The Kampala cancer registry is the longest established in Africa. Trends in incidence rates for a 20-year period (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) for Kyadondo County (Kampala city and a rural hinterland) illustrate the effects of changing lifestyles in urban Africa, and the effects of the epidemic of HIV-AIDS. There has been an overall increase in the risk of cancer during the period in both sexes, with incidence rates of major cancers such as breast and prostate showing particularly marked increases (3.7% and 5.2% annually, respectively). In the 1960s cancer of the oesophagus was the most common cancer of men (and second in women), and incidence in the last 20 years has not declined. Cancer of the cervix, always the most frequent cancer of women, has shown an increase over the period (1.8% per year), although the rates appear to have declined in the last 4 years. HIV prevalence in adults in Uganda fell from a maximum in 1992 to a minimum (about 6%) in 2004, and has risen a little subsequently, while availability of antiretroviral drugs has risen sharply in recent years. Incidence of Kaposi sarcoma in men fell until about 2002, and has been relatively constant since then, while in women there has been a continuing decline since 2000. Other HIV related cancers-non-Hodgkin lymphoma of younger adults, and squamous cell carcinoma of conjunctiva-have shown major increases in incidence, although the former (NHL) has shown a small decline in incidence in the most recent 2 years. IntroductionKampala Cancer Registry (KCR) was established in 1954 with the aim of obtaining information on cancer occurrence in the population of Kyadondo County which includes Kampala city the capital of Uganda. 1 The registry is located in the Department of Pathology of the Makerere University College of Health Sciences, and achieved adequate coverage of the population in 1960. However, after 10 years, registration activity became confined to the recording of pathology diagnoses, during the period of dictatorship and civil war in the 1970s and 1980s. Full coverage of the Kyadondo population was achieved again in 1989 and has continued since then. 2The registry provides the longest time series of cancer incidence in Africa. This makes the data of special value of cancer surveillance and research, particularly in monitoring the epidemic of HIV/AIDS and as a baseline for analytical studies and intervention studies. Screening programmes are now in existence especially for cancer of the cervix, as a consequence of the very high incidence rates recorded by the registry in previous reports.In a previous paper 3 we presented cancer incidence data from KCR for a 16-year time period (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). Here we update this analysis, including more recent data, to identify the consistency or otherwise of the previously observed trends. Materials and MethodsSubmission to the registry is volun...
Trends in the incidence of cancer in the population of Kyadondo County, Uganda—which comprises the city of Kampala and a peri‐urban hinterland—are presented for a period of 25 years (1991‐2015) based on data collected by the Kampala Cancer Registry. Incidence rates have risen overall—age‐adjusted rates are some 25% higher in 2011 to 2015 compared with 1991 to 1995. The biggest absolute increases have been in cancers of the prostate, breast and cervix, with rates of some 100% (prostate), 70% (breast) and 45% (cervix) higher in 2010 to 2015 than in 1991 to 1995. There were also increases in the incidence of cancers of the esophagus and colon‐rectum (statistically significant in men), while the incidence of liver cancer—the fifth most common in this population—increased until 2007, and subsequently declined. By far the most commonly registered cancer over the 25‐year period was Kaposi sarcoma, but the incidence has declined, consistent with the decreasing population‐prevalence of HIV. Non‐Hodgkin lymphomas, also AIDS‐related, increased in incidence until 2006/2007 and then declined—possibly as a result of availability of antiretroviral therapy. The trends reflect the changing lifestyles of this urban African population, as well as the consequences of the epidemic of HIV/AIDS and the availability of treatment with ARVs. At the same time, it highlights the fact that the decreases in cancer of the cervix observed in high and upper‐middle income countries are not a consequence of changes in lifestyle, but demand active intervention through screening (and, in the longer term, vaccination).
Population-based data on survival from childhood cancers in sub-Saharan Africa are sparse. We report data on 221 children with cancer diagnosed between 2010 and 2014 in the population of Kampala, Uganda. Survival for eight of nine children with cancer assessed was below the WHO's global target of 60% (the exception was Hodgkin lymphoma: 86% at 3 years). There was significant (P < .05) decline in survival between 1 and 3 years for Wilms tumour and Kaposi sarcoma (30% and 34% at 3 years, respectively). Survival from Burkitt lymphoma, Wilms tumour and Kaposi sarcoma has not changed compared with results from the 2005-2009 study.
Background The global burden of cervical cancer is concentrated in low-and middle-income countries (LMICs), with the greatest burden in Africa. Targeting limited resources to populations with the greatest need to maximize impact is essential. The objectives of this study were to geocode cervical cancer data from a population-based cancer registry in Kampala, Uganda, to create high-resolution disease maps for cervical cancer prevention and control planning, and to share lessons learned to optimize efforts in other low-resource settings. Methods Kampala Cancer Registry records for cervical cancer diagnoses between 2008 and 2015 were updated to include geographies of residence at diagnosis. Population data by age and sex for 2014 was obtained from the Uganda Bureau of Statistics. Indirectly age-standardized incidence ratios were calculated for sub-counties and estimated continuously across the study area using parish level data. Results Overall, among 1873 records, 89.6% included a valid sub-county and 89.2% included a valid parish name. Maps revealed specific areas of high cervical cancer incidence in the region, with significant variation within sub-counties, highlighting the importance of high-resolution spatial detail. Conclusions Population-based cancer registry data and geospatial mapping can be used in low-resource settings to support cancer prevention and control efforts, and to create the potential for research examining geographic factors that influence cancer outcomes. It is essential to support LMIC cancer registries to maximize the benefits from the use of limited cancer control resources.
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