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Multicenter Study
. 2025 Feb;131(2):170-182.
doi: 10.1002/jso.27878. Epub 2024 Nov 21.

Analysis of Risk Factors, Treatment Patterns, and Survival Outcomes After Emergency Presentation With Colorectal Cancer: A Prospective Multicenter Cohort Study in Nigeria

Adeniyi S Aderibigbe  1 , Anna J Dare  2 , Hannah L Kalvin  3 , Olalekan Olasehinde  4 , Funmilola Wuraola  4 , Adewale Adisa  4 , Adeleye Dorcas Omisore  5 , Akinwumi O Komolafe  6 , Oluwatosin Zainab Omoyiola  6 , Chukwuma Eze Okereke  1 , Aba Katung  1 , Adedeji Egberoungbe  7 , Olufemi Ariyibi  8 , Samuel Adegboyega Olatoke  9 , Ademola Adetoyese Adeyeye  9 , Sulaiman Olayide Agodirin  9 , Matthew Olumuyiwa Bojuwoye  10 , James Oluwaleke Fayenuwo  11 , Oluwabusayomi Roseline Ademakinwa  11 , Dapo Osinowo  12 , Abdul-Razak Lawal  12 , Fatimah B Abdulkareem  12 , Debra Goldman  3 , Gregory Knapp  13 , Shilpa Murthy  14 , Rivka Kahn  15 , Mithat Gonen  1 , T Peter Kingham  15   16 , Olusegun I Alatise  4   11 ; African Research Group in Oncology Colorectal Cancer Working Group
Affiliations
Multicenter Study

Analysis of Risk Factors, Treatment Patterns, and Survival Outcomes After Emergency Presentation With Colorectal Cancer: A Prospective Multicenter Cohort Study in Nigeria

Adeniyi S Aderibigbe et al. J Surg Oncol. 2025 Feb.

Abstract

Background and objectives: Prospective data on presentation and outcomes of colorectal cancer (CRC) in Nigeria are limited; however, emergency presentation with advanced disease is thought common.

Methods: Consecutive CRC patients presenting at six sites over 6 years were included. Risk factors for emergency presentation were evaluated using logistic regression methods. Overall survival (OS) was compared between emergent and elective patients using Kaplan-Meier methods and the log-rank test.

Results: Of 535 patients, 30.7% presented emergently. Median age was 56 years, 55% were men, and 5.0% reported a cancer family history. Emergency patients had more proximal cancers (42.1% vs. 24.0%), Stage IV disease (61.6% vs. 40.2%; p < 0.001), lower household income (₦35 000/month vs. ₦50 000/month), lower education levels (p = 0.008) and accessed care with nonmotorized transport (50.6% vs. 37.2%; p = 0.005). Median OS was shorter in the emergency group (6.4 vs. 17.4 months; p < 0.001). Across clinical stages, emergency presentation was associated with worse OS (Stage IV median OS 4.8 vs. 9.4 months; p = 0.002). Surgery improved survival in both groups, although emergency patients had higher 30-day postoperative mortality (23.2% vs. 9.1%; p < 0.001).

Conclusions: Emergent Nigerian CRC patients have worse OS than elective patients. Cancer control efforts should focus on faster cancer detection, early presentation, diagnosis, and treatment.

Keywords: Nigeria; West Africa; cancer survival; colorectal cancer; emergency presentation; low‐ and middle‐income countries (LMICs).

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References

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