By Eugenie Muchetu
Harare ,(New Ziana)– Colorectal cancer, the third most common cancer globally, is increasingly becoming a major health concern in Zimbabwe, where it accounts for 4 percent of all cases recorded and 4 percent of cancer-related deaths.
Traditionally associated with older adults, the disease is now alarmingly affecting younger populations, raising concern among medical professionals and public health experts.
According to the Zimbabwe Cancer Registry 2019 report, the most frequently occurring cancers across all races include cervix uteri (22 percent), prostate (11 percent), breast (8 percent), oesophagus (5 percent), colorectal (4 percent), stomach (4 percent), Kaposi sarcoma (4 percent), non-Hodgkin lymphoma (3 percent), and liver (3 percent) with the remaining ones making up 36 percent of registered malignancies.
Dr Nothando Christagirl Mutizira, head of the Oncology Radiotherapy Department at the Parirenyatwa Group of Hospitals, described colorectal cancer as one of the emerging cancers of concern.
“We are observing a concerning rise in colorectal cancer in younger populations, as well as an increase in lifestyle-related cancers like breast and prostate cancer, which were previously less common,” she said.
The trend is not unique to Zimbabwe as the National Cancer Institute of the United States has also noted a rise in colorectal cancer among younger age groups, even as rates decline among older populations.
Between 2012 and 2021, the number of new colorectal cancer cases diagnosed per 100 000 people increased by 3.8 percent annually among those aged 15 to 39, rising from 4.1 to 5.6.
Among those aged 40 to 64, cases increased by 1.2 percent annually, from 46.1 to 52.1 while in contrast, rates decreased by 2.2 percent annually among those aged 65 to 74, and by 2.7 percent among those aged 75 and older.
The reasons for the rising incidence among younger people remain unclear, though experts suggest it may be linked to changes in the prevalence of certain risk factors.
Colorectal cancer affects the colon (large intestine) or rectum and is often deadly if not detected early and while most cases occur in people over 50, symptoms such as diarrhea, constipation, blood in the stool, abdominal pain, unexplained weight loss, fatigue, and low iron levels may appear later in the progression of the disease.
Like many cancers, colorectal cancer often presents no symptoms in its early stages, making regular screening critical.
Several lifestyle factors contribute to the development of colorectal cancer, including diets high in processed meats, low intake of fruits and vegetables, sedentary behaviour, obesity, smoking, and excessive alcohol consumption.
Prevention strategies include maintaining a healthy diet, regular physical activity, avoiding tobacco, limiting alcohol intake, and undergoing routine screenings.
The disease disproportionately affects men more than women, with non-black men being the most affected in Zimbabwe.
According to the Zimbabwe Cancer Registry, colon cancer accounted for 8.5 percent of all cancers among non-black men, second only to prostate cancer, which made up 32.5 percent.
Rectal cancer was the5th most common, accounting for 4.3 percent of all cancers in this group. Among black men, colon cancer accounted for 2.6 percent and rectal cancer for 2.4 percent.
For black women, colorectal cancer did not feature among the top ten most common cancers. However, among non-black women, colon cancer was the second most common after breast cancer (31.4 percent), accounting for 11 percent of cases, while rectal cancer made up 7.6 percent.
Simbarashe Chatora, a 54-year-old man from Harare, shared his experience after his doctor ordered a fecal occult blood test (FOBT) due to symptoms including diarrhea, constipation, blood in stool, and fatigue.
“At least I will know what’s wrong with me and can get treatment as soon as possible,” he said, relieved that the test cost only $12 and results would be ready in two hours.
He suspected that his symptoms were due to hemorrhoids rather than cancer.
The World Health Organization (WHO) notes that stool-based tests like FOBT are non-invasive screening tools used to detect colorectal cancer or precancerous polyps.
If abnormalities are found, further diagnostics such as colonoscopy are recommended while treatment options include surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy.
In Zimbabwe, colorectal cancer accounted for 4 percent of cancer-related deaths in 2019 when a total of 2 416 cancer deaths were recorded in Harare, Chitungwiza, and Bulawayo, 47 percent of which were male and 53 percent female.
Leading causes included cervical cancer (12 percent), prostate (11 percent), oesophagus (8 percent), breast (7 percent), liver (6 percent), stomach (5 percent), lung (5 percent), and non-Hodgkin lymphoma (3 percent).
Globally, WHO estimates that in 2020 there were over 1.9 million new cases and 930 000 deaths due to colorectal cancer and by 2040, these numbers are projected to rise to 3.2 million cases and 1.6 million deaths annually.
While incidence rates are declining in high-income countries due to effective screening programs, the disease is rapidly increasing across Africa and the U.S. National Library of Medicine has warned that the burden of colorectal cancer on the continent is growing but remains grossly underreported.
Colorectal cancer is no longer a distant threat confined to aging populations or faraway nations and in Zimbabwe, it is quietly claiming lives and increasingly affecting younger people.
The statistics are sobering, but behind every number is a human story, like that of Chatora, who found himself facing the possibility of a cancer diagnosis after experiencing troubling symptoms.
His relief at the affordability and speed of a simple stool test underscores a powerful truth: early detection can mean the difference between life and death, making his story is a reminder that awareness, access, and action are not luxuries, but lifelines.
New Ziana