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

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


JournalEast and Central African Journal of Surgery
Article typeJournal research article – Clinical research
Publication date – Sep – 2022
Authors – Faraja M. Magwesela, Elirehema Kimaro, David Halter
KeywordsClinicopathological characteristics., Colorectal cancer, Colorectal cancer management, Northern Tanzania
Open access – Yes
SpecialityGeneral surgery, Surgical oncology
World region Eastern Africa
Country: Tanzania
Language – English
Submitted to the One Surgery Index on September 17, 2022 at 3:04 am
Abstract:

Background: Colorectal cancer is one of the most common cancers worldwide with increasing incidence and mortality in low- and middle-income countries. Data from Tanzania shows a six-fold increase in incidence in the
past decade with increased morbidity and mortality rates. This study was conducted to characterize the clinicopathological pattern of colorectal cancer as well as to assess the challenges in treatment.
Methods: A retrospective analysis of histologically confirmed colorectal cancer cases at Arusha Lutheran Medical Centre between January 2015 and December 2020 was done. Data were extracted from patients’ clinical records and analysed using SPSS version 25.
Results: Total of 57 patients were included in this study. Males outnumbered females by ratio of 1.2:1. The median age of presentation was 57years with most patients being 61-70years of age. Most of our patients were urban residents (63.2%), 52.6% had health insurance and 35.1% had other comorbid conditions. Most of our patients (68.4%) presented as elective cases, and most (71.5%) had advanced disease (stage 3 and 4). The most common presenting symptoms were rectal bleeding (42%) and abdominal pain (23.3%). The mean duration from symptom onset to presentation was 14.6months. The rectum was the most common involved site (47.4%). Adenocarcinoma was the most common tumor histology (94.7%), majority being moderately differentiated (42.1%). 59.6% underwent surgery, and 25.9% received adjunctive therapy. The mean follow-up time of patients after surgical intervention was low at 5.8months as majority of the patients were lost to follow-up.
Conclusions: There is poor uptake of treatment options – surgery and adjunctive therapy – necessitating further appraisal for related factors. Also, advanced disease presentation and poor patient follow-up highlights underlying system challenges.

OSI Number – 21753

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