FREQUENCY OF RECTAL CANCER IN PATIENTS HAVING RECTAL BLEEDING AS PRESENTING SYMPTOM PRESENTING AT SURGICAL OPD OF AZIZ BHATTI SHAHEED TEACHING HOSPITAL GUJRAT

Abstract

Objective: To determine the frequency of rectal cancer among patients presenting with rectal bleeding at the surgical outpatient department of Aziz Bhatti Shaheed Teaching Hospital, Gujrat. Methods: This cross-sectional study was conducted in the Department of Surgery, Aziz Bhatti Shaheed Teaching Hospital, Gujrat from April to July, 2026. A total of 140 adult patients (aged 25–80 years) presenting with fresh, painless rectal bleeding were enrolled using consecutive sampling, excluding benign anal conditions, prior pelvic irradiation, and rectal surgery. All participants underwent digital rectal examination and colonoscopy with incisional biopsy of suspicious lesions for histopathological confirmation. Positive cases underwent contrast-enhanced CT of the abdomen and pelvis for TNM staging. Data were analyzed using SPSS version 26. Categorical variables were evaluated using the chi-square test, with p ≤ 0.05 considered statistically significant. Results: Among 140 patients, 18 were diagnosed with histopathologically confirmed rectal carcinoma, yielding an overall frequency of 12.9%. Malignancy was more frequent in males (16.9% vs. 5.9%; p = 0.109) and patients aged ≥50 years (16.5% vs. 6.1%; p = 0.138), though these differences did not reach statistical significance. Smokers also exhibited a higher rate of carcinoma compared to non-smokers (20.8% vs. 8.7%; p = 0.077). Notably, a prior history of rectal bleeding was significantly associated with a diagnosis of rectal cancer (26.4% vs. 4.6%; p = 0.001). Conclusion: Rectal cancer was identified in 12.9% of patients presenting with rectal bleeding. A recurrent history of bleeding represents a critical red-flag symptom that strongly warrants prioritized, prompt colonoscopic evaluation in surgical outpatient settings.