identify Hematological Factors that Distinguish Between Patients with Colorectal Carcinoma and Colorectal Adenoma. Med Sci Monit 2022; 10: e936745.https://doi.org/10.12659/MSM.936745

14. de Assis JV, Coutinho LA, Oyeyemi IT, Oyeyemi OT, Grenfell RFEQ. Diagnostic and therapeutic biomarkers in colorectal cancer: a review. Am J Cancer Res. 2022 Feb 15;12(2):661-680. PMID: 35261794; PMCID: PMC8900002. https://pmc.ncbi.nlm.nih.gov/articles/PMC8900002/

15. Gausman V, Dornblaser D, Anand S, Hayes RB, O'Connell K, Du M, Peter SL. Risk Factors Associated with Early-Onset Colorectal Cancer. Clin Gastroenterol Hepatol. 2020; 18(12): 2641-2644 https://doi.org/10.1016/j.cgh.2019.10.009

16. Yang, LP., Wang, ZX., Zhang, R. et al. Association between cigarette smoking and colorectal cancer sidedness: A multi-center big-data platform-based analysis. J Transl Med. 2021; 19 (150):1-11. https://doi.org/10.1186/s12967-021-02815-4

17. Schmitt M, Silva M, Konukiewitz B, Lang C, Steiger K, Halfter K, Engel J, Jank P, Pfarr N, Wilhelm D. Loss of SATB2 Occurs More Frequently Than CDX2 Loss in Colorectal Carcinoma and Identifies Particularly Aggressive Cancers in High-Risk Subgroups. Cancers. 2021;13: 61-77. https://doi.org/10.3390/cancers13246177

18. Aykan NF, Yalçın S, Turhal NS, Özdoğan M, Demir G, Özkan M, et al. Epidemiology of Colorectal Cancer in Turkey: A Cross-sectional Disease Registry Study (A Turkish Oncology Group trial). Turk J Gastroenterol. 2015; 26:145-53.https://doi.org/10.5152/tjg.2015.5685

19. Kim SE, Paik HY, Yoon H, Lee JE, Kim N, Sung MK. Sex- and Gender-Specific Disparities in Colorectal Cancer Risk. World J Gastroenterol. 2015;21(17): 5167-5175. https://doi.org/10.3748/wjg.v21.i17.5167

20. Meryud-Abood A, Mohammud HM, Mohammed MJ. Epidemiology of Colonic Cancer in Baghdad City, Iraq. Iranian J War Publ Health. 2022; 14(3): 331-337. https:// DOI: 10.29252/ijwph.14.3.331 http://ijwph.ir/article-1-1232-en.html

21. Bishehsari F, Magno E, Swanson G, Desai V, Voigt RM, Forsyth CB, Keshavarzian A. Alcohol and Gut-Derived Inflammation. Alcohol Res. Curr. Rev. 2017; 38(2): 163–171. https://pubmed.ncbi.nlm.nih.gov/28988571/

22. Rossi M, Jahanzaib-Anwar M, Usman A, Keshavarzian A, Bishehsari F. Colorectal Cancer and Alcohol Consumption-Populations to Molecules. Cancers (Basel) 2018;30 (38). https://doi.org/10.3390/cancers10020038

23. Lin TC, Chien WC, Hu JM, Tzeng NS, Chung CH, Pu TW, Hsiao CW, Chen CY. Risk of Colorectal Cancer in Patients with Alcoholism: A Nationwide, Population-based Nested Case-Control Study. PLoS One. 2020;12(15): e0232740. https://doi.org/10.1371/journal.pone.0232740

24. Demb J, Earles A, Martinez ME. Risk Factors for Colorectal Cancer Significantly Vary by Anatomic Site. BMJ Open Gastro. 2019; 6:1-9. e000313.https:// doi%3A%2010.1136/bmjgast%2D2019%2D000313

25. Rawla P, Sunkara T, Barsouk A. Epidemiology of Colorectal Cancer: Incidence, Mortality, Survival, and Risk Factors. Prz Gastroenterol. 2019; 14(2): 89–103. https://doi.org/10.5114/pg.2018.81072

26. Botteri E, Borroni E, Sloan EK, Bagnardi V, Bosetti C, Peveri G, Lugo A. Smoking and Colorectal Cancer Risk, overall and by Molecular Subtypes: A Meta-analysis. Offic J Am Colle Gastroenterol ACG 2020; 115(12): 1940-1949.‏ https://DOI%3A%2010.14309/ajg.0000000000000803

27. Duijster J, Mughini-Gras L, Neefjes J, Occupational Exposure and Risk of Colon Cancer: A Nationwide Registry Study with Emphasis on Occupational Exposure to Zoonotic Gastrointestinal Pathogens. BMJ Open 2021; 11: e050611. https://doi:10.1136/bmjopen-2021-050611

28. Li Y, Xing C, Wei M. Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer. J Cancer. 2019;10(5): 1162-1170. https://doi.org/10.7150/jca.29018

29. Mitrugno A, Tassi –Yunga S, Sylman JL. The Role of Coagulation and Platelets in Colon Cancer-Associated Thrombosis. Am J Physiol. Cell Physiol. 2019;316: C264-C273. https://doi.org/10.1152/ajpcell.00367.2018

30. Cruz-Ramos M, Del Puerto-Nevado L, Zheng B. Prognostic Significance of Neutrophil-to lymphocyte Ratio and Platelet-to lymphocyte Ratio in Older Patients with Metastatic Colorectal Cancer. J Geriatr Oncol. 2019; 10(5): 742-748. https://doi.org/10.1016/j.jgo.2018.10.002

31. Hayama T, Hashiguchi Y, Okada Y. Significance of The 7th Postoperative Day Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer. Int J Colorectal Dis. 2020; 35: 119-124. https: //doi.org/10.1007/s00384%2D019%2D03463%2D3,-Keywords

32. Cimen HI, Halis F, Saglam HS, Gokce A. Can Neutrophil to lymphocyte Ratio Predict lamina Propria Invasion in Patients with Non-Muscle Invasive Bladder Cancer? Int Braz J Urol. 2017; 43(1): 67 -72. https://doi.org/10.1590/S1677-5538.IBJU.2016.0158

33. Sun H, Yin CQ, Liu Q, Wang F, Yuan CH. Clinical Significance of Routine Blood Test Associated Inflammatory Index in Breast Cancer Patients. Med Sci Monit. 2017; 23: 5090- 5095. https://doi.org/10.12659/MSM.906709

34. Mazaki J, Katsumata K, Kasahara K. Neutrophil-to-lymphocyte Ratio is a Prognostic Factor for Colon Cancer: A Propensity Score Analysis. BMC Cancer. 2020; 20: 922. https://doi.org/10.1186/s12885-020-07429-5

35. McSorley, ST, Johnstone M, Steele CW. Normocytic Anemia is Associated with Systemic Inflammation and Poorer Survival in Patients with Colorectal Cancer Treated with Curative Intent. Int. J. Colorectal Dis. 2019; 34: 401-408. https://doi.org/10.1007/s00384-018-3211-7

36. Ristescu I, Pintilie G, Filip D. Perioperative Anemia and Transfusion in Colorectal Cancer Patients. Chirurgia (Bucur). 2019; 114(2):234-242. http://dx.doi.org/10.21614/chirurgia.114.2.234

37. Li H, Lin J, Xiao Y, Zheng W, Zhao L, Yang X, Zhong M, Liu H. Colorectal Cancer Detected by Machine Learning Models Using Conventional Laboratory Test Data. Technol. Cancer Res Treat. 2021; 20. https://doi.org/10.1177/15330338211058352.

38. Virdee PS, Patnick J, Watkinson P, Holt T, Birks J. Full Blood Count Trends for Colorectal Cancer Detection in Primary Care: Development and Validation of a Dynamic Prediction Model. Cancers (Basel). 2022; 14(19):4779. https://doi.org/10.3390/cancers14194779.