Vulvar cancer in Ethiopia

Kroeber, Eric Sven; Assefa, Mathewos; Wondemagegnehu, Tigeneh; Aynalem, Abreha; Gemechu, Tufa; Piszczan, Swantje; Timotewos, Genebo; Addissie, Adamu; Wienke, Andreas; Unverzagt, Susanne; Thomssen, Christoph; Jemal, Ahmedin; Kantelhardt, Eva Johanna

doi:10.1097/md.0000000000010041

Cited by 8 publications

(2 citation statements)

References 19 publications

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“…The impact of large lesions extends beyond medical implications; it also affects the psychological well-being of patients due to postoperative dis gurement of the external genitalia and potential wound failure. [4,5,6].…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and treatment of patients with Vulvar Cancer: experience from a novice Gynecologic Oncology unit in Sub Saharan Africa

Birara,

Gudu,

Mekonen

et al. 2024

Preprint

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Introduction Vulvar cancer is rare accounting approximately for 4% of gynecologic malignancies. The prevalence of vulvar cancer rising in sub-Saharan Africa primarily attributed to high incidence of HIV infections. This study aims to explore clinic-pathologic profile and treatment of patients at a novice gynecologic oncology unit in Ethiopia. Methodology A descriptive cross-sectional study was conducted, among vulvar cancer patients treated at Saint Paul’s Hospital millennium medical college in Ethiopia, gynecology oncologic unit from 2016 to 2020. Data was collected from patients’ medical records and hospital registries using a simple data extraction format. Data was analyzed using IBM SPSS 23.1 computer statistical software. Results The magnitude of vulvar cancer was 3.6%, with mean age of patients being 42 years. Commonest symptoms were vulvar swelling, itching, and ulceration. The average duration of symptoms was 12 months and 66 percent of patients were HIV positive. The mean lesion size was 5 cm, with squamous cell carcinoma being the most prevalent (82%). Disease was early stage in 56% percent of patients. Fifty seven Percent were given treatment. Surgery was done to 37% of patients, postoperative wound complications rate being 30 percent. 43 percent had Postoperative follow-up and among those who adhered to follow-up, 85 individuals were disease-free at the last assessment, with only one case of recurrent disease. Conclusions Vulvar cancer is not uncommon being more prevalent among HIV patients. Early diagnosis and staging are crucial for improved patient outcomes. Interventions to raise awareness, implementing screening programs, and ensuring early referrals are imperative.

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Section: Discussionmentioning

confidence: 99%

Clinical profile and treatment of patients with Vulvar Cancer: experience from a novice Gynecologic Oncology unit in Sub Saharan Africa

Birara,

Gudu,

Mekonen

et al. 2024

Preprint

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“…This may lead to less reliable results and possibly the wrong scientific conclusions. In clinical retrospective studies in the region, in some cases only around 50% of the patient records or formalin-fixed paraffin-embedded blocks were found and classified [ 25 , 26 ] due to storage of reports and blocks loose in boxes. In our study 5 centres stored their pathology reports and half of the centres their formalin-fixed paraffin embedded-blocks loosely in boxes.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer pathology services in sub-Saharan Africa: a survey within population-based cancer registries

Ziegenhorn

Frie

Ekanem

et al. 2020

BMC Health Serv Res

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Background Pathologists face major challenges in breast cancer diagnostics in sub-Saharan Africa (SSA). The major problems identified as impairing the quality of pathology reports are shortcomings of equipment, organization and insufficiently qualified personnel. In addition, in the context of breast cancer, immunohistochemistry (IHC) needs to be available for the evaluation of biomarkers. In the study presented, we aim to describe the current state of breast cancer pathology in order to highlight the unmet needs. Methods We obtained information on breast cancer pathology services within population-based cancer registries in SSA. A survey of 20 participating pathology centres was carried out. These centres represent large, rather well-equipped pathologies. The data obtained were related to the known population and breast cancer incidence of the registry areas. Results The responding pathologists served populations of between 30,000 and 1.8 million and the centres surveyed dealt with 10–386 breast cancer cases per year. Time to fixation and formalin fixation time varied from overnight to more than 72 h. Only five centres processed core needle biopsies as a daily routine. Technical problems were common, with 14 centres reporting temporary power outages and 18 centres claiming to own faulty equipment with no access to technical support. Only half of the centres carried out IHC in their own laboratory. For three centres, IHC was only accessible outside of the country and one centre could not obtain any IHC results. A tumour board was established in 13 centres. Conclusions We conclude that breast cancer pathology services ensuring state-of-the-art therapy are only available in a small fraction of centres in SSA. To overcome these limitations, many of the centres require larger numbers of experienced pathologists and technical staff. Furthermore, equipment maintenance, standardization of processing guidelines and establishment of an IHC service are needed to comply with international standards of breast cancer pathology.

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