Burden of cancer in Malawi; common types, incidence and trends: National population-based cancer registry

Abstract

BackgroundCancer is a leading cause of morbidity and mortality worldwide with a majority of cases and deaths occurring in developing countries. While cancer of the lung, breast, colorectum, stomach and prostate are the most common types of cancer globally, in east and southern Africa these are less common and comprehensive data to inform policies are lacking.MethodsNationwide cancer registry was conducted between September and October 2010 in Malawi. New cancer cases registered from 2007 to 2010 were identified from hospital and clinic registers of 81 out of 84 health facilities providing cancer diagnosis, treatment or palliative care services. Demographic and cancer data were extracted from registers and case notes using a standard form.ResultsA total of 18,946 new cases of cancer were registered in Malawi from 2007-2010. Of these 55.9% were females, 7.2% were children aged less than 15 years, 76.5% were adults aged 15-59 years and 16.4% were elderly aged 60 years or more. Only 17.9% of the cases had histologically verified diagnosis, 33.2% were diagnosed clinically and 49.6% based on clinical and some investigations. Amongst females, cancer of the cervix was the commonest accounting for 45.4% of all cases followed by Kaposi sarcoma (21.1%), cancer of the oesophagus (8.2%), breast (4.6%) and non-Hodgkin lymphoma (4.1%). In males, Kaposi sarcoma was the most frequent (50.7%) then cancer of oesophagus (16.9%), non-Hodgkin lymphoma (7.8), prostate (4.0%) and urinary bladder (3.7%). Age-standardised incidence rate per 100,000 population for all types of cancer in males increased from 31 in 1999-2002 to 56 in 2007-2010. In females it increased from 29 to 69. Kaposi sarcoma and cancer of the oesophagus, cervical cancer and Kaposi sarcoma were the main causes for the increased incidence in males and females respectively. It was estimated that, annually at least 8,151 new cases of cancer (all types) occur in Malawi.ConclusionsThis study provided data on common types and trends of cancer that could be used to focus prevention, treatment and control interventions in the context of limited resources. The problem of under-reporting and misdiagnosis of cancer cases has been highlighted.

Environmental risk factors for oesophageal cancer in Malawi: A case-control study

“…1 OC is the second most common cancer in men and the third most common cancer in women, and age-standardized rates of OC are increasing. 1 In nearby African countries, OC incidence is estimated at 76/100,000, much higher than 2.2/100,000 in the United States. 2 In West Africa, OC is also rare.…”

Targetable subsets of non-Hodgkin lymphoma in Malawi define therapeutic opportunities

“…A recent registry survey of 18 946 new cancer diagnoses among Malawians from 2007 to 2010 revealed that NHL accounted for 5.7% of all new cancer diagnoses and was the most common malignancy among children under age 15 years (56.4% of all pediatric cancer). 6 Notably, only 17.9% of all of the registry's cases were confirmed by pathology data. 6 The Department of Histopathology at the University of Malawi College of Medicine (UOMCOM) in Blantyre, Malawi processes ;3000 specimens per year, and pathologic diagnoses are based solely on interpretation of hematoxylin and eosin (H&E)-stained sections.…”

“…6 Notably, only 17.9% of all of the registry's cases were confirmed by pathology data. 6 The Department of Histopathology at the University of Malawi College of Medicine (UOMCOM) in Blantyre, Malawi processes ;3000 specimens per year, and pathologic diagnoses are based solely on interpretation of hematoxylin and eosin (H&E)-stained sections. 8,9 Most cases diagnosed as lymphoma at UOMCOM are categorized as Burkitt lymphoma (BL) or non-BL NHL.…”

Incidence of Endemic Burkitt Lymphoma in Three Regions of Mozambique

“…The burden of eBL in other parts of the country is unknown. However, the high levels of malaria transmission as well as the high eBL burden in neighboring countries such as Malawi and Zambia 13,14 suggest that eBL may represent a major cause of pediatric cancer. The current report provides for the first time a description of eBL epidemiology across different regions of Mozambique.…”