# Epidemiological, Clinical, and Therapeutic Features of Colon Cancer in the General Surgery Department of the National Institute of Hepato-Virology (INHV) in Nouakchott, Mauritania: A Series of 40 Cases

## TL;DR

This study describes colon cancer cases in Mauritania, showing it mainly affects middle-aged men and is often diagnosed late.

## Contribution

The paper provides the first detailed analysis of colon cancer in a Mauritanian hospital setting.

## Key findings

- Colon cancer predominantly affected middle-aged adults with a male predominance.
- Abdominal pain and bowel obstruction were the most common presenting symptoms.
- Most patients underwent curative surgery, but access to early diagnosis and chemotherapy was limited.

## Abstract

Background and objectives

In low- and middle-income countries, colon cancer is a growing public health concern and is often diagnosed at an advanced stage. In Mauritania, local data remain scarce. This retrospective, hospital-based descriptive study aimed to describe the epidemiological, clinical, and therapeutic characteristics of surgically managed colon cancer cases in the general surgery department of the National Institute of Hepato-Virology (INHV), Nouakchott, Mauritania, a public tertiary referral hospital serving the general population and receiving referrals from Nouakchott and other regions of the country.

Methods

We conducted a retrospective, descriptive study including 40 patients who underwent surgery for colon cancer between 2020 and 2023. Variables collected included age, sex, medical and surgical history, presenting symptoms, diagnostic delay, tumor location, and therapeutic modalities. Data were extracted from medical records and analyzed using SPSS version 27 (IBM Corp., Armonk, NY).

Results

The mean age was 56.3 ± 14.2 years (range: 30-88). Males accounted for 65% (26 men, 14 women), with a sex ratio of 1.86. Colon cancer accounted for 4% of all admissions in the General Surgery Department at INHV during the study period (department-level denominator). Abdominal pain was the most frequent symptom (19 patients, 47.5%), followed by bowel obstruction in six patients (15.0%) and lower gastrointestinal bleeding in five patients (12.5%). The mean delay between symptom onset and diagnosis was 2.12 months (range: 1-12.5). Tumors were more frequently located in the right colon (22 cases, 55.0%) than in the left colon (18 cases, 45.0%). Laparotomy was performed in 36 cases (90.0%) and laparoscopy in four cases (10.0%). Right hemicolectomy was the most common procedure (15 patients, 37.5%), followed by left hemicolectomy (11 patients, 27.5%). Segmental colectomy was performed in five patients (12.5%), and palliative-intent surgery in nine patients (22.5%). Adjuvant chemotherapy was administered to nine patients (22.5%), mainly for advanced tumors.

Conclusion

In this Mauritanian hospital-based series, colon cancer predominantly affected middle-aged adults with a male predominance. Abdominal pain and bowel obstruction were the most common presenting symptoms. Most patients underwent curative-intent surgery; however, access to early diagnosis and adjuvant oncologic treatment remains limited. Given the retrospective descriptive design and limited standardized follow-up, survival and recurrence outcomes were not formally analyzed. These findings highlight the need to promote early detection, improve access to colonoscopy, and strengthen multidisciplinary management.