Cancer in Rwanda

Newton, Robert; Ngilimana, P J; Grulich, Andrew E.; Beral, Valerie; Sindikubwabo, B; Nganyira, A; Parkin, D. Maxwell

doi:10.1002/(sici)1097-0215(19960328)66:1<75::aid-ijc14>3.0.co;2-a

Cited by 52 publications

(16 citation statements)

References 17 publications

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“…Laboratory verification of cancer diagnosis (for example, by histology, cytology or blood chemistry) was available on 60% of cases (all of which were invasive tumours) and 63% of controls. Typical of studies in developing countries where laboratory services are limited, this proportion compares favourably with other cancer series reported from Africa (Bassett et al, 1995;Newton et al, 1996a;Wabinga et al, 2000). Another potentially important source of bias is the high proportion of adults who were not tested for HIV in the early stages of the study.…”

Section: Discussionsupporting

confidence: 58%

The epidemiology of conjunctival squamous cell carcinoma in Uganda

et al. 2002

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As part of a larger investigation of cancer in Uganda, we conducted a case -control study of conjunctival squamous cell carcinoma in adults presenting at hospitals in Kampala. Participants were interviewed about social and lifestyle factors and had blood tested for antibodies to HIV, . The odds of each factor among 60 people with conjunctival cancer was compared to that among 1214 controls with other cancer sites or types, using odds ratios, estimated with unconditional logistic regression. Conjunctival cancer was associated with HIV infection (OR 10.1, 95% confidence intervals [CI] 5.2 -19.4; P50.001), and was less common in those with a higher personal income (OR 0.4, 95% CI 0.3 -1.2; P50.001). The risk of conjunctival cancer increased with increasing time spent in cultivation and therefore in direct sunlight (w 2 trend=3.9, P=0.05), but decreased with decreasing age at leaving home (w 2 trend=3.9, P=0.05), perhaps reflecting less exposure to sunlight consequent to working in towns, although both results were of borderline statistical significance. To reduce confounding, sexual and reproductive variables were examined among HIV seropositive individuals only. Cases were more likely than controls to report that they had given or received gifts for sex (OR 3.5, 95% CI 1.2 -10.4; P=0.03), but this may have been a chance finding as no other sexual or reproductive variable was associated with conjunctival cancer, including the number of self-reported lifetime sexual partners (P=0.4). The seroprevalence of antibodies against HPV-18 and -45 was too low to make reliable conclusions. The presence of anti-HPV-16 antibodies was not significantly associated with squamous cell carcinoma of the conjunctiva (OR 1.5, 95% CI 0.5 -4.3; P=0.5) and nor were anti-KSHV antibodies (OR 0.9, 95% CI 0.4 -2.1; P=0.8). The 10-fold increased risk of conjunctival cancer in HIV infected individuals is similar to results from other studies. Squamous cell carcinoma of the conjunctiva is thought to be an extreme form of a spectrum of clinical conditions, collectively known as 'ocular surface squamous neoplasias', which range in severity from mild dysplasia, to carcinoma in situ and, ultimately, to invasive carcinoma. Symptoms can range from none, to severe pain and visual loss. Lesions generally arise on exposed areas of the eye, particularly on the nasal side, and treatment involves local excision, or in more severe cases, orbital clearance. Metastases are rare and the prognosis is usually favourable.Although relatively rare everywhere, conjunctival carcinoma is more frequent in parts of sub-Saharan Africa. Uganda offers a good setting in which to investigate the epidemiology of squamous cell carcinoma of the conjunctiva, because the tumour was relatively frequent there, even before the onset of the HIV epidemic (Templeton, 1973;Wabinga et al, 2000). In this report, we examine the association of conjunctival tumours with over 50 possible risk factors, including evidence of infection with HIV-1, HPV-16, -18 and -45 and Kaposi's sarcoma-associa...

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Section: Discussionsupporting

confidence: 58%

The epidemiology of conjunctival squamous cell carcinoma in Uganda

et al. 2002

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“…No analysis of ethnic distribution was attempted because no reliable information was available. This relatively low level of oral cancer in this population corroborates similar findings in Zimbabwe (7) and Rwanda (8).…”

Section: Discussionsupporting

confidence: 90%

Oral cancer at Kenyatta National Hospital, Nairobi

Onyango¹,

Omondi²,

Njiru³

et al. 2004

E Af Med Jrnl

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“…With the obvious exception of Mali, higher rates of cancer tend to be found in populations residing at higher altitude. Studies of the relative frequencies of cancers, for example in Southern Rwanda (Ngendahayo and Parkin, 1986;Newton et al, 1996) at an altitude of 1500-2000 m and the Kilimanjaro area of Tanzania (Lauren and Kitinya, 1986) at an altitude of 1000 m have supported this finding. Relative frequency data from the 1950s and 1960s suggest that the probable high incidence in these areas is long-standing (Cook and Burkitt, 1971) and that it extended also into Burundi and neighbouring Zaire as well as Tanzania.…”

Section: Discussionmentioning

confidence: 93%

A minimum estimate for the incidence of gastric cancer in Eastern Kenya

et al. 2001

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SummaryWe documented available information concerning incident cases of gastric cancer in part of Kenya's Eastern Province between 1991 and 1993. By reviewing the records of all major health facilities in the area, 200 cases of gastric carcinoma were found giving an annual average crude incidence rate of 7.01 per 100 000 males and 3.7 for females (world age-standardised rates, 14.3 for males and 7.1 for females). There is likely to be underascertainment of cases especially among those aged over 65 years. Previous incidence estimates for the same area of Kenya were reviewed and a 10-fold increase in the recorded indirectly standardised incidence rate between the periods 1965-70 and 1991-93 was noted but this may be due to improved diagnostic facilities. The recent rates in this part of Kenya are comparable to Eastern European rates and similar to those recorded in other highland regions of Africa.

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Cancer in Rwanda

Cited by 52 publications

References 17 publications

The epidemiology of conjunctival squamous cell carcinoma in Uganda

The epidemiology of conjunctival squamous cell carcinoma in Uganda

Oral cancer at Kenyatta National Hospital, Nairobi

A minimum estimate for the incidence of gastric cancer in Eastern Kenya

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