Relationship Between Family History, Bloody Stool, Palpable Mass, Anemia and MSCT Abdomen and Kolon Carsinoma Cross-Sectional Study at Dr.Kariadi General Hospital in 2016

RELATIONSHIP BETWEEN FAMILY HISTORY, BLOODY STOOL, PALPABLE MASS, ANEMIA, AND MSCT ABDOMEN AND KOLON CARSINOMA Cross-Sectional Study at Dr.Kariadi General Hospital in 2016
Ricat Hinaywan Malik*  -  Department of Medical Services, Sultan Agung Islamic Hospital/ Faculty of Medicine, Sultan Agung Islamic University, Semarang, Indonesia, Indonesia
Winarto Winarto  -  Department of Microbiology & Eyes, Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
Selamat Budijitno  -  Department of Surgical Oncology, Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
Udadi Sadhana  -  Department of Pathology Anatomy, Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
Yan Wisnu Prajoko  -  Department of Surgical Oncology, Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia

(*) Corresponding Author
DOI: 10.30659/sainsmed.v9i1.2264

Background: Colon cancer, a colorectal cancer, is the third most common epithelial malignancy in the world. Family history, bloody stool, palpable mass, anemia, and abdominal MSCT are symptoms and signs of colon carcinoma.

Objective: To determine the relationship between the 5 variables and the incidence of colon carcinoma at Dr. Kariadi Hospital, Semarang in 2016.


Methods: a Cross-sectional observational analytical study using medical record (RM) and complementary primary data. The inclusion criteria were
the complete medical record, and clinical diagnosis of suspected colon carcinoma. Data obtained from the department of Anatomy Pathology/PA (11,794PA results) were traced to the medical record section (46 patients with suspected colon carcinoma). The incomplete data were confirmed by: contacting the patient/family, obtaining the archive in the laboratory and radiology resulting in 27 patients meeting the inclusion criteria. Analysis was done using chi-square test, Spearman-Kendall bivariate correlation, and logistic regression.


Results: Abdominal MSCT was moderately associated with colon carcinoma (p = 0.003; r = 0.488), while family history, bloody stool, palpable mass, and anemia were not associated with colon cancer. Analysis between predictors of outcome: Bloody stool was moderately associated with anemia (p = 0.006; r = 0.411), and anemia was weakly associated MSCT (p = 0.035; r = 0.351). Abdominal MSCT was the predictive factor for colon carcinoma (p = 0.021).


Conclusion: Abdominal MSCT was found to be associated with the incidence of colon carcinoma. Bloody stool was associated with anemia, and anemia was associated with abdominal MSCT. MSCT was the predictive factor for colon cancer.

Keywords: predictors;diagnosis;family history;bloody stool;palpable mass;anemia;MSCT abdomen;colon carcinoma

  1. American Cancer Society (2015) ‘Testing Biopsy and Cytology Specimens for Cancer: How is Cancer Diagnosed?’
  2. Ang, C. W. et al. (2008) ‘The diagnostic value of digital rectal examination in primary care for palpable rectal tumour’, Colorectal Disease, 10(8), pp. 789–792. doi: 10.1111/j.1463-1318.2007.01381.x.
  3. Arisman (2010) Gizi Dalam Daur Kehidupan, EGC. Jakarta: EGC.
  4. Astin, M. et al. (2014) ‘The diagnostic value of symptoms for colorectal cancer in primary care ’:, BritishJournalofGeneralPractice, (May), pp. e231–e243. doi: 10.3399/bjgp11X572427.Conclusion.
  5. Bekkink, O. M. et al. (2010) ‘Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer’, British Journal of Cancer. Nature Publishing Group, 102(1), pp. 48–58. doi: 10.1038/sj.bjc.6605426.
  6. Biswas, M., Ades, A. E. and Hamilton, W. (2015) ‘Symptom lead times in lung and colorectal cancers: What are the benefits of symptom-based approaches to early diagnosis?’, British Journal of Cancer, 112(2), pp. 271–277. doi: 10.1038/bjc.2014.597.
  7. Boardman, L. A. et al. (2007) ‘{A figure is presented}Colorectal Cancer Risks in Relatives of Young-Onset Cases: Is Risk the Same Across All First-Degree Relatives?’, Clinical Gastroenterology and Hepatology, 5(10), pp. 1195–1198. doi: 10.1016/j.cgh.2007.06.001.
  8. Camaschella, C. and DL, L. (2015) ‘Iron-Deficiency Anemia’, New England Journal of Medicine, 372(19), pp. 1832–1843. doi: 10.1056/NEJMra1401038.
  9. Durigova, A. et al. (2013) ‘Anemia and iron biomarkers in patients with early breast cancer. Diagnostic value of hepcidin and soluble transferrin receptor quantification1)’, Clinical Chemistry and Laboratory Medicine, 51(9), pp. 1833–1841. doi: 10.1515/cclm-2013-0031.
  10. Esteva, M. et al. (2013) ‘Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer’, BMC Cancer, 13, pp. 1–13. doi: 10.1186/1471-2407-13-87.
  11. Etzel, J. P. et al. (2012) ‘Diagnostic yield of colonoscopy to evaluate melena after a nondiagnostic EGD’, Gastrointestinal Endoscopy. Elsevier Inc., 75(4), pp. 819–826. doi: 10.1016/j.gie.2011.11.041.
  12. Floriani, I. et al. (2010) ‘Performance of imaging modalities in diagnosis of liver metastases from colorectal cancer: A systematic review and meta-analysis’, Journal of Magnetic Resonance Imaging, 31(1), pp. 19–31. doi: 10.1002/jmri.22010.
  13. Haggar, F. a, Boushey, R. P. and Ph, D. (2009) ‘Colorectal Cancer Epidemiology : Incidence , Mortality , Survival , and Risk Factors’, Clin Colon Rectal Surg, 22(4), pp. 191–197. doi: 10.1055/s-0029-1242458.
  14. Huang J et al. (2013) ‘Family history of liver cancer is not associated with prognosis for patients with hepatocellulcar carcinoma after hepatectomy’, Hpb, 15, p. 147. Available at: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed11&NEWS=N&AN=71036156nhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed11&NEWS=N&AN=71036408.
  15. Jellema, P. et al. (2010) ‘Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis’, Bmj, 340(mar31 3), pp. c1269–c1269. doi: 10.1136/bmj.c1269.
  16. Jensen, L. F. et al. (2015) ‘Symptom attributions in patients with colorectal cancer’, BMC Family Practice. BMC Family Practice, 16, p. 115. doi: 10.1186/s12875-015-0315-9.
  17. Kang, B. et al. (2016) ‘Added value of integrated whole-body PET/MRI for evaluation of colorectal cancer: Comparison with contrast-enhanced MDCT’, American Journal of Roentgenology, 206(1), pp. W10–W20. doi: 10.2214/AJR.14.13818.
  18. Kato, T. et al. (2016) ‘Tumor size is an independent risk predictor for metachronous colorectal cancer’, Oncotarget, 7(14), pp. 17896–17904. doi: http://dx.doi.org/10.18632/oncotarget.7555.
  19. Kemenkes RI, P. D. dan I. (2015) Buletin Jendela Data dan Informasi Kesehatan : Situasi Penyakit Kanker.
  20. Ludwig, W. et al. (2004) ‘ARB: A software environment for sequence data’, Nucleic Acids Research, 32(4), pp. 1363–1371. doi: 10.1093/nar/gkh293.
  21. Macciò, A. et al. (2014) ‘The role of inflammation, Iron, And nutritional status in cancer-related anemia: Results of a large, Prospective, Observational study’, Haematologica, 100(1), pp. 124–132. doi: 10.3324/haematol.2014.112813.
  22. National Cancer Institute (2016) ‘NCI Dictionary of Cancer Terms’, National Cancer Institute.
  23. National Institute for Health and Care Excellence (NICE) Guideline (2014) ‘Colorectal cancer: diagnosis and management’, NICE. National Institute for Health and Care Excellence, pp. 1–25.
  24. Nerad, E. et al. (2016) ‘Diagnostic accuracy of CT for local staging of colon cancer: A systematic review and meta-analysis’, American Journal of Roentgenology, 207(5), pp. 984–995. doi: 10.2214/AJR.15.15785.
  25. Parish, B. et al. (2011) ‘Report Incidence of Colorectal Cancer in Dr. Kariadi General Hospital Semarang 2009 – 2010’, in 1st Makassar Colorectal Cancer Conference, p. Jun 2-4.
  26. Park, S. H. et al. (2014) ‘Clinicopathological Characteristics of Colon Cancer Diagnosed at Primary Health Care Institutions’, Intestinal Research, 12(2), pp. 131–138. doi: 10.5217/ir.2014.12.2.131.
  27. Renzi, C. et al. (2016) ‘Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England’, British Journal of Cancer. Nature Publishing Group, 115(7), pp. 866–875. doi: 10.1038/bjc.2016.250.
  28. Sastroasmoro, S. and Ismoel, S. (2014) Dasar-dasar Metodologi Penelitian Klinis. 5th edn. Jakarta: CV Sagung Seto.
  29. Shu, T. et al. (2015) ‘Hepcidin in tumor-related iron deficiency anemia and tumor-related anemia of chronic disease: Pathogenic mechanisms and diagnosis’, European Journal of Haematology, 94(1), pp. 67–73. doi: 10.1111/ejh.12402.
  30. Simatupang, A. (2010) ‘Pedoman WHO tentang Penulisan Resep yang Baik sebagai Bagian Penggunaan Obat yang Rasional’, Majalah Kedokteran UKI, p. XXV:26-38.
  31. Sjamsuhidajat R (ed), de Jong (ed), Karnadiharjo W (ed), Prasetyono TOH (ed), R. R. (ed) (2011) Buku Ajar Ilmu Bedah Sjamsuhidajat – de Jong. 3rd edn. Edited by R. R. (ed) Sjamsuhidajat R (ed), de Jong (ed), Karnadiharjo W (ed), Prasetyono TOH (ed). Jakarta: EGC.
  32. Spivak, J. L., Gascon, P. and Ludwig, H. (2009) ‘Anemia Management in Oncology and Hematology’, The Oncologist, 14(Supplement 1), pp. 43–56. doi: 10.1634/theoncologist.2009-S1-43.
  33. Tanaka, T. et al. (2010) ‘Biomarkers for colorectal cancer’, International Journal of Molecular Sciences, 11(9), pp. 3209–3225. doi: 10.3390/ijms11093209.
  34. Taylor CR, Lin EC, et al (2015) ‘Colon Cancer Imaging: Overview, Radiography, Computed Tomography’, Medscape.
  35. Teama, A., El-Badry, A. and Yousef, E. (2016) ‘The role of multislice computed tomography in the diagnosis of gastric malignant tumors’, Tanta Medical Journal, 44(3), p. 119. doi: 10.4103/1110-1415.198480.
  36. Telang, J. M. et al. (2017) ‘Prostate cancer family history and eligibility for active surveillance: a systematic review of the literature’, BJU International, 120(4), pp. 464–467. doi: 10.1111/bju.13862.
  37. Tettamanti, M. et al. (2010) ‘Prevalence, incidence and types of mild anemia in the elderly: The “Health and Anemia†population-based study’, Haematologica, 95(11), pp. 1849–1856. doi: 10.3324/haematol.2010.023101.
  38. Vega-Villaamil, P. et al. (2013) ‘Evaluation of the implementation of Galician Health Service indications and priority levels for colonoscopy in symptomatic patients: prospective, cross-sectional study’, Revista Española de Enfermedades Digestivas, 105(10), pp. 600–608. doi: 10.4321/S1130-01082013001000005.
  39. Walter, F. M. et al. (2016) ‘Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: Results from a prospective cohort study’, British Journal of Cancer. Nature Publishing Group, 115(5), pp. 533–541. doi: 10.1038/bjc.2016.221.
  40. World Cancer Report (2015) ‘World Cancer Report’.
  41. World Cancer Research Fund and American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective., Cancer Research. doi: 978-0-9722522-2-5.
  42. World Health Organisation (2011) Noncommunicable Diseases in The South-East Asia Region – Situation and Responses 2011, Geneva: World Health Organization. doi: 978-92-9022-413-6.

Open Access Copyright (c) 2018 Sains Medika
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Sains Medika: Jurnal Kedokteran dan Kesehatan
is published by Faculty of Medicine Universitas Islam Sultan Agung, Indonesia in association with FOKI (FORUM KEDOKTERAN ISLAM INDONESIA).

Contact: Jl. Raya Kaligawe Km.4, PO BOX 1054/SM Semarang 50112, Indonesia
Phone: +62 8122-9933-369
Website: https://fkunissula.ac.id
Email: sainsmedika@unissula.ac.id

ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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

Get a feed by atom here, RRS2 here and OAI Links here

apps