A 5-Year Epidemic, Clinical, and Diagnostic Investigation of Colorectal Cancers Reveals Age- and Gender-specificity in Predominance and Types, Ha’il, Saudi Arabia

Background: Understanding the regional epidemiology and clinicopathological char-acteristics of colonic disorders, including colorectal cancer (CRC) and its precursors, is vital for optimizing local healthcare strategies. This study aimed to characterize these features in a tertiary care setting in Ha’il region, Saudi Arabia. Methods: We retrospec-tively analyzed the medical records of 602 patients seen between January 2020 and December 2024 at King Salman Specialist Hospital (KSSH) Ha’il. Collected data in-cluded demographics, final diagnoses (e.g., adenocarcinoma, tubulovillous adenoma with dysplasia [TVA], dysplasia, chronic active colitis, no malignancy, polyps, or dif-ferential diagnosis), biopsy type, and relevant clinical history. Descriptive statistics and inferential tests including the Chi-square and Mann-Whitney U tests were used for data analysis. Results: The cohort was 59.3% (n=357) male and 40.7% (n=245) fe-males. The prevalence of adenocarcinoma increased with age, peaking among males aged 50-69 (53.0%) and females aged 70-89 (84.2%). TVA was prominent in males aged 30-49 (28.0%) and females aged 50-69 (36.1%). Overall, males had higher frequencies of both adenocarcinoma (n=137 vs. 95) and TVA (n=73 vs. 59) compared to females. Rectosigmoid biopsy was the most common method for diagnosing adenocarcinoma (42.4% of specified biopsies), whereas colon biopsy was more frequently used for TVA (27.1%). The highest proportion of "No malignancy" diagnosis was observed in the 15-29-year age group (males: 65.4%, females: 64.7%). Clinical histories indicating "co-lon tumor or polyps" were strongly associated with adenocarcinoma (47.0%) and TVA (30.3%). Statistically significant associations were found between diagnosis and spec-imen type, as well as between clinical history and diagnosis. Conclusions: This study highlights distinct age- and gender-specific patterns in colonic disorders. Neoplastic conditions were particularly prevalent among older individuals, with adenocarcinoma occurring more frequently in males. The distribution of biopsy sites varied by diagno-sis. These regional findings may support the development of targeted screening pro-grams, more effective diagnostic strategies, and informed healthcare resource alloca-tion.