COLORECTAL CANCERS IN COTONOU FROM 2013 TO 2023: EPIDEMIOLOGICAL, DIAGNOSTIC, THERAPEUTIC AND PROGNOSTIC ASPECTS.

Abstract

Introduction: The increasing incidence and high mortality of colorectal cancer (CRC) make it a major public health concern in developing countries.

Objective: The aim of this work was to study the epidemiological, diagnostic, therapeutic, and prognostic aspects of colorectal cancers from 2013 to 2023 in Cotonou.

Methods: This was a descriptive, analytical study with retrospective data collection, covering CRC patients managed in specialized centers in Cotonou (university clinics of visceral surgery, internal medicine and hepatogastroenterology at CNHU-HKM and the Cotonou Cancer Center).

Results: Total of 194 CRC cases were identified out of 13857 patients seen during the study period (1.4%), with a peak incidence in 2023. The median age was 53, with an interquartile range of [64-40]; 25% of subjects were under 40. The sex ratio was 1.3 (110 men and 84 women). The median time to diagnosis was 8.4 months. Constipation (78.8%), abdominal pain (71.5%), and haematochezia (61.8%) were the main clinical presentation, and occlusive forms in 27.5%. Tumor location was recto-sigmoid in 51.5%. CRC was stage III or IV in 60.4%, with 38.7% metastases. The main treatments applied were curative surgery (8.3%), palliative surgery (68.8%) and palliative chemotherapy (68.8%). Median overall survival was 22.5 months, with a 5-year survival rate of 5%. Factors predictive of death were duration of progression before diagnosis (p<0.001), World Health Organization performance status index (p=0.001), and absence of chemotherapy treatment (p=0.026).

Conclusion: CRC is increasingly common in Cotonou, and has a very poor prognosis. Early diagnosis and appropriate treatment could improve prognosis.