Clinical presentation, histopathological patterns, and management approach of colorectal cancer patients at a specialized hospital in Mogadishu, Somalia: a retrospective study

Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide, with a rapidly increasing burden in sub-Saharan Africa. In Somalia, data on CRC are scarce, and patients frequently present at advanced stages. This study aimed to describe the clinical presentation, histopathological patterns, disease stage, and surgical management of colorectal cancer patients treated at a major tertiary hospital in Mogadishu. A retrospective observational study was conducted at Mogadishu Somali–Türkiye Recep Tayyip Erdoğan Training and Research Hospital. Medical records of all adult patients with histologically confirmed colorectal cancer who underwent surgery between January 2020 and December 2024 were reviewed. Data on demographics, clinical presentation, tumor characteristics, disease stage, surgical procedures, and postoperative complications were extracted from the hospital’s electronic database and analyzed using descriptive statistics. A total of 59 patients were included, of whom 69.5% were male. The mean age was 57.44 ± 16.48 years, with 32.2% of patients aged ≤ 50 years. The most common presenting symptom was intestinal obstruction (74.6%), followed by rectal bleeding (15.3%) and perforation (8.5%). The caecum (35.6%) and sigmoid colon (32.2%) were the most frequent tumor sites. Adenocarcinoma was the predominant histological type (67.8%), followed by mucinous adenocarcinoma (15.3%) and signet-ring cell carcinoma (5.1%). Well-differentiated tumors accounted for 49.2% of cases, while 30.5% were poorly differentiated. Lymphovascular invasion and perineural invasion were present in 37.3% and 42.4% of patients, respectively. Most patients presented with advanced disease, with Stage III and Stage IV accounting for the majority of cases. Surgical management was dominated by resection and anastomosis (42.4%) and end ileostomy (30.5%), with right hemicolectomy being the most common operation (42.3%). Postoperative complications included wound infection (10.2%) and anastomotic leak (8.5%). Colorectal cancer patients in Somalia commonly present with advanced-stage disease and potentially aggressive histopathological features, leading to a high burden of emergency and palliative surgical care. Limited access to chemotherapy and the absence of radiotherapy further restrict treatment options. Strengthening early detection, diagnostic services, screening capacity, and oncology infrastructure is essential to facilitate timely diagnosis and improve colorectal cancer care in Somalia.