More than six out of every 10 colorectal cancer patients in Ghana die within five years of diagnosis, according to a new study by researchers at Kwame Nkrumah University of Science and Technology.

The study, published in BMC Gastroenterology, analysed clinical outcomes for 281 patients treated between 2016 and 2022 at Komfo Anokye Teaching Hospital, one of Ghana’s largest referral centres.

It found a five-year overall survival rate of 39.3%, meaning roughly 60% of patients died within five years of diagnosis,  far below survival rates reported in high-income countries.

The research, led by Dr. Tonnies Abeku Buckman of KNUST’s Department of Molecular Medicine, identified late-stage diagnosis as the strongest predictor of poor survival.

“Most patients are still coming in very late, when treatment options are limited and outcomes are poor,” Buckman said.

Nearly 70% of patients were diagnosed at advanced stages of the disease, with almost one in three presenting with stage IV colorectal cancer. Patients diagnosed at this stage had a five-year survival rate of just 16.4%, compared with more than 90% among those diagnosed at stage I.

Median overall survival across all patients was 45 months, with survival declining steadily each year after diagnosis.

The study also found that more than a quarter of patients were under the age of 45, raising concerns that existing screening guidelines may be failing to capture younger, at-risk populations.

Several factors were independently associated with poorer survival outcomes, including cigarette smoking, having multiple chronic conditions such as diabetes or hypertension, and the use of herbal medicine alongside conventional cancer treatment. Patients who reported using herbal remedies had a median survival of 26 months, compared with 50 months for those who did not.

Colorectal cancer incidence has been rising steadily in Ghana, driven by urbanisation, changing diets and longer life expectancy, yet screening coverage remains limited despite national guidelines introduced more than a decade ago.

Buckman said expanding screening programmes and improving access to timely diagnosis and treatment could significantly reduce preventable deaths. “Early detection changes everything,” he said. “When we find the disease early, survival improves dramatically.”

The authors called for stronger national cancer control strategies focused on public awareness, earlier diagnosis and improved referral pathways.

They also highlighted the need for targeted funding to support further research into how diet, body composition and physical activity influence colorectal cancer prevention and survivorship in Ghana, areas they said remain under-studied despite their growing relevance to cancer outcomes.