Colorectal Cancer Survival and Its Prognostic Factors in Karachi, Pakistan

Uzma Shamsi, Sajida Qureshi, Munira Moosaji, Iqbal Azam, Romana Idrees

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To determine the survival rates of colorectal cancer (CRC) in the Pakistani population and determine the prognostic factors for survival among the CRC patients. STUDY DESIGN: Retrospective cohort study. Place and Duration of the Study: The cancer registry of the Aga Khan University Hospital, Karachi, Pakistan, from 2010 to 2016. METHODOLOGY: The abstracted data from the cancer registry was cleaned and updated regarding the vital status at the last follow-up. Survival analyses were performed using the Kaplan-Meier method. Adjusted hazard ratios (aHR) and their 95% confidence intervals (CIs) were estimated using a cox regression model to assess the prognostic factors for survival. RESULTS: The overall proportion of late-onset CRC (>50 years of age) was 55.3% and early-onset CRC (<=50 years of age) was higher than expected (45.7%). A high level of carcinoembryonic antigen (CEA) (>5 ng/ml) was associated with poor survival compared to patients with CEA levels of ≤5 ng/ml (aHR = 1.68, 95% CI = 1.04, 2.72). Patients, who experienced recurrence, showed poorer survival (aHR = 4.27, 95% CI = 2.55, 7.14). Patients, who did not undergo surgery, showed significantly poorer survival compared to those who underwent surgery (aHR = 5.53, 95% CI = 2.35, 13.03). CONCLUSION: The findings suggest that monitoring CEA levels, ensuring prompt surgical treatment and follow-up care for recurrent cases can improve survival outcomes in patients with colorectal cancer. KEY WORDS: Colorectal cancer (CRC), Surgery, Recurrence, Grade, Cancer registry.

Original languageEnglish
Pages (from-to)688-692
Number of pages5
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Issue number6
Publication statusPublished - 1 Jun 2024


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