A retrospective cross-sectional study ： comparison of the clinicopathological features with schistosomal and non-schistosomal colorectal cancer in Central China

Abstract Aim To analyze the clinicopathological features of schistosomal and non-schistosomal colorectal cancer in Central China and compare them with other areas of the Yangtze River Basin. Method The 501 cases of CRC were retrospectively analyzed from 2020 to 2022. They were divided into two groups: 406 cases of colorectal cancer without schistosomiasis (CRC-NS) and 95 cases of colorectal cancer with schistosomiasis (CRC-S). The clinicopathological characteristics included the distribution of schistosomiasis eggs, patient age, sex, tumor differentiation, lymph node metastasis, and clinical stage, etc. By retrieving the database, we compared the clinicopathological differences of colorectal cancer with schistosomiasis in other areas of the Yangtze River basin. Results Colorectal cancer with schistosomiasis infection accounted for 18.9%. CRC-S patients were significantly older than CRC-NS patients (P < 0.05). There was a statistical difference in the location of occurrence (P < 0.05) between the two groups. There were no significant differences between CRC-S and CRC-NS patients in other clinicopathological features (P > 0.05). In other areas of the Yangtze River Basin, there were statistical differences in the age of occurrence and T stage (P < 0.05) between colorectal cancer with schistosomiasis and non-schistosomal colorectal cancer. Conclusion In Central China, colorectal cancer with chronic schistosomiasis infection occurs more in the rectum and sigmoid colon. It is more common in individuals over 60 years old, consistent with the findings in the Yangtze River Basin. Additionally, schistosomal colorectal cancer had a higher TNM stage in the Yangtze River Basin. This may be related to the malignant biological behavior of colorectal cancer and could result in a relatively poor prognosis. Therefore, the elderly population in schistosomiasis endemic areas should pay more attention to early screening and tumor prevention.