Surgery for Colorectal Cancer Improves Survival in Uganda: A Cohort Study

Abstract

Colorectal carcinoma (CRC) incidence and mortality rates are rising in Uganda and other developing low-income nations in Sub-Saharan Africa, while CRC rates are dropping in high-income industrialized countries. In Uganda, many people with CRC do not have access to curative surgery or oncological care. To analyze the impact of surgery and oncology care on CRC in the resource-limited environment of a low-income developing nation, we compared the survival results of patients who underwent curative surgery and, if necessary, adjuvant chemotherapy to those who did not. The study included people who were diagnosed with CRC between January 1, 2008, and December 31, 2018. The Kampala Cancer Registry and medical records from Ugandan hospitals were linked for these patients. The researchers wanted to know if the individuals had had curative surgery and adjuvant treatment. Our outcome variable was survival at 3 years. The log-rank test was used to calculate and compare survival. A total of 247 patients were involved in the study. There were 177 (71.66 %) patients who received curative surgery and 70 (28.34 %) who did not. Curative rectal cancer surgery had a better survival than no curative surgery (p=0.003). Curative colon cancer surgery tended to have a better survival than no surgery (p=0.137). Curative surgery and adjuvant chemotherapy showed better survival than no surgery with no adjuvant chemotherapy (p=0.007). Curative surgery, if necessary, paired with adjuvant chemotherapy, improves survival in a resource-constrained situation. As a result of the increasing burden of CRC, the findings of our study serve to support the extension of CRC care by upgrading surgery and oncology infrastructure in resource-limited areas.