CLINICAL PROFILE AND SURGICAL MANAGEMENT OF COLORECTAL CANCER IN A TERTIARY CENTER IN NORTHWEST NIGERIA: A 10-YEAR DESCRIPTIVE STUDY
Abstract
Background: Colorectal cancer (CRC) is a common surgical problem globally, with an increasing incidence and worse outcomes in Low- and medium-income countries, where the magnitude remains under-reported.
Objective: To describe the presentation of colorectal cancer in a tertiary hospital in Northwest Nigeria and highlight the challenges of surgical management.
Methods: The study period was 10 years, January 2012 to December 2021, for all patients presenting with histologic diagnosis of colon or rectal cancer presenting through the surgical outpatient clinics, emergency departments, or seen through non-surgical wards of Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria during the study period.
Results: There was a total of 221 patients with histologically confirmed colon and rectal cancers over the study period. The male-to-female ratio was 1.1:1, age range was 14–80 years, and a peak age group of 30-40years. 195 patients (88.24%) were 50 years or less, early-onset CRC. There was a rise in the yearly hospital-based incidence of presentation in CRC for 12 patients in 2012 to 32 patients in 2019. Majority, 140 patients (63.35%), presented in emergency, and delay in presentation was a common feature, with over 60% of patients presenting for the first time 6 months after onset of symptoms. The rectum was the most affected site, accounting for 66.06% of patients (n=146). A third of patients did not receive surgical intervention due to advanced inoperable disease, financial constraints, or refusal of colostomy. Majority of the patients presented with advanced stage. 55% of patients (n=121) presented with Dukes’ stage C. 10% of patients (n=22) had metastatic disease.
Conclusion: Colorectal Cancer incidence is increasing in our environment. Early-onset disease at an advanced stage is the common presentation. With the challenges of surgical care, poor outcomes have been maintained in our patients.
Keywords:
Colorectal, cancer, presentation, Surgical Challenges, early onset colorectal cancer, Nigeria.Downloads
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Copyright (c) 2024 Umar Muktar , Usman Mohammed Bello

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References
Arnold, M., Sierra, M. S., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2017). Global patterns and trends in colorectal cancer incidence and mortality. Gut, 66(4), 683–691. https://doi.org/10.1136/gutjnl-2015-310912
Awedew, A. F., Asefa, Z., and Belay, W. B. (2022). Burden and trend of colorectal cancer in 54 countries of Africa 2010–2019: A systematic examination for Global Burden of Disease. BMC Gastroenterology, 22, 204. https://doi.org/10.1186/s12876-022-02275-0
Baldwin, M., Niyibizi, B. A., Rangira, D., Rangira, B., Kazindu, M. K., Seifu, D., Stefan, C. D., Rugengamanzi, E., & Manirakiza, A. V. C. (2024). Colorectal cancer disease profile and treatment patterns at an urban tertiary hospital in Rwanda. Ecancermedicalscience, 18, 1687. https://doi.org/10.3332/ecancer.2024.1687
Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 74(3), 229–263. https://doi.org/10.3322/caac.21834
Burkitt, D. P. (1971). Epidemiology of cancer of the colon and rectum. Cancer, 28(1), 3–13. https://doi.org/10.1002/1097-0142(197107)28:1<3: aid-cncr2820280104>3.0.co;2-n
Irabor, D. O. (2017). Emergence of Colorectal Cancer in West Africa: Accepting the Inevitable. Nigerian Medical Journal: Journal of the Nigeria Medical Association, 58(3), 87. https://doi.org/10.4103/0300-1652.234076
Irabor, D. O., Afuwape, O. O., and Ayandipo, O. O. (2014). The Present Status of the Management of Colon and Rectal Cancer in Nigeria. Journal of Cancer Research, 2014(1), 267190. https://doi.org/10.1155/2014/267190
Jemal, A., Bray, F., Forman, D., O’Brien, M., Ferlay, J., Center, M., and Parkin, D. M. (2012). Cancer burden in Africa and opportunities for prevention. Cancer, 118(18), 4372–4384. https://doi.org/10.1002/cncr.27410
Katsidzira, L., Gangaidzo, I., Thomson, S., Rusakaniko, S., Matenga, J., & Ramesar, R. (2017). The shifting epidemiology of colorectal cancer in sub-Saharan Africa. The Lancet Gastroenterology and Hepatology, 2(5), 377–383. https://doi.org/10.1016/S2468-1253(16)30183-2
List of Nigerian states by population. (2021). In Wikipedia. https://en.wikipedia.org/w/index.php?title=List_of_Nigerian_states_by_population&oldid=1057267017
Mbah, N. (2009). Hospital frequency of large bowel cancer: Factors thought to influence outcome. Nigerian Journal of Clinical Practice, 12(1), 37–41.
Ningi, A. (2020). The Burden of Colorectal Cancers in Nigeria: Patterns and Presentations in North-Eastern Nigeria Article Information. J Cancer Res Oncobiol, 3–4. https://doi.org/10.31021/jcro.20203128
Sharma, A., Alatise, O. I., Adisa, A. O., Arowolo, O. A., Olasehinde, O., Famurewa, O. C., Omisore, A. D., Komolafe, A. O., Olaofe, O., Katung, I. A., Ibikunle, D. A., Egberongbe, A. A., Olatoke, S. A., Agodirin, S. O., Adesiyun, A. O., Adeyeye, A., Ibrahim, K., Kolawole, O. A., Idris, O. L., … Kingham, T. P. (2019). Treatment of Colorectal Cancer in Sub-Saharan Africa: Results from a Prospective Nigerian Hospital Registry. Journal of Surgical Oncology, 121(2), 342. https://doi.org/10.1002/jso.25768
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
Tazinkeng, N. N., Pearlstein, E. F., Manda-Mapalo, M., Adekunle, A. D., Monteiro, J. F. G., Sawyer, K., Egboh, S.-M. C., Bains, K., Chukwudike, E. S., Mohamed, M. F., Asante, C., Ssempiira, J., & Asombang, A. W. (2024). Incidence and risk factors for colorectal cancer in Africa: A systematic review and meta-analysis. BMC Gastroenterology, 24(1), 303. https://doi.org/10.1186/s12876-024-03385-7