Emergency presentation of colorectal cancer in Africa: a scoping review.

OBJECTIVES

This review identified and mapped the current evidence on emergency presentation of colorectal cancer in Africa.

DESIGN

Scoping review based on methodology by Arksey and O'Malley.

DATA SOURCES: Medline (via PubMed), Embase and African Journals Online were searched between 29 January 2025 and 6 March 2025.

ELIGIBILITY CRITERIA: Studies published in English and describing the burden, risk factors and management options for emergency presentation of colorectal cancer in Africa were included. Full-text articles of all epidemiological study designs were considered with no publication date limit. Grey literature such as conference abstracts and letters to the editor were considered if sufficient study detail was provided to map data to the research questions.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data from the included studies onto a standardised electronic form. Data were narratively synthesised using predefined themes.

RESULTS

Twenty-seven studies are included in this review. There was wide variability in reported emergency presentation colorectal cancer rates (8.3% to 64.9%). There were few data on early mortality, and none on long-term outcomes following surgery for colorectal cancer. Emergency presentation of colorectal cancer was characterised clinically by bowel obstruction, bowel perforation and peritonitis. Only one study reported on risk factors for emergency presentation of colorectal cancer. Use of diagnostic modalities was variable and depended on resource availability. Surgery was the mainstay of treatment. Endoscopic stenting was only available as a treatment option in South Africa.

CONCLUSIONS

Emergency presentation of colorectal cancer is a significant clinical, oncological and health system metric, yet there is a dearth of evidence on the subject in the African context. Available evidence demonstrates the need for more studies on emergency presentation of colorectal cancer, focused on risk factors, prevalence, treatment options and short-term and long-term outcomes.