Management challenges of advanced colorectal cancer in a young adult from a low-resource setting: A case report.

Introduction and importance: Colorectal cancer (CRC) is traditionally considered a disease of older adults; however, the incidence of young-onset colorectal cancer (YOCRC) is steadily increasing worldwide. This trend presents diagnostic and therapeutic challenges, particularly in resource-limited settings where awareness and screening programs are often lacking. Case presentation: We report the case of a 26-year-old male with a three-year history of vague abdominal symptoms, including intermittent pain, bloating, and altered bowel habits. Despite multiple healthcare visits, the underlying pathology remained undiagnosed until he presented with acute intestinal obstruction. Emergency exploratory laparotomy revealed an advanced colonic mass. Histopathological examination confirmed the diagnosis of moderately differentiated adenocarcinoma of the colon, staged as pT3N2Mx. Clinical discussion: This case highlights the diagnostic challenges of YOCRC, which often presents with nonspecific symptoms and is underestimated in younger populations. In low-resource environments, limited access to diagnostic modalities and low clinical suspicion contribute to frequent misdiagnoses and delayed detection, resulting in presentation at advanced stages and reduced chances for curative treatment. Conclusion: This report emphasizes the need for heightened clinical suspicion of colorectal cancer in younger patients presenting with persistent gastrointestinal complaints, highlights the importance of timely access to diagnostic tools to reduce delays in care, and underscores the public health value of awareness campaigns and consideration of earlier screening to address the rising burden of YOCRC.