Delay in First Treatment Initiation and Associated Factors among Colorectal Cancer Patients at TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Cohort Study

Background: Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. There is a paucity of data on the clinical and demographic characteristics of CRC patients and factors associated with delayed treatment initiation. Methods: This retrospective cohort study was conducted in 274 patients with CRC from July 1st 2019 to July 1st 2022. Data were collected from medical records, including demographic and clinical characteristics, symptoms, diagnostic findings, treatment modalities, and treatment delay. Bivariate and multivariate logistic regression analysis was performed to determine factors associated with delayed treatment initiation. Results: The mean age of onset for CRC was 47.7+/- 14,7 years, with a slight male predominance. Patients experienced an average duration of complaints of 9.8 months, with bleeding per rectum, bowel habit change, and a rectal mass being the most frequently reported symptoms. Over 90% of cases were diagnosed at advanced stages, with the rectum being the most commonly affected site. Only 35% of patients received multidisciplinary team (MDT) care for the initial treatment plan, and radiotherapy was the most frequently delayed treatment modality, with a mean delay of 164.4 days. Multivariate logistic regression analysis revealed that delayed treatment initiation was significantly associated with the first treatment modality. Conclusion: This study highlights the clinical and demographic characteristics of CRC patients, and the high incidence of delayed treatment initiation, particularly for radiotherapy. Efforts should be made to increase awareness and screening for CRC, improve utilization of MDT care, and reduce delays in treatment initiation.