This study provides a current assessment of studies on colorectal adenocarcinoma in Uganda, with a focus on the implications of the increased prevalence of cases seen in our hospitals. This study also highlights differences in tumour site compared to the Western world, as well as the difficulties in achieving an early diagnosis of CRC in Ugandan patients. CRC is increasing steadily in various Sub-Saharan African nations, however this is accompanied with greater CRC-related morbidity and mortality. The nutrition transition in Sub-Saharan Africa, which is characterised by decreasing consumption of dietary fibre, starch, and plant proteins in favour of a Western diet associated with consumption of fatty foods and red meat, could be one reason for this increase. Noncommunicable disorders such as diabetes and obesity, as well as increasing alcohol intake and smoking, all raise the risk of CRC. In Uganda, there is a generational shift relative to high-income nations, with 22.8 percent of CRC cases detected at age 40, compared to 3-7 percent in high-income countries. The fact that this beginning occurs at such a young age is related with aggressive biological behaviour and a poor prognosis. Uganda's population is more susceptible to screening due to the high prevalence of left-sided colon and rectal cancer. The availability of endoscopic training and equipment, pricing, the availability of diagnostic services, and patient acceptance are all issues that Uganda and other Sub-Saharan African countries face. Screening will lead to an increase in CRC cases being diagnosed, which will necessitate an expansion in surgical and oncological infrastructure to manage CRC patients. Given the observed epidemiological trends, improving CRC diagnosis, screening, and treatment by enhancing surgical and endoscopic capability with the help of international medical and surgical societies should be a public health priority in Uganda. To reduce mortality in Uganda's population, national screening programmes to detect CRC at an early stage must be implemented in the future.
Author (S) Details
Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda. and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
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