Symptoms and Outcomes in Colorectal Cancer Patients: A Saudi Tertiary Hospital's Five-Year Analysis

<b>Background:</b> Colorectal cancer (CRC) is the third most common cancer worldwide. In Saudi Arabia, the 2020 cancer incidence report found that CRC was the most common cancer among men and had the highest mortality rate. Given the correlation between cancer symptom awareness and early detection and recognizing the significance of patient history in CRC diagnosis, this study aims to identify the presenting symptoms of CRC, assess survival by stage across the population, and better understand disease demographics in Saudi Arabia. <b>Methods:</b> We conducted a retrospective cohort analysis of 655 patients with CRC diagnosed between 2016 and 2020, inclusive. The cancer registry database at King Khalid University Hospital was used to retrospectively collect data from electronic records. Various relevant data were extracted and analyzed. <b>Results:</b> The results showed that the most common presenting symptom was abdominal pain (329, 50.2%), followed by weight loss (262, 40%), hematochezia (rectal bleeding or blood in stool) (242, 36.9%), and anemia (238, 36.3%). The overall three-year survival rate was 77.6%. For stages I, II, III, and IV it was 100%, 91.9%, 86.4%, and 61.8%, respectively. with a significant difference (p = 0.0001). <b>Conclusions:</b> Rectal bleeding and other "alarming symptoms" were observed in fewer than 40% of the studied population. In the cohort, only one patient was diagnosed via a screening colonoscopy. Study also confirmed that survival improved with earlier stages at diagnosis. Encouraging preventative measures, raising awareness of CRC, and improving access to screening, could all contribute to earlier identification, reduced staging, and a better prognosis.