Colorectal cancer care in Uganda: a narrative review and case-based health needs assessment from Mbarara Regional Referral Hospital.

TL;DR

Uganda faces significant barriers to colorectal cancer care including limited endoscopic/pathology capacity, medication stockouts, and inconsistent access to advanced diagnostic testing. A single-institution health needs assessment identifies infrastructure expansion, workforce development, and supply-chain management as critical priorities for improving outcomes in resource-limited settings.

Key findings

• CRC diagnosis and treatment in Uganda are hindered by insufficient endoscopic and pathology capacity, medication stockouts, and lack of immunohistochemistry and molecular testing
• Screening programs remain underdeveloped due to inadequate resources for follow-up diagnostics, though chemotherapy and surgery are available at some centers despite equipment shortages and long wait times
• Palliative care is a relative strength in Uganda, supported by national morphine availability and Hospice Africa Uganda, though integration with oncology remains incomplete
• Sustainable improvements require expanding diagnostic infrastructure, digitizing health records, workforce development, and strengthening supply-chain management, with near-term focus on addressing chemotherapy and medication stockouts

Why this matters at the bedside

High—describes systemic barriers to CRC care in Sub-Saharan Africa affecting diagnosis, staging, treatment, and supportive care, with direct implications for quality improvement strategies and resource allocation in low-income settings.