Retrospective study of colorectal cancer at a Sudanese regional center

Colorectal cancer patients treated at the White Nile Oncological Center during Sudan’s ongoing conflict were relatively young, with 48.9% of the 86 cases diagnosed before age 50, according to a retrospective, cross-sectional, hospital-based study. The research included all colorectal cancer patients who presented to the regional center between April 2023 and March 2025. Most originated from Sudan’s central states, and the tumors were concentrated in the left side of the colorectum: the rectosigmoid accounted for 28 cases, or 32.6%, while the low rectum was involved in 26 cases, or 30.2%.

The cohort had a mean age of 52.2 years, with a standard deviation of 13.9 years, and included 52.3% men. Rectal bleeding was the most frequently reported presenting symptom, affecting 28 patients, or 32.6%. Symptoms of intestinal obstruction occurred in 17 patients, or 19.8%, and altered bowel habits were reported in 12, or 14.0%. These observations characterize people who reached one specialized regional oncology center during a period of conflict-related disruption to Sudan’s health system and referral pathways. Because the study was retrospective, hospital-based and limited to a single center, its results do not establish the population-wide distribution of colorectal cancer in Sudan or explain why the patients had the ages, tumor locations or symptoms recorded.

Pathology identified moderately differentiated adenocarcinoma as the predominant diagnosis, representing 47 patients, or 54.7% of the cohort. Most patients had stage I or II disease under the Tumour, Node, Metastasis staging system, accounting for 59.3% of cases. The liver was the most frequently identified site of metastasis, with liver metastases found in 16 patients, or 18.6%. The findings therefore combine a substantial proportion of relatively young patients and left-sided tumors with a majority classified as having early-stage disease at diagnosis. However, the study describes clinicopathological patterns among patients able to access regional cancer services; it does not show that conflict caused a particular age distribution, stage pattern or metastatic pattern, nor does it establish how these features affected survival.

The authors interpreted the results as evidence for the central role of decentralized oncology services when the wider health system and referral pathway are disrupted. In their conclusion, they said early colorectal cancer detection in Sudan requires stronger regional endoscopy services, expanded pathology facilities, training for health providers and improved screening programs. The analysis also carries the usual limitations of a retrospective, cross-sectional study at one regional center: the cohort was small, it included only patients who reached the facility, and its two-year sample cannot by itself distinguish the observed clinical pattern from broader changes in access, referral or case ascertainment. Its clearest contribution is a detailed snapshot of how colorectal cancer presented at a Sudanese regional oncology center during the conflict, including the proportions of patients younger than 50, tumors arising in the rectosigmoid and low rectum, early-stage classifications and liver metastases.

Subject of Research: Clinicopathological patterns of colorectal cancer at a Sudanese regional oncology center during the Sudan conflict

Article Title: Clinicopathological patterns of colorectal cancer during the Sudan conflict: a regional oncology center experience

Article References: Azoz, M. E. H., Suleiman, A. A. A., Makkawi, A. M. M., Ali, M. M. A. H., Elimam, N. S. A., Ahmed, M. A. A., Alshareef, A. M., Abuelnour, A. E. K., & Bakhiet, M. Y. (2026). Clinicopathological patterns of colorectal cancer during the Sudan conflict: a regional oncology center experience. BMC Cancer. https://doi.org/10.1186/s12885-026-16761-1

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16761-1

Keywords: colorectal cancer, Sudan, armed conflict, regional oncology, early-onset cancer, left-sided tumors, cancer staging, liver metastases, healthcare disruption, retrospective study, Clinicopathological, patterns