CLINICAL PROFILE AND SURGICAL MANAGEMENT OF COLORECTAL CANCER IN A TERTIARY CENTER IN NORTHWEST NIGERIA: A 10-YEAR DESCRIPTIVE STUDY

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.