To investigate the clinicopathological characteristics, diagnosis, and treatment of rectal cancer in Tibet, in order to provide reference for the standardized diagnosis and treatment of this malignancy in Tibet Autonomous region.

The medical records of 64 Tibetan patients with rectal cancer who were hospitalized at Tibet Autonomous Region People’s Hospital from January 2016 to December 2019 were retrospectively analyzed.

A total of 64 patients were included, with an average age of (58.3±11.4) years, including 42 males and 22 females. The most common clinical symptom was bloody stool. The proportion of middle and low rectal cancer was 78.1% (50/64), and among patients with middle and low rectal cancer, only 24% (12/50) underwent pelvic enhanced magnetic resonance imaging (MRI). There were two (3.1%) cases with stage Ⅰ disease, 13 (20.3%) with stage Ⅱ, 21 (32.8%) with stage Ⅲ, and 28 (43.8%) with stage Ⅳ. Thirteen (20.3%) patients received mismatch repair protein test, 19 (29.7%) received human epidermal growth factor receptor-2 test by immunohistochemical method, and no patients received gene test. Thirty-three (51.6%) patients received surgery, of whom 23 (69.7%) were operated in Tibet Autonomous Region. Among 28 patients with stage Ⅳ and three patients with recurrence and/or metastasis after radical operation, 19 (61.3%) received systemic chemotherapy. No patients received preoperative concurrent chemoradiotherapy, and no patients had treatment plans formulated through a multidisciplinary team (MDT).

The incidence of rectal cancer in Tibetan begins to rise rapidly at the age of 40, with the majority being male. The low rate of pelvic enhanced MRI examination in patients with middle and low rectal cancer leads to inaccurate clinical staging. There is an urgent need to establish a radiotherapy specialty in Tibet and further strengthen the concept of MDT, so as to benefit more Tibetan patients.