Clinical and Epidemiological Profiles of Colorectal Cancer Patients Diagnosed on Colonoscopy in Nigeria

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer globally, and the second most common cause of cancer death. CRC incidence is increasing in Nigeria, while its national demographic data distribution is limited. This study aims to determine the frequency of CRC found on colonoscopies in various parts of Nigeria.Methods: This was a retrospective study of CRCs diagnosed in Nigeria between 2021 and 2023. Data from endoscopy registers include patients' demographics, regional location, preparation, scope used, tumour location, and histology. A Google form was used for data collection from all contributors. Data was analysed using SPSS version 20, means and standard deviations were used to summarise continuous variables, while frequencies and percentages were used for categorical variables. Categorical variables were compared using chi-square or Fisher exact tests. P values less than 0.05 were considered significant.Results: A total of 2387 procedures were performed in 8 centres. Epsom salt with Dulcolax was the most commonly used cleansing agent with an average preparation score of 6.6. A total of 322 patients had suspected colonic tumour with a prevalence of 13.5%. After censoring for missing data, a total of 272 patients were analysed. The mean age ± standard deviation was 56.3 ± 15.5 years. Females were 53.3% with a M: F ratio of 1:1.14. A statistically significant difference was observed between genders across the country regions (P = 0.013). The most common indication was bleeding pre-rectum (38.24%) while screening colonoscopy was done only in 10 (3.8%). The most common tumour location was a recto-sigmoid colon (48.16%), while the commonest tumour histology was adenocarcinoma. Conclusion: Our study provides data on the prevalence of colon cancer in Nigeria. The findings suggest rectal bleeding is an important warning feature. This emphasizes the need for early detection of average-risk individuals and prompt treatment of cases.