Colorectal cancer (CRC) represents the second most prevalent malignancy among Palestinian patients. Although cancer care services in West Bank hospitals have advanced in recent years, specialized interventions—such as palliative care, targeted therapy, bone marrow transplantation, and personalized treatment—remain limited. This study aimed to evaluate the stages at diagnosis, treatment protocols, and survival outcomes of CRC patients in the West Bank. This retrospective study utilized medical records from An-Najah National University Hospital (NNUH), a major oncology center in the region. Patients with histologically confirmed CRC (stages I–IV) who received surgical and/or medical treatment were included. Data were systematically extracted using a standardized collection form. Statistical analyses were conducted using SPSS version 27, and survival analysis was performed via regression modeling, examining the relationship between survival duration (from diagnosis to last follow-up) and treatment modalities (surgery, chemotherapy, radiotherapy). Data were analyzed for 252 CRC patients from NNUH, comprising 143 males and 109 females aged 27–86 years (mean 60.6 ± 11.4 years). Among them, 183 (72.6%) had colon cancer, 29 (11.5%) had rectal cancer, and 40 (15.9%) presented with both. At diagnosis, 3 patients (1.2%) were in stage I, 33 (13.1%) in stage II, 57 (22.6%) in stage III, and 159 (63.1%) in stage IV. Surgery was the most common treatment (230 patients, 91.3%), followed by chemotherapy (227 patients, 90.1%) and radiotherapy (38 patients, 15.1%). Regarding chemotherapy regimens, 40 patients (15.8%) received FOLFOX (folinic acid, fluorouracil, oxaliplatin), 25 (9.9%) received FOLFIRI (folinic acid, fluorouracil, irinotecan), and 187 (74.2%) were treated with agents such as capecitabine, oxaliplatin, bevacizumab, cetuximab, regorafenib, cisplatin, etoposide, or gemcitabine, alone or in combination. Patient outcomes were categorized into six groups: death, cure, disease progression, recurrence, under-treatment, and unknown. Mortality was substantial, with 104 patients (41.3%) dying within a short period post-diagnosis, likely due to late presentation. Surgical intervention significantly improved survival (p = 0.033). The majority of patients were diagnosed at advanced stages of CRC. Although treatment followed international guidelines, survival outcomes remained poor, reflecting high mortality and low cure rates. Further research is warranted to evaluate the implementation and optimization of chemotherapy protocols. Enhanced survival may be achieved through the active participation of clinical pharmacists in chemotherapy selection, dosing, and monitoring. This study underscores the importance of public education and the pivotal role of primary care–based CRC screening in achieving earlier detection and improved prognosis.
