Colorectal cancer in northern Tanzania: A retrospective, descriptive study of patients with histologically confirmed diagnoses at a tertiary referral hospital

Abstract

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Background: Tanzanian data indicate a sixfold increase in colorectal cancer incidence over the past decade, accompanied by increased morbidity and mortality rates.

Methods: We conducted a retrospective analysis of colorectal cancer cases managed at Arusha Lutheran Medical Centre between January 2015 and December 2020. Data were extracted from clinical records to confirm diagnoses and evaluate outcomes. Analysed variables included symptom duration, tumour stage, surgical and adjunctive treatments, and follow-up. We also investigated associations of treatment-related outcomes with demographics, as well as with provider- and system-level factors, applying chi-square and Student’s t-tests with P<0.05 as the statistical significance threshold.

Results: The study included 57 patients. Men outnumbered women, with a ratio of 1.2:1. The median age at presentation was 57 years, with the majority aged between 61 and 70 years. Urban residents accounted for 63.2% of patients, 52.6% had health insurance, and 35.1% had comorbid conditions. Elective presentations were most common, accounting for 68.4% of cases, and 71.5% presented with advanced disease (stages 3 and 4). Rectal bleeding (42%) and abdominal pain (23.3%) were the most prevalent symptoms. The mean duration from symptom onset to presentation was 14.6 months. The rectum was the most commonly affected site (47.4%). Adenocarcinoma was the predominant tumour histology (94.7%), with the majority being moderately differentiated (42.1%). Surgical intervention was performed in 59.6% of cases, and 25.9% received adjunctive therapy. The mean postoperative follow-up duration was 5.8 months, as most patients were lost to follow-up.

Conclusions: The low uptake of treatment options, including surgery and adjunctive therapy, calls for deeper investigations into the factors contributing to colorectal cancer in this setting. Additionally, the presentation of patients with advanced disease and subsequent suboptimal patient follow-up underscore the systemic challenges present.