Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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Subject: search.filters.subject.Sri Lanka-epidemiology

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    Survival following curative surgery for colorectal cancer (CRC) in the middle-aged population: data from a South Asian cohort
    (Springer, 2021) Vishwajith, P.; Chandrasinghe, P.; Gunasekare, K.; Gajasinghe, S.; Kumarage, S.
    BACKGROUND/AIM : Colorectal cancer (CRC) is the fourth commonest cancer in Sri Lanka. Disease burden and survival among the middleaged population (50–70 years) with CRC is less studied. With the aging global population, this cohort has a high economic and a social impact. This study aims to analyse the survival pattern and contributing factors in a middle-aged patient cohort with CRC. METHODS: CRC patients managed with a curative intent between 1997 and 2020 at a specialised tertiary care unit were analysed. Demographic data, tumour characteristics and survival of the patients aged between 50 and 70 years was analyzed. Overall survival was compared with the younger (\50 years) and older ([70 years) populations with CRC using Kaplan–Meire curves. Individual variable analysis was performed to sought for significant association of survival with age, sex, tumour stage and tumour site. Multifactorial analysis was performed using Cox-proportional hazard model. RESULTS: A total of 411 patients between 50 and 70 years age group with CRC were analysed (mean 60.07 years; range—50–70 years, male—47.45%). Overall survival of the middle-aged population was significantly better (mean— 133 months, SE 6.84) compared to the elderly population (mean—58 month, SE = 7.74) but worse compare to the younger population (mean—167 month, SE = 10.81). Majority of the tumours (60.5%) in the middle-aged group were locally advanced on presentation ([T3). Tumor site and age at presentation were significant factors that influence survival in this age group. CONCLUSION: Middle-aged patients have a better mean overall survival than their older counterparts but fare worse compared to the younger age group. Tumor stage and age were the only factor that significantly influenced survival
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    Survival pattern and clinicopathological data from a South Asian cohort of young colorectal cancers treated with curative intent
    (Springer, 2021) Gunasekare, K.; Godahewa, S.; Vishwajith, P.; Gajasinghe, S.; Ekanayake, M.; Kumarage, S.; Chandrasinghe, P.
    BACKGROUND/AIM :Colorectal cancer (CRC) has the fourth highest incidence among cancers in Sri Lanka. Although CRC is considered as a disease of the elderly, currently there is a shift towards an increasing incidence of young cancers globally. Despite the increasing incidence there is a scarcity of data from the South Asian region. This study aims to analyze the clinicopathological features and long term survival of young CRC from a South Asian cohort of patients. METHODS: All patients treated for CRC at a tertiary care center from 1997 to 2017 were prospectively followed up. Demographics, tumour characteristics and survival data were recorded. Age less than 45 years at diagnosis was considered as a young cancer. Overall survival among the populations was compared using Kaplan-Mire survival curves. A P value of\0.05 was considered significant. Results: A total of 113 (16.5%) young cancers (Mean age 36.35; range 17–45; female 53.1%) were operated during the period. Rectum (60.2%) was the commonest site followed by the right colon (24.8%) and left colonic (15%) tumors. Adenocarcinomas of moderately differentiated variety (72.4%) was the commonest histological type. Seventy percent of cases had locally advanced disease (T3/T4) with 53.2% having positive nodal status. Of the total 27% received neoadjuvant treatment and 66.7% received adjuvant treatment. Young CRC patients had a significantly better overall survival compared to their older counterparts (P = 0.008). CONCLUSION Young cancers accounts for a significant proportion of the colorectal cancers in this cohort. Over 75% of the cancers were on the left colon and the majority was locally advanced disease. Overall survival of the young CRCs were better compared to the older population in this cohort.
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    Incidence and risk factors for Non-Alcoholic Fatty Liver Disease in an urban, adult Sri Lankan population – a community cohort follow-up study
    (Sage Publishing, 2015) Niriella, M.; Kasturiratne, A.; de Silva, S.; Perera, R.; Subasinghe, C.; Kodisinghe, K.; Priyantha, C.; Rishikeshavan, V.; Dassanayake, A.; de Silva, A.; Pathmeswaran, A.; Kato, N.; de Silva, H.J.
    INTRODUCTION: We previously reported a community prevalence of 33% for NAFLD in an urban, adult Sri Lankan population. We also found a significant association between patatin-like phospholipase domain containing 3 (PNPLA3) gene rs738409 polymorphism, and susceptibility to NAFLD in the same population, after testing 10 selected single nucleotide polymorphisms (SNPs) in a case control study. AIMS & METHODS: The aim of this study was to assess the incidence and risk factors for NAFLD in this population after seven years of follow-up. The study population consisted of 42-71-year-old adults, originally selected by age stratified random sampling from electoral lists from Ragama, Sri Lanka. The target population was screened initially in 2007 and subsequently invited back for re-evaluation in 2014. On both occasions they were assessed using a structured interview, clinical and anthropometric measurements, liver ultrasound, and biochemical and serological tests. NAFLD was diagnosed on established ultrasound criteria for fatty liver (two out of three criteria: increased echogenecity of the liver compared to kidney and spleen, obliteration of the vascular architecture of the liver and deep attenuation of the ultrasonic signal), safe alcohol consumption (Asian standards: 514 units/week for men, 57 units/week for females) and absence of hepatitis B and C markers. Non-NAFLD controls were defined as subjects who did not have any of the ultrasound criteria for NAFLD. We also performed an updated case-control study to investigate associations of selected genetic variants with incident NAFLD [SNPs: PNPLA3 (rs738409), LYPLAL1 (rs12137855), GCKR (rs780094), PPP1R3B (rs4240624) and NCAN (rs2228603), APOC3 (rs2854117 and rs2854116), ADIPOR2 (rs767870) and STAT3 (rs6503695 and rs9891119)]. RESULTS: Of the 2985 original study participants, 2155 (72.2%) (1244 women and 911 men; mean age 59.2 years [SD, 7.7]) participated in the follow-up assessment. 1322 [mean age 58.9 years (SD, 7.6), 483 (53.0%) men and 839 (67.4%) women] had NAFLD. Out of 795 [466 (58.6%) women] participants who did not have NAFLD in the original study, 365 [226 (61.9%) women, mean age 58.6 years (SD, 7.9)] had developed NAFLD after 7 years, giving an annual incidence rate 6.6%. On multivariate analysis, increased waist circumference [OR 1.96(1.30 – 2.97), p=0.001], BMI4 23 kg/m2 [OR 2.93(1.99 – 4.30), p50.001] and raised plasma triglycerides (TG) [OR 1.49(1.03 – 2.13), p=0.03] were independently predictive of incident NAFLD in this cohort, while raised BP and reduced HDL, were not. In the updated association study involving 1310 cases and 427 controls, we found borderline association with NAFLD at two of the 10 candidate loci: rs4240624 at PPP1R3B and rs738409 at PNPLA3 (one-tailed P=0.044 and 0.033, respectively). CONCLUSION: In this community cohort follow-up study in an urban, adult population in Sri Lanka, the annual incidence of NAFLD was 6.6%. Incident NAFLD was associated with features of the metabolic syndrome, and showed tendency of association at PNPLA3 and PPP1R3B gene polymorphisms. Disclosure of Interest: None declared