Oesophageal cancer magnitude and presentation in Ethiopia 2012–2017

Wondimagegnehu, Abigiya; Hirpa, Selamawit; Abaya, Samson Wakuma; Gizaw, Muluken; Getachew, Sefonias; Ayele, Wondimu; Yirgu, Robel; Demeke, Tamiru; Dessalegn, Berhe; Diribi, Jilcha; Kaba, Mirgissa; Assefa, Mathewos; Jemal, Ahmedin; Kantelhardt, Eva Johanna; Addissie, Adamu

doi:10.1371/journal.pone.0242807

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…This is not surprising as the majority of the patients presented for care in the late stage. Our results are in accordance with reports from Mozambique, the Netherlands, the United States of America and Ethiopia, where most patients had the best supportive care, palliative radiotherapy and feeding gastrostomy insertion [ 81 , 85 , 89 – 91 ].…”

Section: Discussionsupporting

confidence: 92%

Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda

Obayo¹,

Mulumba²,

Thompson³

et al. 2023

ecancer

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Background Oesophageal cancer is the seventh most common cancer and the sixth leading cause of cancer death worldwide, and its incidence varies globally. In Uganda, the incidence and trend are on the increase. However, there is a paucity of published data regarding this population’s oesophageal cancer clinicopathologic characterisation and treatment outcomes. Objectives To study the patients’ clinicopathologic characteristics and treatment outcomes of oesophageal cancer over 10 years at the Uganda Cancer Institute. Methods Patients’ charts with histologically confirmed diagnoses of oesophageal cancer for 2009–2019 were identified. Case information, which included patient demographics, history of alcohol use or smoking, tumour location, histological type, tumour grade, clinical TNM (Tumour, Node, Metastasis) staging treatment exposure and treatment outcomes, was evaluated retrospectively. The median survival time was estimated with the Kaplan-Meier method and the median follow-up period was estimated using the reverse Kaplan-Meier. Results 1,965 oesophageal cancer patients were identified; 1,380(70.23%) were males and 585(29.77 %) females, their mean age was 60.20 years (±12.66). Most males had a history of both alcohol consumption and smoking 640(46.38%). The lower third of the oesophagus was the most common anatomical location 771(39.24%). The majority had squamous cell carcinoma histological type 1,783(90.74%) followed by adenocarcinomas 182(9.26%) in the distal oesophagus. Poorly differentiated tumour grade 743(37.81%) was predominant. The majority of the patients were in stage IVB, 733(37.30%), and most patients were planned for the best supportive care, 731(37.20%). Radiation alone was offered to 621(31.60%) and feeding gastrostomy to 249(12.70%). Treatment outcomes: at the time of the current analysis, 58.68% had died, 1.48% were alive and 39.84% were lost to follow-up. The median follow-up period was 65 months (IQR:35.83–83.30) with a median survival time of 4.47 months (95% CI: 4.17–4.80). Conclusion Treatment outcomes of Ugandan oesophageal cancer patients seeking care are poor as most patients present with advanced disease. There is a significant loss of follow-up after treatment initiation. Therefore, reduction in exposure to known modifiable risk factors, early detection and timely referral for treatment strategies are needed to improve outcomes of these patients in our population. Designing interventions to improve treatment adherence is necessary.

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Section: Discussionsupporting

confidence: 92%

Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda

Obayo¹,

Mulumba²,

Thompson³

et al. 2023

ecancer

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“…The predominant type globally is ESCC (~88%), which is also the dominant type in geographical hotspots such as parts of China, Iran and the eastern African corridor. This corridor stretches from Ethiopia [ 4 ] to South Africa [ 5 ] and includes several countries, for example, Kenya, Malawi, Tanzania, Zambia and Zimbabwe. In 2020 estimates, the age standardised incidence rates for EC were 20.3 and 15.2 per 100,000 person-years for males and females respectively in Malawi.…”

Section: Introductionmentioning

confidence: 99%

A very-hot food and beverage thermal exposure index and esophageal cancer risk in Malawi and Tanzania: findings from the ESCCAPE case–control studies

et al. 2022

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Background Consumption of very-hot beverages/food is a probable carcinogen. In East Africa, we investigated esophageal squamous cell carcinoma (ESCC) risk in relation to four thermal exposure metrics separately and in a combined score. Methods From the ESCCAPE case–control studies in Blantyre, Malawi (2017-20) and Kilimanjaro, Tanzania (2015-19), we used logistic regression models adjusted for country, age, sex, alcohol and tobacco, to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for self-reported thermal exposures whilst consuming tea, coffee and/or porridge. Results The study included 849 cases and 906 controls. All metrics were positively associated with ESCC: temperature of drink/food (OR 1.92 (95% CI: 1.50, 2.46) for ‘very hot’ vs ‘hot’), waiting time before drinking/eating (1.76 (1.37, 2.26) for <2 vs 2–5 minutes), consumption speed (2.23 (1.78, 2.79) for ‘normal’ vs ‘slow’) and mouth burning (1.90 (1.19, 3.01) for ≥6 burns per month vs none). Amongst consumers, the composite score ranged from 1 to 12, and ESCC risk increased with higher scores, reaching an OR of 4.6 (2.1, 10.0) for scores of ≥9 vs 3. Conclusions Thermal exposure metrics were strongly associated with ESCC risk. Avoidance of very-hot food/beverage consumption may contribute to the prevention of ESCC in East Africa.

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“…The younger age of presentation is not unique to pancreatic cancer in sub-Saharan Africa or Ethiopia for that matter. Studies evaluating gastric, esophageal and colorectal cancers also suggest a younger age at onset (29)(30)(31).…”

Section: Treatment and Outcomementioning

confidence: 99%

Surgical Management of Pancreatic cancer in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A 5 years retrospective hospital-based study

Aga,

Abdurahman

2023

Preprint

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Introduction: Pancreatic cancer is one of the most lethal human cancers. It ranks fourteenth in terms of new cancers cases in 2020 and it is the seventh leading cause of cancer-related deaths worldwide. The incidence is different in different parts of the world. It is a cancer with the worst prognosis of all malignancies. Pancreatic cancer is predominantly a disease of an older population. There are different environmental (modifiable) and non-modifiable risk factors associated with the development of pancreatic cancer. The clinical manifestation is determined by tumor site. At present, surgical resection is the only potential cure for pancreatic cancer. However, as only 10–20% of the patients have resectable disease at the time of diagnosis, the role of surgical palliation is significant in resource limited setups like ours. Although the perioperative morbidities of surgeries for pancreatic cancers remain high the perioperative mortality has shown significant reduction in the past few decades. Numerous reports have been published by western countries on this disease entity but only few works have been done in Africa and to the best of our knowledge, no study has been conducted to investigate pancreatic cancer in Ethiopia. Objectives To assess the clinico-pathologic profile, associated factors, surgical management and short-term outcome of patients with pancreatic cancer in Tikur Anbessa Specialized hospital. Methods A 5 years retrospective hospital-based cross-sectional study was conducted on 52 patients operated with the diagnosis of pancreatic cancer with either curative or palliative intents. The study period was from April 2016 to July 2021. The data collected includes demographic profile, associated risk factors and comorbidities, clinical presentations, biochemical parameters, pathologic features of the tumors as well as type of treatment offered and short term treatment outcome. The data was analyzed using SPSS version 25. Result The mean and median age of patients was 54.1 and 54.5% respectively. Males constitute about 52% the patients. 21% of the patients have potential risk factors; whereas only 10 (19.2%) of the patients had medical comorbidities. Median duration of symptoms at diagnosis was 12 weeks. Abdominal pain (88.5%) was the most common presenting symptom followed by anorexia (80.8%) and significant weight loss (78.8%), while 71.2% of the patients have jaundice. On clinical evaluation, 69.2% were jaundiced, while 34.6% had a palpable gallbladder. More than two third of patients presented with advanced disease. 76.9% of the tumors are located in the head of pancreas. More than three quarters (77%) of the surgeries performed were palliative. Postoperative morbidity and mortality were 19.2% and 3.8% respectively. Conclusion Age at first diagnosis of pancreatic cancer is relatively earlier in our setup. Most patients present with advanced condition, only amenable for palliative measures. The post-operative outcome is in our setup is acceptable. The need for adjuvant therapy in pancreatic cancer cannot be over emphasized

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Oesophageal cancer magnitude and presentation in Ethiopia 2012–2017

Cited by 8 publications

References 33 publications

Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda

Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda

A very-hot food and beverage thermal exposure index and esophageal cancer risk in Malawi and Tanzania: findings from the ESCCAPE case–control studies

Surgical Management of Pancreatic cancer in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A 5 years retrospective hospital-based study

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