IntroductionColorectal cancer (CRC) is the third most common cancer worldwide, with higher rates in industrialized countries. By 2030, the number of CRC cases may rise by 60%, reaching 2.2 million new cases and 1.1 million deaths. In 2020, CRC accounted for 1.93 million new cases and 940,000 deaths, with the highest prevalence in New Zealand, Australia, and Europe, while lower rates were observed in Southern Asia and Africa. In Pakistan, CRC is the second most common cancer, accounting for 4.8% of all diagnoses. The risk factors include family history, smoking, genetic syndromes, and diet. Screening is recommended from the age of 45. Advances in immunotherapy, chemoradiotherapy, and targeted therapies have improved survival rates. This five-year study analyzed CRC cases at a Pakistani hospital to identify associations between various clinical and demographic factors and mortality.MethodsThis retrospective study, conducted at the Department of Surgery at Jinnah Post Medical Graduate Centre, Karachi, included 121 confirmed CRC patients from July 2022 to August 2024. Data from electronic medical records included diagnostic procedures and treatment histories. Tumor location and staging were determined according to the TNM staging system. Statistical analysis identified trends in tumour location, disease stage, and demographics.ResultsAmong the 121 patients with CRC, the majority were middle-aged (39.7%) and male (62%). The common symptoms included abdominal pain (65.3%) and constipation (43.8%). Most patients were in Duke stage C (42.1%), with metastasis in 7.2% of cases. Open surgery was performed in 71.9% of patients. Significant associations were found between vomiting, abdominal distention, fever, and mortality, as well as between cancer type and surgical method.ConclusionCRC is increasingly common in middle-aged individuals, and early onset CRC is increasing in Pakistan. Targeted screening and personalized treatment are crucial, and further research is needed to address the increasing incidence, especially in younger populations.