Patterns of Esophageal Cancer in the National Cancer Institute at the University of Gezira, in Gezira State, Sudan, in 1999-2012

Abstract

Background: Esophageal cancer (EC) is among the most common malignancies in Eastern Africa, but the occurrence of EC in Sudan has rarely been described in the scientific literature. This paper reports the results of a consecutive case series of all EC patients who visited one of the two public cancer treatment centers in the country in 1999-2012, providing a first description of this disease in a treatment center located in central Sudan. Materials and Methods: Clinical and demographic data for all EC patients who visited the Department of Oncology of the National Cancer Institute at the University of Gezira (NCI-UG) from 1999 to the end of 2012 were abstracted and tabulated by sex, tumor type and other characteristics. Results: A total of 448 EC patients visited NCI-UG in 1999-2012, and the annual number of EC cases increased steadily from 1999. Squamous cell carcinoma (SCC) was the predominant EC tumor type (90%), and adenocarcinoma (ADC) was reported in 9.4% of the EC cases. The overall male-to-female ratio for EC was 1:1.8, but the ratio was tumor type-dependent, being 1:2 for SCC and 2:1 for ADC. Only 20% of EC patients reported having ever used tobacco and/or alcohol, and the vast majority of these patients were male. At the time of EC diagnosis, 47.3% of the patients resided in Gezira State. Some EC patients from Gezira State seek out-of-state treatment in the national capital of Khartoum instead of visiting NCI-UG. Conclusions: The annual number of EC patients visiting NCI-UG has increased in recent years, approximately half of these patients being from Gezira State. Although this consecutive series of EC patients who visited NCI-UG was complete, it did not capture all EC patients from the state. A populationbased cancer registry would provide more complete data required to better understand EC patterns and risk factors.

Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting‐specific exposures to known and putative risk factors

“…ESCC is also reported in Kampala and Northern Uganda . Further north in Ethiopia, the highland Bale and Arsi zones of the Oromia region have raised incidence rates, whilst in Sudan, higher incidence areas in the north and in the south have both been documented …”

“…39,40 Further north in Ethiopia, the highland Bale and Arsi zones of the Oromia region have raised incidence rates, 41,42 whilst in Sudan, higher incidence areas in the north and in the south have both been documented. 43,44 Moving south, in South Africa's 2010 Cancer Registry Report, EC (all histologies) ranked the third and fifth most common cancer in Black men and Black women respectively whilst it ranked much lower in other racial groups. 45 This country's highest incidence areas are in the former Ciskei and Transkei areas within today's Eastern Cape Province and were the subject of early investigations by Rose, Burrell, Jaskiewicz, van Rensburg and others.…”

Esophageal cancer male to female incidence ratios in Africa: A systematic review and meta-analysis of geographic, time and age trends

“…X) Gharbiah 2003–2007 1 1.99 110 (1.7) 56 (0.9) 166 Libya IARC (2013) CI5 (vol. X) Benghazi 2003–2005 1 2.70 18 (1.6) 3 (0.2) 21 Morocco Chbani (2012) [ 18 ] Literature Fez 2004–2010 2 0.97 33 34 67 Sudan Gasmelseed (2015) [ 19 ] Literature Gezira state 1999–2012 2 0.49 133 270 403 Tunisia IARC (2003) CIA Sousse 1993–1997 1 1.02 3 (0.4) 3 (0.4) 6 IARC (2003) CIA Tunis 1994 1 ...…”

Oesophageal Cancer Magnitude and Presentation in Ethiopia

“…A systematic review and a meta-analysis conducted in 36 African countries revealed that being male was a risk factor for oesophageal cancer cases (1.7; 95% CI: 1.4, 2.0) [27]. In opposite to these findings, a study conducted in Sudan showed that 1:1.8 male to female ratio of oesophageal cancer cases [28]. In the present study male to female ratio is 1: 1.3 which was not as high as studies conducted in many developed countries and African countries.…”