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Colorectal Cancer in Nigeria

Rising rates, preventable deaths — what Nigerians need to know

Colorectal cancer (cancer of the colon and rectum) is rising in Nigeria as diets become more Westernised. It remains under-diagnosed because symptoms are attributed to 'pile' (haemorrhoids) or other common causes, and colonoscopy screening is rarely done. Most colorectal cancers begin as polyps — growths that can be removed before they become cancer — making this one of the most preventable cancers with appropriate screening.

Signs and Symptoms

✓ Change in bowel habits lasting more than 4 weeks (diarrhoea, constipation, or alternating)
✓ Rectal bleeding — bright red or dark blood mixed with stool
✓ Blood in stool — red, maroon, or black (tarry) stool
✓ Persistent abdominal discomfort — cramping, bloating, or pain
✓ Feeling that the bowel is not fully empty after passing stool
✓ Unexplained fatigue and weakness (often from anaemia due to slow bleeding)
✓ Unexplained weight loss
✓ A mass felt in the abdomen

Risk Factors

When to Seek Help

Rectal bleeding at any ageNever attribute rectal bleeding to haemorrhoids without investigation — colorectal cancer must be excluded. See a doctor.
Change in bowel habit for more than 4 weeksEspecially in someone over 40 — warrants colonoscopy.
Black tarry stoolIndicates upper GI bleeding (stomach or small bowel) — always urgent.
Unexplained anaemia in a man or post-menopausal womanColorectal cancer causing slow blood loss is a common cause. Colonoscopy is essential.

Tests & Diagnosis

🧪 Faecal occult blood test (FOBT)
Detects hidden blood in stool — a simple screening test. Positive result requires colonoscopy.
🧪 Colonoscopy
The gold standard — views the entire colon and allows polyps to be removed at the same time. Should be done from age 50 (or 40 if family history). Requires bowel preparation the day before.
🧪 Flexible sigmoidoscopy
Views the lower colon only — less comprehensive than colonoscopy but available where full colonoscopy is not.
🧪 CT colonography (virtual colonoscopy)
CT scan to view the colon — less invasive than colonoscopy but requires bowel prep. Available in some private radiology centres.
🧪 CEA (carcinoembryonic antigen)
A tumour marker used to monitor response to treatment and detect recurrence after surgery — not for initial screening.

Treatment Options

1
Surgery
Colectomy (removal of part of the colon) is the main treatment for localised colorectal cancer. For rectal cancer, total mesorectal excision (TME) is the standard. Many early-stage cancers are cured by surgery alone.
2
Chemotherapy
FOLFOX or CAPOX regimens are used after surgery (adjuvant) for Stage III disease, and for metastatic cancer. Oral capecitabine is an option.
3
Radiotherapy
For rectal cancer — often given before surgery to shrink the tumour and reduce local recurrence.
4
Targeted therapy
Bevacizumab and cetuximab improve outcomes in metastatic colorectal cancer depending on tumour genetic profile (KRAS/BRAS/NRAS status).
5
Polyp removal (colonoscopic polypectomy)
Removing polyps during colonoscopy prevents cancer from developing — the most effective cancer prevention available in gastroenterology.

Frequently Asked Questions

Are haemorrhoids (pile) the same as colorectal cancer?
No — haemorrhoids are swollen blood vessels around the anus and are not cancer. However, they share symptoms (rectal bleeding, discomfort). Never assume bleeding is from haemorrhoids without a doctor's assessment — rectal bleeding always warrants evaluation.
How is colorectal cancer screening done in Nigeria?
Colonoscopy is the standard — available at teaching hospitals and private gastroenterology clinics in Lagos, Abuja, and Ibadan. Costs range from N80,000–N250,000 privately. FOBT (faecal occult blood test) kits are cheaper and can be done at home; a positive result leads to colonoscopy.
At what age should I start screening?
Age 50 for average-risk individuals. Age 40 (or 10 years before the youngest affected family member's age) if you have a first-degree relative with colorectal cancer. People with inflammatory bowel disease should start screening 8 years after diagnosis.
Is colorectal cancer related to diet?
Yes — strongly. High red and processed meat consumption, low fibre, and low vegetable intake increase risk. A diet rich in vegetables, legumes, whole grains, and fibre reduces risk by 30–40%. This is one of the most diet-responsive cancers.
Can colorectal cancer be inherited?
Yes — familial adenomatous polyposis (FAP) and Lynch syndrome are hereditary conditions that dramatically increase colorectal cancer risk. If 2 or more first-degree relatives have had colorectal cancer, genetic counselling and earlier, more frequent colonoscopy are recommended.

Related Pages

Prostate Cancer in NigeriaCervical Cancer Prevention in NigeriaLiver Cancer (Hepatocellular Carcinoma) in NigeriaBreast Cancer in Nigeria

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