Introduction: Colon cancer, a type of cancer affecting the large intestine, is the fourth most common cancer worldwide, with 1,142,286 new cases and the fifth leading cause of cancer death, with 538,167 deaths reported in 2022 (GLOBOCAN). This retrospective study examines overall survival (OS) and the impact of sociodemographic and clinical factors on colon cancer patients.

Methodology: The study included colon cancer patients diagnosed and treated at Tata Memorial Hospital, Mumbai, between January and December 2017, with a 5-year follow-up until 2022. Of the 761 cases registered, 434 received treatment and were eligible for analysis. OS and its variation by socio-demographics were assessed using the Kaplan-Meier method and log-rank test, while the Cox proportional hazard model variables indicate the impact of multiple factors on survival.

Results: Among 434 patients (mean age 50 ± 13.6 years, 64% male), adenocarcinoma was the predominant histology (81.7%), with 98% microscopically confirmed diagnoses. Regional and distant disease were present in 32.9% and 23.5%, respectively. The 1-, 3- and 5-year OS rates were 88%, 77% and 71%. Survival was significantly higher in early-stage disease than advanced disease (5-year OS: 89% versus 43%). On multivariable analysis, advanced clinical extent (aHR 7.42; 95% CI: 3.67–14.9) and signet ring cell histology (aHR 1.95; 95% CI: 1.06–3.59) were independently associated with increased mortality, while combined-modality treatment was independently protective (aHR 0.48; 95% CI: 0.25–0.91).

Conclusion: The study suggests that improving socioeconomic conditions and encouraging proactive treatment-seeking behaviour are key to increasing colon cancer survival. Cancer hospitals, together with India’s public healthcare system, including clinicians and policymakers, should implement these strategies to strengthen cancer care in low- and middle-income countries.