Related Experiment Video
Updated: Aug 5, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Pediatric Colorectal Cancer in Africa: A Multicenter Study on Epidemiology, Management, and Outcomes Between 2000 and
Jaques van Heerden1,2, Joyce Balagadde-Kambugu3, Veronica Nyakato4
1Department of Paediatric Haemato-Oncology, MIPRO Laboratory Antwerp University Hospital, University of Antwerp Antwerp Belgium.
Insights
Pediatric colorectal cancer (CRC) in Africa presents with delayed diagnosis and advanced stages, leading to poor survival rates. Further research and multidisciplinary care are crucial for improving outcomes in young CRC patients.
Area of Science:
- Oncology
- Pediatric Medicine
- Epidemiology
Background:
- Colorectal cancer (CRC) incidence is rising in Africa, with limited data on pediatric and adolescent cases.
- Understanding the specific epidemiology and outcomes of CRC in young African populations is essential.
Purpose of the Study:
- To describe the epidemiology, management strategies, and survival outcomes of colorectal cancer in children and adolescents across Africa.
- To analyze patient and tumor characteristics, treatment modalities, and survival rates in pediatric CRC cases.
Main Methods:
- A retrospective analysis of pediatric CRC cases (under 19 years) diagnosed between 2000 and 2023 from 14 African countries.
- Data collection included patient demographics, tumor characteristics, treatment details, and survival outcomes. GLOBOCAN data were used for geographical distribution analysis.
Main Results:
- 108 pediatric CRC patients (mean age 14.9 years) were identified, with a median diagnostic delay of 90 days.
- Most common symptoms included abdominal discomfort and bowel habit changes. Ascending colon was the most frequent primary site, with 73.1% presenting at Stage III or IV.
- Two-year and five-year overall survival rates were 40.0% and 16.9%, respectively. Advanced disease stage and incomplete resection were associated with poorer outcomes.
Conclusions:
- Pediatric CRC in Africa is often diagnosed late and at advanced stages, resulting in significantly lower survival rates compared to adults.
- There is a critical need for focused research and enhanced multidisciplinary management to improve the understanding and outcomes of pediatric CRC.
Introduction:
Colorectal cancer (CRC) is increasing in Africa, yet reports in children and adolescents are limited. We describe the epidemiology, management, and survival outcomes of CRC in African children.
Methods:
Retrospective data of children under 19 years diagnosed with CRC between 2000 and 2023 were collected from 14 African countries. Patient and tumor characteristics and treatment data were described and survival outcomes analyzed. GLOBOCAN data were used to evaluate age-related geographical distribution of CRC.
Results:
Hundred-and-eight patients, 57.4% males, were diagnosed with a mean age of 14.9 (range 5-18) years. The mean symptom-onset-to-diagnosis duration was 90 days (range 2-1200). Most common symptoms were abdominal discomfort (70.6%) and change in bowel habits (57.8%). The commonest primary site was the ascending colon (30.6%) with a mean tumor size of 64.3 mm (range 30-150 mm) and 37% presenting in stage III and 36.1% in stage IV. Most (83.3%) tumors were confirmed on histology, of which 78.7% were adenocarcinoma. Carcinoembryonic antigen was performed in 38.9% of patients. Complete resection was achieved in 55.6% of cases, while 18.5% received radiotherapy. Folinic acid, Fluorouracil, Oxaliplatin (FOLFOX) was the first line chemotherapy in 48.1% of patients. A third of patients were lost to follow-up while 25.6% experienced disease progression. The 2-year and 5-year overall survival rates were 40.0% and 16.9%, respectively. Disease stage (p = 0.07) and degree of resection (p = 0.02) predicted outcomes.
Conclusion:
Pediatric CRC is characterized by delayed diagnosis and advanced stage presentation, contributing to a significantly lower overall survival compared to adults. Focused research and multidisciplinary management are needed to understand pediatric CRC and improve outcomes.
