Document Type : Original Article(s)

Authors

• Khder H Rasul ¹
• Bestoon Hasan ²
• Basak Barzngy ²
• Zjwan Housein ³
• Abbas Salihi ⁴

¹ Department of Biology, College of Science, Salahaddin University-Erbil, Erbil, Kurdistan Region, Iraq. Medical Analysis Department, Tishk International University, Erbil, Iraq.

² Department of Cancer Registry, Cancer Control Unit, Erbil Directorate of Health, Erbil, Iraq

³ Department of Medical Laboratory Technology, Technical Health and Medical College, Erbil Polytechnic University, Erbil, Kurdistan Region 44002, Iraq.

⁴ Department of Biology, College of Science, Salahaddin University-Erbil, Erbil, Kurdistan Region, Iraq. Center of Research and Strategic Studies, Lebanese French University, Erbil, Iraq.

Abstract

Aim: This study explores sex, age, histological subtype, cancer stages, treatment methods and genetic studies (mutation and expression) of Adenomatous Polyposis Coli (APC), Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS), Tumor Protein 53 (TP53) and Deleted in Colorectal Cancer (DCC) genes for colorectal cancer (CRC).
Method: In this retrospective research study, 2625 CRC patients were included. The study spanned eleven years, from 2013 to 2023, and revealed fascinating trends and patterns within each category. GraphPad Prism version 9.0. (GraphPad Software, Inc.) was used to analyze acquired data. T test was used for the comparison between two groups. A P-value of 0.05 or below was considered statistically significant. 
Results: The data demonstrate a considerable rise in CRC incidences throughout the study's period, peaking in 2021 and men outnumbered women annually. The age-based analysis showed individuals of all ages were vulnerable to CRC, with the number of cases rising until peaking at 60. Histologically, colon cancer was more common than rectal cancer, and adenocarcinoma was the most common subtype. Most cases were grade 2 based on Tumor (T), Node (N) and Metastasis (M) staging system, with T3N1M0 and T3N2M0 being the most prevalent subtypes. The majority CRC patients received curative treatments. Regarding genetic studies of CRC related APC, KRAS, TP53 and DCC genes in International Cancer Genome Consortium databases, APC had the most mutations, with single-base substitutions being predominant. In the Catalogue of Somatic Mutations in Cancer database, KRAS had the highest mutations which included 8 missense substitutions. Regarding gene expression, public database Gene Expression Database of Normal and Tumor Tissues 2 showed significant differences between the four selected genes in CRC as compared with the normal tissue.
Conclusion: The study results highlight the complex nature of CRC and its prevalence and treatment. The genetic studies of CRC in databases revealed that APC and KRAS had the most mutations and gene expression analysis indicated significant differences between CRC and normal tissue for the selected genes.

Highlights

Bestoon Hasan (google scholar)

Khder Rasul (google scholar)

Keywords

• CRC
• APC gene
• KRAS gene
• TP53 gene
• DCC gene

Main Subjects

• Cancer Biology/Genetics

Please cite this article as: Barzngy B, Hasan B, Housein Z, Rasul K, Salihi A. An In-Depth Analysis of Colorectal Cancer in Erbil: Demographic Factors, Regional Disparities, Treatment Approaches and Genetic Studies. Middle East J Cancer. 2026; 17(2): p-p. doi: 10.30476/mejc.2025.103890.2157.