article · ecancermedicalscience
An evaluation of colorectal cancer care at the Ocean Road Cancer Institute in Tanzania between 2014 and 2019 assessed treatment patterns and quality measures before national guidelines were introduced. Out of 678 patients, 421 presented with non-metastatic cancer. Care patterns differed substantially by tumour location. Patients with colon cancer generally received high-quality care, with 93 percent undergoing surgical resection and most receiving timely adjuvant chemotherapy. However, surgical pathology reporting was limited, with only 6 percent of reports recording the examination of more than 12 lymph nodes. Care for rectal cancer was markedly less consistent: only 24 percent of rectal cancer patients had surgery, 24 percent received no treatment, and the use of preoperative chemoradiation was low. These results provide a baseline to evaluate the impact of national treatment guidelines and highlight the difficulty of delivering complex multidisciplinary care in resource-constrained environments.
Colorectal cancer is a major cause of illness and death in Tanzania, yet non-metastatic cases can be cured with appropriate treatment. By identifying specific gaps in rectal cancer management and pathology reporting, health systems can better direct resources, establish targeted clinical training, and evaluate whether new national treatment guidelines improve patient outcomes.
The abstract outlines health systems research and clinical quality metrics rather than a commercial product or service, so it does not indicate a direct commercialisation pathway. However, the identified gaps in multidisciplinary treatment and pathology reporting point to potential opportunities for healthcare organisations to implement standardised pathology reporting tools, oncology data tracking systems, or clinical workflow solutions to support guideline adherence in low-resource settings.
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Background: Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality in Tanzania. Non-metastatic CRC is a potentially curable disease that requires multidisciplinary management. This study aimed to evaluate clinicopathologic characteristics for CRC, treatment patterns and select quality metrics at Ocean Road Cancer Institute from 2014 to 2019, the time period immediately preceding the release of Tanzania's first National Cancer Treatment Guidelines in 2020. Methods: Quality metrics were selected a priori based upon existing international quality measures, the newly released Tanzania National Cancer Treatment Guidelines and key stakeholder input. Demographic, clinicopathologic and treatment data were abstracted from medical charts for all adult patients with newly diagnosed non-metastatic CRC presenting to Ocean Road Cancer Institute from 2014 to 2019. A clinician reviewed all case report forms for quality assurance. Patient characteristics, treatment patterns and quality metrics were examined using descriptive analyses. Results: Of 678 patients with CRC, 421 (62%) had non-metastatic disease. Of those with non-metastatic disease, 92 (22%) had colon cancer, 175 (42%) had rectal cancer and 154 (36%) were classified as CRC primary site not otherwise specified. Most patients with colon cancer (n = 86, 93%) underwent surgical resection. Quality of adjuvant chemotherapy was high for colon cancer, with most patients receiving timely treatment (73% within 8 weeks of surgery) and most (81%) with stage III disease receiving appropriate treatment. Documentation in surgical pathology reports was poor, with only 5 of 78 (6%) documenting examination of >12 lymph nodes. Among rectal cancer patients, use of preoperative chemoradiation (7%) and perioperative chemotherapy (27%) was low for locally advanced disease. Overall, only 42 (24%) of patients with rectal cancer underwent surgery and 42 (24%) received no treatment. Conclusion: The majority of patients with non-metastatic colon cancer received high-quality care, whereas care delivery was less consistent among patients with rectal cancer. This suggests possible challenges in delivering complex, multidisciplinary care in low-resource settings. These findings will serve as a contemporary benchmark for future evaluations of the Tanzanian National Cancer Treatment Guidelines and their impact on CRC care and outcomes.
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DOI: 10.3332/ecancer.2025.1991
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