Clinicopatholigical Presentation and Treatment Modalities of Colorectal Cancer in a Low-Middle-Income Country

Abstract

Background Colorectal cancer (CRC) is one of the leading causes of cancer morbidity and mortality worldwide, with a rising incidence in low- and middle-income countries (LMICs). In Sub-Saharan Africa (SSA), limited screening, diagnostic delays, and weak health infrastructure contribute to late-stage presentation and poor outcomes. This study assessed the clinicopathological presentation and treatment modalities of CRC patients in a tertiary cancer centre within a resource-constrained setting. Methods A retrospective review was conducted using electronic medical records of CRC patients managed at the MEDSERVE–LUTH Cancer Centre, Lagos, Nigeria, between May 2019 and June 2024. Data extracted included demographic characteristics, clinical presentation, histology, stage, metastatic sites, and treatment received. Descriptive and correlation analyses were performed using SPSS version 27. Results A total of 448 CRC patients were analyzed, with a mean age of 54.07 ± 14.08 years (range: 10–89 years). Males comprised 57.2%. The most frequent presenting symptoms were rectal bleeding (51.3%), weight loss (44.2%), and abdominal pain (38.2%). Adenocarcinoma was the predominant histological type (87.3%), with 77.5% of tumors located on the left side. Nearly half (46%) presented with stage IV disease. The liver (27.2%) and lungs (20.5%) were the most common metastatic sites. Surgery was performed in 64.1% of patients, chemotherapy administered to 35.9%, and radiotherapy to 44.4%. Comorbidities were present in 46.2% of patients, mainly hypertension and diabetes. Conclusion Colorectal cancer in Nigeria continues to present at a relatively young age and advanced stage, with left-sided adenocarcinoma predominating. Limited access to screening, diagnostics, and comprehensive treatment underlies poor outcomes in LMICs. Strengthening public awareness, early detection programs, and health-system capacity are essential to improve survival and reduce the growing burden of CRC in Sub-Saharan Africa.