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

BMC Research Notes

Damson Kathyola¹  Titha Dzowela¹  Marshal Lemerani¹  Steve Kamiza³  Catherine Mdokwe¹  Charles Dzamalala³  Kelias Phiri Msyamboza² 

[1] Ministry of Health, Lilongwe, Malawi;World Health Organisation, Malawi Country Office, ADL House, 2nd Floor, City Centre, P.O. Box 30390 Lilongwe 3, Malawi;University of Malawi, College of Medicine, Histopathology Department, Blantyre, Malawi

关键词: Malawi;    Sub-Saharan Africa;    Non-communicable diseases;    Cancer;   

Others  :  1166578
DOI  :  10.1186/1756-0500-5-149

 received in 2011-10-28, accepted in 2012-03-16,  发布年份 2012

【 摘 要 】

Background

Cancer 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.

Methods

Nationwide 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.

Results

A 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.

Conclusions

This 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.

【 授权许可】

   
2010 Msyamboza et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]World Health Organization International Agency for Research on Cancer (IARC): Globocan 2008 Report. IARC: Lyon; 2008. 2008
• [2]World Health Organization: Cancer fact sheet no. 297. Geneva: World Health Organization; 2011.
• [3]Parkin DM, Ferlay J, Hamdi-Cherif M, Sitas F, Thomas J, Wabinga H, Whelan S L: Cancer in Africa: Epidemiology and Prevention. Lyon, France: lnternational Agency for Research on Cancer; 2003.
• [4]Casper C: The increasing burden of HIV-associated malignancies in resource-limited regions. Annu Rev Med 2011, 62:157-170.
• [5]Sitas F, Parkin M, Chirenje Z, Stein L, Mqoqi N, Wabinga H: Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): World Bank; 2006.
• [6]Venook AP, Papandreou C, Furuse J, de Guevara LL: The incidence and epidemiology of hepatocellular carcinoma: a global and regional perspective. Oncologist 2010, 15(Suppl 4):5-13.
• [7]Msyamboza KP, Ngwira B, Dzowela T, Mvula C, Kathyola D, Harries AD, Bowie C: The Burden of Selected Chronic Non-Communicable Diseases and Their Risk Factors in Malawi: Nationwide STEPS Survey. PLoS One 2011, 6(5):e20316.
• [8]Damasceno A, Azevedo A, Silva-Matos C, Prista A, Diogo D, Lunet N: Hypertension prevalence, awareness, treatment, and control in Mozambique: urban/rural gap during epidemiological transition. Hypertension 2009, 54(1):77-83.
• [9]Nsakashalo-Senkwe M, Siziya S, Goma FM, Songolo P, Mukonka V, Babaniyi O: Combined prevalence of impaired glucose level or diabetes and its correlates in Lusaka urban district, Zambia: a population based survey. Int Arch Med 2011, 4(1):2. BioMed Central Full Text
• [10]Dalal S, Beunza JJ, Volmink J, Adebamowo C, Bajunirwe F, Njelekela M, Mozaffarian D, Fawzi W, Willett W, Adami HO, Holmes MD: Non-communicable diseases in sub-Saharan Africa: what we know now. Int J Epidemiol 2011, 40(4):885-901.
• [11]Office Malawi National Statistical: Demographic Health Survey 2010. National Statistical Office: Zomba; 2011.
• [12]Mutalima N, Molyneux EM, Johnston WT, Jaffe HW, Kamiza S, Borgstein E, Mkandawire N, Liomba GN, Batumba M, Carpenter LM, Newton R: Impact of infection with human immunodeficiency virus-1 (HIV) on the risk of cancer among children in Malawi - preliminary findings. Infect Agent Cancer 2010, 5:5. BioMed Central Full Text
• [13]Bower M, Palmieri C, Dhillon T: AIDS-related malignancies: changing epidemiology and the impact of highly active antiretroviral therapy. Curr Opin Infect Dis 2006, 19(1):14-19.
• [14]Geser A, Brubaker G, Draper CC: Effect of a malaria suppression program on the incidence of African Burkitt's lymphoma. Am J Epidemiol 1989, 129(4):740-752.
• [15]Malawi Ministry of Health: Malawi Antiretroviral treatment Pogramme Quarterly Report: 1st Quarter 2011. Lilongwe. Ministry of Health 2011.
• [16]Williams JH, Grubb JA, Davis JW, Wang JS, Jolly PE, Ankrah NA, Ellis WO, Afriyie-Gyawu E, Johnson NM, Robinson AG, Phillips TD: HIV and hepatocellular and esophageal carcinomas related to consumption of mycotoxin-prone foods in sub-Saharan Africa. Am J Clin Nutr 2010, 92(1):154-160.
• [17]Mlombe Y, Dzamalala C, Chisi J, Othieno-Abinya N: Oesophageal cancer and Kaposi's sarcoma in Malawi: a comparative analysis. Malawi Med J 2009, 21(2):66-68.
• [18]Reeve PA: Lung cancer in Malawi: experience of bronchoscopy in Zomba General Hospital. Cent Afr J Med 1989, 35(3):355-358.
• [19]Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin 2011, 61(2):69-90.
• [20]Segal I, Ally R, Mitchell H: Gastric cancer in sub-Saharan Africa. Eur J Cancer Prev 2001, 10(6):479-482.
• [21]Banda LT, Parkin DM, Dzamalala CP, Liomba NG: Cancer incidence in Blantyre, Malawi 1994-1998. Trop Med Int Health 2001, 6(4):296-304.
• [22]Phipps W, Ssewankambo F, Nguyen H, Saracino M, Wald A, Corey L, Orem J, Kambugu A, Casper C: Gender differences in clinical presentation and outcomes of epidemic Kaposi sarcoma in Uganda. PLoS One 2010, 5(11):e13936.
• [23]Mosam A, Aboobaker J, Shaik F: Kaposi's sarcoma in sub-Saharan Africa: a current perspective. Curr Opin Infect Dis 2010, 23(2):119-123.
• [24]Naresh KN, Raphael M, Ayers L, Hurwitz N, Calbi V, Rogena E, Sayed S, Sherman O, Ibrahim HA, Lazzi S, Mourmouras V, Rince P, Githanga J, Byakika B, Moshi E, Durosinmi M, Olasode BJ, Oluwasola OA, Akang EE, Akenòva Y, Adde M, Magrath I, Leoncini L: Lymphomas in sub-Saharan Africa - what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research? Br J Haematol 2011. doi: 10.1111/j.1365-2141.2011.08772.x
• [25]Mlotha J, Naidoo S: Oro-facial manifestations of Burkitt's lymphoma: an analysis of 680 cases from Malawi. ADJ 2011, 66(2):77-79.
• [26]Ministry of Health- Sexual and Reproductive Health Services: VIA Programme Report June 2011. Lilongwe, Mininstry of Health 2011.
• [27]World Health Organization: WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre): Summary Report 2010. Geneva: World Health Organization; 2010.
• [28]Gage JC, Ajenifuja KO, Wentzensen NA, Adepiti AC, Eklund C, Reilly M, Hutchinson M, Wacholder S, Harford J, Soliman AS, Burk RD, Schiffman M: The age-specific prevalence of human papillomavirus and risk of cytologic abnormalities in rural nigeria: Implications for screen-and-treat strategies. Int J Cancer 2011. doi: 10.1002/ijc.26211
• [29]Smith JS, Melendy A, Rana RK, Pimenta JM: Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health 2008, 43(4 Suppl):S5-25-e1-41.
• [30]Sahasrabuddhe V, Parham G, Mwanahamuntu M, Vermund S: Cervical Cancer Prevention in Low- and Middle-Income Countries: Feasible, Affordable, Essential. Cancer Prev Res (Phila) 2011, in press.
• [31]Mabeya H, Khozaim K, Liu T, Orango O, Chumba D, Pisharodi L, Carter J, Cu-Uvin S: Comparison of Conventional Cervical Cytology Versus Visual Inspection With Acetic Acid Among Human Immunodeficiency Virus-Infected Women in Western Kenya. Low Genit Tract Dis 2011, in press.
• [32]Sankaranarayanan R, Nessa A, Esmy PO, Dangou JM: Visual inspection methods for cervical cancer prevention. Best Pract Res Clin Obstet Gynaecol 2011, in press.
• [33]Okobia MN: Cancer care in sub-Saharan Africa - Urgent Need for Population-based Cancer Registries. Ethiop J Health Dev 2003, 17(2):89-98.
• [34]Office Malawi National Statistical: Population and Housing Census 2008 Zomba. Office: National Statistical; 2008.