Early-onset colorectal cancer in patients under 30: a case series from Tanzania highlighting an emerging epidemiological shift.

Early-onset colorectal cancer (EOCRC) is increasingly recognized, particularly in low- and middle-income countries where patients often present with advanced disease. We describe a case series of three patients under 30 years managed at a tertiary referral centre in northern Tanzania. All presented after prolonged symptoms, including rectal bleeding, altered bowel habits, abdominal pain, and weight loss. Two patients had rectosigmoid tumors, while one had a right-sided lesion. Histopathology demonstrated mucinous adenocarcinoma in two cases and adenocarcinoma not otherwise specified in one case. One patient had a family history suggestive of hereditary predisposition. Management included surgical intervention, frequently with stoma formation, and chemotherapy where feasible. Outcomes were poor, including one postoperative mortality and one case requiring palliative chemotherapy. Delayed presentation, limited diagnostic resources, and restricted oncology services significantly impacted care. EOCRC in this setting demonstrates aggressive disease and poor prognosis, highlighting the need for early diagnosis and improved cancer care infrastructure.