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Mengistu ST, Kesete Y, Achila OO, Fikadu GT, Abrhaley F, Fikadu ET, Said SM, Gheberehiwet MA, Hamida ME, Ghidei YT. High Incidence of Esophageal Cancer in Women in Eritrea and Its Potential Link to Low Age at Menopause: Evidence from a 10-Year Retrospective Data Analysis. J Cancer Epidemiol 2024; 2024:5566016. [PMID: 38962101 PMCID: PMC11221988 DOI: 10.1155/2024/5566016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 07/05/2024] Open
Abstract
Background Detecting a group of esophageal cancer (EC) cases in endemic regions is essential in identifying high-risk populations and executing appropriate interventions. The main aim of this study was to determine the epidemiology of EC in Eritrea. Methods A retrospective (period: 2011 - 2021) study was carried out by abstracting data on EC patients from the logbook kept at the National Health Laboratory (ENHL). Information on socio-demographic, clinical history, and biopsy analysis findings was collected. For the statistical assessment of data, the End Results (SEER) Joinpoint Regression Program (V.4.5.0.1) was used to calculate crude incidence rate (CIR), age-adjusted incidence rate (ASR), and estimated annual percentage change (EAPC) by sex, age, and histotype. Results A total of 189 patient's samples (134 (70.9%) females vs. 55 (29.1%) males, ratio 2.43 : 1) were evaluated. Of the 155 patients with EC, 44 (28.4%) and 111 (71.6%) were diagnosed with esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), respectively (AC/ESCC ratio, 0.4). The median age (IQR) of patients with EC was 60 years (46.0 - 70 years) - (males 62 (IQR: 49.0 - 77 years) vs. females 60 (IQR: 46 -67 years), p-value =0.43. Within age bands, the F: M ratios in patients with ESCC were as follows: >20 -29 years =2: 1; 30-39 years =8 : 1; 40 - 49 years =10.5 : 1; 50-59 years =6.67 : 1; 60-69 years =3.25.1; 70-79 years =1.5 : 1 and>80 years =2 : 1. The all-age CIR and ASR for EC were 0.468 per 100 000 and 2.281 per 100 000 persons, respectively. Similarly, the all-age ASR for both males and females was 2.88 per 100 000 and 1.61 per 100 000. Over the study period, the EAPC for all cases was -3.0% (95% CI, -11.3 to 6.1, p-value =0.455). Conclusion In large part, EC is a women's disease in Eritrea. The unusually high incidence of ESCC and the high female-to-male ratio point at sex-dependent exposures as a major driver of the EAC epidemic in the country. Therefore, research on the risk factors of EC in Eritrea is urgently needed.
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Affiliation(s)
| | - Yafet Kesete
- Nakfa HospitalMinistry of Health Northern Red Sea branch, Nakfa, Eritrea
| | | | - Genet Tekeste Fikadu
- Department of PathologyNational Health LaboratoryMinistry of Health, Asmara, Eritrea
| | - Feven Abrhaley
- Department of PathologyNational Health LaboratoryMinistry of Health, Asmara, Eritrea
| | | | - Salih Mohammed Said
- Department of MicrobiologyNational Health LaboratoryMinistry of Health, Asmara, Eritrea
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Abdihamid O, Abdourahman H, Ibrahim A, Kareu T, Hadi A, Omar A, Mutebi M. Landscape of esophageal cancer in Northern Kenya: experience from Garissa Regional Cancer Center. Ecancermedicalscience 2024; 18:1694. [PMID: 38774561 PMCID: PMC11108053 DOI: 10.3332/ecancer.2024.1694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Indexed: 05/24/2024] Open
Abstract
Introduction Esophageal cancer (EC) is the ninth most common cancer and the sixth leading cause of cancer deaths worldwide. More than 80% of cases and deaths from EC occur within developing countries. In Kenya, cancer is the second leading cause of non-communicable disease deaths, and the trend of cancer deaths is projected to increase as per the 2020 GLOBOCAN report showing 42,116 new cases annually with a mortality of 27,092 cases. EC is the leading cancer in men and the third most common in women in Kenya. The Garissa Regional Cancer Center (GRCC) is one of the three regional cancer centres in Kenya. Despite the rising EC incidence in the region, there is limited data about the clinicopathological features and treatment outcomes of EC, therefore, this is the first study to look at the landscape of EC in the northern Kenya region. Methods This was a retrospective study involving patients' file review of confirmed EC cases diagnosed or treated at the GRCC from 2019 to 2023. Data collected from each patient's chart included age, sex, risk factors, family history of EC, histological type, stage at diagnosis, treatment type and survival outcomes. For patients who were no longer in contact with the staff through clinic visits, the patients or their next of kin were contacted through phone calls for patients' survival status. Data were collected and stored using the STATA software. Results Over the study period, 124 esophageal cases were identified, 64 (51.4%) were males and 60 (48.4%) were females with a mean age of 57.56 years. In terms of risk factors, hot beverage consumption was the highest (47 cases, 37.9%), followed by history of peptic ulcer disease (27 cases, 21.8%), smoking (8.9%) and gastresophageal reflux disease (2 cases, 1.6%). Stage of diagnosis at presentation was stage 1 (1 case, 0.8%), stage 2 (22 cases, 17.8%), stage 3 (25 cases, 20.2%), stage 4 (50 cases, 40.3%), not staged (26 cases, 21%). The majority had squamous cell carcinoma (SCC) (105 cases, 84.7%), followed by adenocarcinoma (5 cases, 4%), anaplastic (5 cases, 4%), SCC+ adenocarcinoma (1 case, 0.8%), unknown histology (8 cases, 3.2%). Nearly all patients had triple assessment (Endoscopy, histology and staging scans) accounting for 92 cases (74.2%), 24 cases (20%) had endoscopy+ histology only, and 8 cases (3.2%) had only imaging scans. In terms of family history of EC, 20 cases (16.1%) had a family history of EC.Most of the patients were of ethnic Kenyan-Somali background (108 cases, Kenyan Somali, 87.1%) and majority were from Garissa County 96 cases (77.4%), 12 cases (9.7%) Wajir County, 12 cases (9.7%) from Tana River County and 4 cases (3.2%) from other counties. Many patients lacked health insurance (27 cases, 25.8%), while the majority paid out of pocket (92 cases,74.1%). Only 21% (26 cases) received chemotherapy alone, 5 cases (4%) got radiotherapy alone, 12.9% (16 cases) got chemoradiotherapy and a significant number of patients (77 cases, 62.1%) did not receive hospital-based cancer treatment. Conclusion This study is the first esophageal study at the GRCC and in northern Kenya in general. Our study confirmed the clinicopathological features of one of the most common cancers in Kenya and more so among Kenyan-Somalis.The study also validates the predominance of histological subtypes of esophageal SCC with the late presentation, short survival and significant loss of follow-up. We recommend future EC studies employing a large prospective design with a large sample size to determine the impact of the new GRCC on the outcomes of EC patients and the local community.
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Affiliation(s)
- Omar Abdihamid
- Garissa Regional Cancer Center, Garissa County Referral Hospital, PO Box 29-70100, Garissa, Kenya
- Shared first authors
| | - Houda Abdourahman
- Department of Pathology, Hopital De Balbala Cheiko, Balbala, PO Box 669, Republic of Djibouti
- Shared first authors
| | - Abdulsadiq Ibrahim
- Garissa Regional Cancer Center, Garissa County Referral Hospital, PO Box 29-70100, Garissa, Kenya
| | - Thinwa Kareu
- Garissa Regional Cancer Center, Garissa County Referral Hospital, PO Box 29-70100, Garissa, Kenya
| | - Abdullahi Hadi
- Department of Gastroenterology, University of Pretoria, PO Box Prinshof 349-Jr, Pretoria 0002, South Africa
| | - Abeid Omar
- Kenyatta University Teaching Research and Referral Hospital, PO Box 7674 – 00100, GPO Nairobi, Kenya
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, PO Box 30270-00100, Nairobi, Kenya
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Obayo S, Mulumba Y, Thompson CL, Gibson MK, Cooney MM, Orem J. The distribution of esophageal cancer patients enrolled in care at the Uganda Cancer Institute by sub-regions, districts and ethnicity. Afr Health Sci 2024; 24:198-205. [PMID: 38962344 PMCID: PMC11217853 DOI: 10.4314/ahs.v24i1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
Background There is limited published data regarding the distribution of esophageal cancer patients by sub-regions, districts and ethnicity in Uganda. Objectives To study the distribution by sub-regions, districts, ethnicity and sub-regions post-care outcomes of esophageal cancer patients in care over ten years at the Uganda Cancer Institute. Methods Patients' charts with confirmed diagnoses of esophageal cancer for 2009-2019 were identified. Case information, which included demographics, clinical presentation, distribution by sub-regions, districts, ethnicity and sub-regions post-care outcomes, were retrospectively abstracted. Results Central 671(34.15%), Southwestern 308(15.67%), Elgon 176(8.95%) and East central 163(8.29%) sub-regions had most patients. Mostly from administrative districts of Wakiso 167(8.50%), Mbarara 51(2.59%), Tororo 53(2.70%), Busia 33(1.68). Baganda, Banyakole, Bagisu and Basoga ethnic groups predominate. Patients from neighbouring countries were mainly from Rwanda 56(2.85%), South Sudan 24(1.22%), then Kenya 21(1.07%), and Rwandese, Dinka and Luo by ethnicity, respectively. Central and Southwestern sub-regions had the most post-care outcomes of the patients regarding living, death, and loss to follow-up. Conclusion Patients are commonly from the administrative districts of Central, Southwestern, Elgon and East Central sub-regions and neighbouring countries of Rwanda, South Sudan and Kenya. Baganda, Banyakole, Bagisu and Basoga are the main ethnic groups. Central and Southwestern sub-regions are with most post-care outcomes.
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Affiliation(s)
| | | | | | - Michael K Gibson
- Vanderbilt University Medical Centre, Vanderbilt-Ingram Cancer Center
| | - Matthew M Cooney
- Case Western Reserve University, Case Comprehensive Cancer Centre
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Ran X, Zeng H, Zheng R, Sun K, Han B, Wang S, Chen R, Li L, Wei W, He J. Geographic, sex and socioeconomic disparities in esophageal cancer incidence in China: A population-based study. Int J Cancer 2024; 154:477-487. [PMID: 37728072 DOI: 10.1002/ijc.34730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 09/21/2023]
Abstract
Geographic and sex differences in esophageal cancer have been reported in China, but data are lacking at the local level. We aimed to investigate geographic and sex disparities in esophageal cancer incidence among Chinese counties and whether county-level socioeconomic status was associated with these variations. We obtained esophageal cancer data from 2015 to 2017 for 782 counties from population-based cancer registries in China. We calculated age-standardized incidence rates and male-to-female incidence rate ratios (IRRs) by county. We performed hotspot analysis to identify geographical clusters. We used negative binomial regression models to analyze the association between incidence rates and county-level socioeconomic factors. There were significant geographic disparities in esophageal cancer incidence, with 8.1 times higher rate in the 90th-percentile county than in the 10th-percentile county (23.7 vs 2.9 per 100 000 person-years). Clusters of elevated rates were prominent across north-central China. Nationally, men had 2.9 times higher incidence of esophageal cancer than women. By county, the male-to-female IRRs ranged from 1.1 to 21.1. Clusters of high male-to-female IRRs were observed in northeast China. Rurality (IRR 1.16, 95% CI 1.10-1.22), per capita gross domestic product (IRR 0.95, 0.92-0.98) and percentage of people with a high school diploma (IRR 0.86, 0.84-0.87) in a county were significantly associated with esophageal cancer incidence. The male-to-female IRRs were higher in counties with higher socioeconomic status. Substantial differences in incidence rates and sex ratios of esophageal cancer exist between Chinese counties, and county-level socioeconomic status was associated with these variations. These findings may inform interventions to reduce these disparities.
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Affiliation(s)
- Xianhui Ran
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Zeng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongshou Zheng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kexin Sun
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingfeng Han
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoming Wang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ru Chen
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Obayo S, Mulumba Y, Thompson CL, Gibson MK, Cooney MM, Orem J. Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda. Ecancermedicalscience 2023; 17:1576. [PMID: 37533943 PMCID: PMC10393309 DOI: 10.3332/ecancer.2023.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Indexed: 08/04/2023] Open
Abstract
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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Affiliation(s)
- Siraji Obayo
- Uganda Cancer Institute, Upper Mulago Hill Road PO Box 3935, Kampala, Uganda
| | - Yusuf Mulumba
- Uganda Cancer Institute, Upper Mulago Hill Road PO Box 3935, Kampala, Uganda
| | - Cheryl L Thompson
- Case Western Reserve University, Case Comprehensive Cancer Centre, Cleveland, OH 44106, USA
- Case Western Reserve University, University Hospitals Seidman Cancer Center, Cleveland, OH 44106, USA
| | - Michael K Gibson
- Vanderbilt University Medical Centre, Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA
| | - Matthew M Cooney
- Case Western Reserve University, Case Comprehensive Cancer Centre, Cleveland, OH 44106, USA
- Case Western Reserve University, University Hospitals Seidman Cancer Center, Cleveland, OH 44106, USA
| | - Jackson Orem
- Uganda Cancer Institute, Upper Mulago Hill Road PO Box 3935, Kampala, Uganda
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Shumba S, Musonda P, Lombe D, Chongwe G, Kayamba V. Oesophageal cancer cases recorded in the Zambia National Cancer Registry: a cross-sectional study. Pan Afr Med J 2023; 44:128. [PMID: 37275285 PMCID: PMC10237221 DOI: 10.11604/pamj.2023.44.128.32907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 10/28/2022] [Indexed: 06/07/2023] Open
Abstract
Introduction the aim of this study was to determine what proportion of patients with confirmed esophageal cancer at the largest hospital in the country were recorded in the Zambia National Cancer Registry (ZNCR). Methods we reviewed esophageal cancer records at the University Teaching Hospital (UTH) and ZNCR, between 2015 and 2017. Using Stata version 15, data were summarised and the Kruskal-Wallis was used to compute comparisons, Kaplan-Meier curves for survival estimates and Cox regression for associated factors. Results included in the final analysis were records for 222 patients with confirmed esophageal cancer and of these 51/222 (41%) were appearing in the ZNCR. The mean age of the patients was 56.2 years (SD, 13.0) and only 2/222 (1%) were confirmed alive at the time of data analysis. The median time from endoscopic diagnosis to histological confirmation was 12.5 days (IQR 7.5 - 21.5) and arrival at the Cancer Diseases Hospital (CDH) for treatment was 20 days (IQR 10 - 34). The overall median survival time in the study was 259 days (CI 95%; 151 - 501). Age, sex, time to diagnosis, histological classification and grade of tumour did not show any evidence of predicting survival in both the univariate and multivariable cox regression model (p>0.05). Conclusion a significant proportion of esophageal cancer cases seen at UTH were not included in the national registry suggesting that official figures for the prevalence of esophageal cancer in Zambia are underestimated. There is an urgent need to improve the collection of data on esophageal cancer in Zambia.
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Affiliation(s)
- Samson Shumba
- University of Zambia School of Public Health, Department of Epidemiology and Biostatistics, Lusaka, Zambia
| | - Patrick Musonda
- University of Zambia School of Public Health, Department of Epidemiology and Biostatistics, Lusaka, Zambia
| | - Dorothy Lombe
- Cancer Diseases Hospital, Nationalist Road, Lusaka, Zambia
| | - Gershom Chongwe
- University of Zambia School of Public Health, Department of Epidemiology and Biostatistics, Lusaka, Zambia
- Tropical Diseases Research Centre, Ndola, Zambia
| | - Violet Kayamba
- Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, PO Box 50398, Lusaka, Zambia
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Degu A, Karimi PN, Opanga SA, Nyamu DG, Cui Y. Determinants of survival outcomes among esophageal cancer patients at a national referral hospital in Kenya. Chronic Dis Transl Med 2023; 9:20-28. [PMID: 36926251 PMCID: PMC10011667 DOI: 10.1002/cdt3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction The overall 5-year survival rate for esophageal cancer patients in low- and middle-income countries was reported to be low, despite the availability of advanced treatments. Thus, this study aimed to assess determinants of survival outcomes among esophageal cancer patients in Kenya. Methods A retrospective cohort study was employed among 299 adult esophageal cancer patients. The data were collected using a data abstraction tool consisting of patients' clinical characteristics and survival outcome measuring parameters. Statistical Package for the Social Sciences (SPSS) statistical software (version 20.0, IBM. USA) was used to analyze the data. The Kaplan-Meier and Cox regression analyses were used to determine the survival outcome and determinants of mortality, respectively. Results The mortality rate was 43.1%, and 11.1% of patients demonstrated distant metastases in the follow-up period. Despite treatment, 20.1% had progressed disease, and 13.0% did not respond to treatment. Radiotherapy (AHR: 3.3, 95% CI: 1.4-7.8, p = 0.007), chemotherapy (AHR: 3.9, 95% CI: 1.2-6.1, p = 0.020), and chemoradiation (AHR: 5.6, 95%CI: 1.6-10.2, p = 0.006) were the significant determinants of survival in advanced stage (III and and IV) patients. Conclusions There was a high mortality rate, disease progression, and nonresponse of esophageal cancer patients. Hence, it is essential to improve the survival of patients through early detection and timely initiation of the available treatment options.
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Affiliation(s)
- Amsalu Degu
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Sciences United States International University-Africa Nairobi Kenya.,Department of Pharmacy, Faculty of Health Sciences University of Nairobi Nairobi Kenya
| | - Peter N Karimi
- Department of Pharmacy, Faculty of Health Sciences University of Nairobi Nairobi Kenya
| | - Sylvia A Opanga
- Department of Pharmacy, Faculty of Health Sciences University of Nairobi Nairobi Kenya
| | - David G Nyamu
- Department of Pharmacy, Faculty of Health Sciences University of Nairobi Nairobi Kenya
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Bispo IMC, Granger HP, Almeida PP, Nishiyama PB, de Freitas LM. Systems biology and OMIC data integration to understand gastrointestinal cancers. World J Clin Oncol 2022; 13:762-778. [PMID: 36337313 PMCID: PMC9630993 DOI: 10.5306/wjco.v13.i10.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/22/2021] [Accepted: 10/03/2022] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal (GI) cancers are a set of diverse diseases affecting many parts/ organs. The five most frequent GI cancer types are esophageal, gastric cancer (GC), liver cancer, pancreatic cancer, and colorectal cancer (CRC); together, they give rise to 5 million new cases and cause the death of 3.5 million people annually. We provide information about molecular changes crucial to tumorigenesis and the behavior and prognosis. During the formation of cancer cells, the genomic changes are microsatellite instability with multiple chromosomal arrangements in GC and CRC. The genomically stable subtype is observed in GC and pancreatic cancer. Besides these genomic subtypes, CRC has epigenetic modification (hypermethylation) associated with a poor prognosis. The pathway information highlights the functions shared by GI cancers such as apoptosis; focal adhesion; and the p21-activated kinase, phosphoinositide 3-kinase/Akt, transforming growth factor beta, and Toll-like receptor signaling pathways. These pathways show survival, cell proliferation, and cell motility. In addition, the immune response and inflammation are also essential elements in the shared functions. We also retrieved information on protein-protein interaction from the STRING database, and found that proteins Akt1, catenin beta 1 (CTNNB1), E1A binding protein P300, tumor protein p53 (TP53), and TP53 binding protein 1 (TP53BP1) are central nodes in the network. The protein expression of these genes is associated with overall survival in some GI cancers. The low TP53BP1 expression in CRC, high EP300 expression in esophageal cancer, and increased expression of Akt1/TP53 or low CTNNB1 expression in GC are associated with a poor prognosis. The Kaplan Meier plotter database also confirmed the association between expression of the five central genes and GC survival rates. In conclusion, GI cancers are very diverse at the molecular level. However, the shared mutations and protein pathways might be used to understand better and reveal diagnostic/prognostic or drug targets.
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Affiliation(s)
- Iasmin Moreira Costa Bispo
- Núcleo de Biointegração, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45.029-094, Bahia, Brazil
| | - Henry Paul Granger
- Núcleo de Biointegração, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45.029-094, Bahia, Brazil
| | - Palloma Porto Almeida
- Division of Experimental and Translational Research, Brazilian National Cancer Institute, Rio de Janeiro 20231-050, Brazil
| | - Patricia Belini Nishiyama
- Núcleo de Biointegração, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45.029-094, Bahia, Brazil
| | - Leandro Martins de Freitas
- Núcleo de Biointegração, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45.029-094, Bahia, Brazil
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Chabeli MS, Wang X, Yinghao L, Chen C, Yang C, Shou Y, Wang S, Chen K. Similarities between wound re-epithelialization and Metastasis in ESCC and the crucial involvement of macrophages: A review. Cancer Treat Res Commun 2022; 32:100621. [PMID: 36007473 DOI: 10.1016/j.ctarc.2022.100621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
In cancer, tumor-associated macrophages (TAMs) possess crucial functions in facilitating epithelial-mesenchymal transition (EMT). EMT is a crucial process in tumor metastasis. Tumor metastasis is one of the hallmarks of cancer and leads to patient mortality. Cancer cells often find ways to evade being detected and attacked by the immune system. This is achieved by cross-talk between cancer cells and the altered microenvironment. The accumulation of tumor-associated macrophages (TAMs) in the tumor microenvironment (TME) creates an immunosuppressive and tumor-supportive environment. Circulating monocytes and macrophages which are recruited into tumors are defined as tumor-associated macrophages once in the TME. Based on the activated stimuli and function, macrophages can be divided into M1 macrophages and M2 macrophages. M1 macrophages, also known as classically activated macrophages, exhibit pro-inflammatory and antitumor activities. M2 macrophages, also known as alternatively activated macrophages, exhibit anti-inflammatory, pro-tumorigenic, and wound healing activities. TAMs are considered to be of the M2 phenotype. The TME polarizes recruited macrophages into M2 macrophages as they provide an immunosuppressive pro-tumoral environment. Accumulating studies show that the presence of TAMs in esophageal squamous cell carcinoma (ESCC) leads to tumor progression. In this review, we discuss how EMT can be used by TAMs to cause tumor migration and metastasis in ESCC. We also discuss the potential therapies targeting TAMs.
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Affiliation(s)
- Maletsooa Story Chabeli
- Academy of medical sciences, Department of Pathology, Zhengzhou University, Zhengzhou, Henan, China; Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China,.
| | - Xiaoqian Wang
- BGI College and Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Liang Yinghao
- BGI College and Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Chao Chen
- Academy of medical sciences, Department of Pathology, Zhengzhou University, Zhengzhou, Henan, China; Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China
| | - Chenbo Yang
- Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China
| | - Yuwei Shou
- Academy of medical sciences, Department of Pathology, Zhengzhou University, Zhengzhou, Henan, China; Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China
| | - Shuaiyuan Wang
- Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China
| | - Kuisheng Chen
- Academy of medical sciences, Department of Pathology, Zhengzhou University, Zhengzhou, Henan, China; Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Henan, China; Provincial Key Laboratory of Tumor Pathology, Zhengzhou, 450052, China,.
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Ismail M, Mondlane L, Loforte M, Dimande L, Machatine S, Carrilho C, Sacarlal J. Demographic, endoscopic and histological profile of esophageal cancer at the Gastroenterology Department of Maputo Central Hospital from January 2016 to December 2018. Pan Afr Med J 2022; 41:100. [PMID: 35465369 PMCID: PMC8994464 DOI: 10.11604/pamj.2022.41.100.30941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/14/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION esophageal cancer is a major public health problem in Mozambique. It is the nineth most common cancer worldwide in terms of incidence (604.000 new cases/year), and sixth in overall mortality (544.076 deaths/year). In Mozambique esophageal cancer was the seventh most common cancer in males and the fifth in females between 1991 and 2008. METHODS it was done a cross-sectional hospital-based epidemiological study, using secondary demographics endoscopic and pathologic features data. A retrospective analysis of the existing information of patients classified as esophageal cancer diagnosed with upper gastrointestinal endoscopy observed from January 1st, 2016 to December 31st, 2018 at the Gastroenterology Service of Maputo Central Hospital. A coding sheet was created a priori, and data analysed in SPSS version 20. RESULTS of the 205 cases with complete records where included in the analysis, there was a higher frequency of females with 56.6% (116/205). The average age was 59.5 years with standard deviation of ± 12.9 years. Most of the patients were native of southern Mozambique, with 92.7% (190/205), of which Maputo made up 53.2% (109/205). Regarding race, 99.5% (204/205) were black. The most affected endoscopic location was the middle third with 48.8% (100/205), followed by the lower third with 29.8% (61/205) and the upper third with 21.5% (44/205). Squamous cell carcinoma was the most frequent, with 92.7% (190/205), followed by adenocarcinoma with 4.9% (10/205). CONCLUSION due to the high number of observed cases of esophageal cancer, a high degree of clinical suspicion is needed for timely diagnosis and more effective treatment. Updated prevalent studies are needed throughout the country to understand the true impact of esophageal cancer on the Mozambican population.
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Affiliation(s)
- Muhammad Ismail
- Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique,,Corresponding author: Muhammad Ismail, Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique.
| | - Liana Mondlane
- Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique
| | - Michella Loforte
- Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique
| | - Luzmira Dimande
- Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique
| | - Sheila Machatine
- Serviço de Gastroenterologia, Hospital Central de Maputo, Maputo, Mozambique
| | - Carla Carrilho
- Serviço de Anatomia Patológica, Hospital Central de Maputo, Maputo, Mozambique,,Departamento de Patologia, Faculdade de Medicina, UEM, Maputo, Mozambique
| | - Jahit Sacarlal
- Departamento de Patologia, Faculdade de Medicina, UEM, Maputo, Mozambique
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Middleton DRS, Mmbaga BT, Menya D, Dzamalala C, Nyakunga-Maro G, Finch P, Mlombe Y, Schüz J, McCormack V. Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi. Lancet Glob Health 2022; 10:e236-e245. [PMID: 34921758 PMCID: PMC8766315 DOI: 10.1016/s2214-109x(21)00506-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/09/2021] [Accepted: 10/18/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The contribution of alcohol to the large burden of oesophageal squamous cell carcinoma (ESCC) in east Africa remains uncertain and difficult to assess owing to complex consumption patterns of traditional and commercial drinks. We aimed to assess whether alcohol drinking, overall and at specific intake levels, contributes to ESCC risk in east Africa. METHODS We did a hospital-based case-control study in Kenya, Tanzania, and Malawi, which included comprehensive assessment of a variety of locally consumed alcohol that we used to classify drinkers as exclusively low alcohol-by-volume (ABV; <30% ABV) drinkers or drinkers of some high-ABV drinks, as well as the number of drinks consumed, average weekly ethanol intake, and the contribution of each drink type to overall ethanol consumption. Cases were patients aged 18 years and older with incident primary ESCC, confirmed histologically for the majority of cases, and a clinical diagnosis for the remainder. Controls were frequency-matched on age and sex in a 1:1 ratio with cases. The controls were recruited from the same hospitals as cases and included outpatients, inpatients, and hospital visitors who did not have cancer or any other digestive disease. Consenting participants took part in face-to-face interviews in which they were asked whether they had ever consumed alcohol (the primary exposure variable); those who had were asked follow-up questions about their consumption habits for different alcoholic drinks. FINDINGS 1279 cases and 1346 controls were recruited between Aug 5, 2013, and May 24, 2020, including 430 cases and 440 controls from Kenya, 310 cases and 313 controls from Tanzania, and 539 cases and 593 controls from Malawi. 65 (4·8%) of 1344 cases were excluded. Consistent positive associations with ESCC risk were found for ever having consumed alcohol in Kenyan men and Tanzanian men, and for daily number of drinks and estimated ethanol intake in Kenya, Tanzania (both sexes) and Malawian women. Corresponding population-attributable fractions of ESCC for those reporting ever drinking alcohol (vs never drinking) were 65% (95% CI 52-78) in Kenyan men and 23% (<1-45) in Kenyan women, and 56% (95% CI 36-76) in Tanzanian men and 5% (0-42) in Tanzanian women. Increased risk and population-attributable fractions were almost entirely due to risks in high-ABV drinkers. INTERPRETATION Alcohol appears to be a substantial contributor to ESCC risk in east Africa, particularly among men, and a large fraction of ESCC could be prevented by cessation or reduction of alcohol consumption. Future studies should consider independent ascertainment of alcohol intake to assess the potential of under-reporting in Malawi. FUNDING US National Cancer Institute, Wereld Kanker Onderzoek Fonds, and the IARC Environment and Lifestyle Epidemiology Branch. TRANSLATIONS For the Swahili and Chichewa translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Daniel R S Middleton
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Diana Menya
- School of Public Heath, Moi University, Eldoret, Kenya
| | | | - Gissela Nyakunga-Maro
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Peter Finch
- Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France.
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Rehabilitation Nursing Intervention Can Improve Dysphagia and Quality of Life of Patients Undergoing Radiotherapy for Esophageal Cancer. JOURNAL OF ONCOLOGY 2021; 2021:3711699. [PMID: 34394350 PMCID: PMC8360714 DOI: 10.1155/2021/3711699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022]
Abstract
Objective To seek the improvement of rehabilitation nursing intervention on dysphagia and quality of life of patients with esophageal cancer undergoing radiotherapy. Methods A total of 109 patients with esophageal cancer undergoing radiotherapy were selected as research objects. According to the random number table, they were separated into the control group (CG) and intervention group (IG), with 45 cases in CG and 64 cases in IG. In CG, patients were given routine nursing intervention, while those in IG were given rehabilitation nursing intervention. After intervention, the degree of acute radiation injury and the improvement of swallowing function were observed to compare the self-nursing ability, quality of life, and incidence of complications between the two groups. Results The degree of injury in CG was heavier than that in IG. The improvement of swallowing function in IG was better than that in CG. The scores of self-nursing ability and life quality in IG were higher than those in CG, with statistically significant differences (p < 0.05). The incidence of complications in IG was obviously lower than that in CG (p < 0.05). Conclusion Rehabilitation nursing intervention can ameliorate dysphagia, improve the quality of life, and reduce the incidence of complications for patients with esophageal cancer undergoing radiotherapy. It is worthy of clinical application.
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Lian D, Jin B. Expression of Bcl-xL, LDH, IPF, and MMP-9 in thoracic cavity infection after esophageal cancer surgery and their role in predicting sepsis. Shijie Huaren Xiaohua Zazhi 2021. [DOI: 10.11569/wcjd.v29.i14.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Lian D, Jin B. Expression of Bcl-xL, LDH, IPF, and MMP-9 in thoracic cavity infection after esophageal cancer surgery and their role in predicting sepsis. Shijie Huaren Xiaohua Zazhi 2021; 29:788-795. [DOI: 10.11569/wcjd.v29.i14.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients with esophageal cancer (EC) are prone to thoracic infection after surgery, but there is a lack of early prediction markers. Based on the fact that matrix metalloproteinase-9 (MMP-9), immature platelet ratio, macromolecular B lymphocytoma, and changes in lactate dehydrogenase levels are all related to infection, it was speculated that these changes may be candidate markers for clinical prediction of thoracic infection and sepsis.
AIM To investigate the expression of B-cell lymphoma-extra large (Bcl-xL) protein, lactate dehydrogenase (LDH), immature platelet fraction (IPF), and MMP-9 in chest infections after EC surgery and their role in predicting sepsis.
METHODS From February 2016 to October 2020, 187 patients with chest infection after EC surgery were selected as an observation group. The patients were divided into either a sepsis subgroup (16 cases) or a non-sepsis (171 cases) subgroup according to whether sepsis occurred. And 187 patients with no infection after EC surgery with matched clinical data during the same period were selected as a control group. The levels of Bcl-xL protein, LDH, IPF, and MMP-9 between the two groups and between patients with and without sepsis were compared. Pearson analysis was performed to investigate the relationship of Bcl-xL, LDH, IPF, and MMP-9 with the severity of sepsis. Logistic regression was used to analyze the factors related to sepsis. Receiver operating characteristic curve (ROC) was used to analyze the performance of Bcl-xL, LDH, IPF, and MMP-9 in predicting sepsis.
RESULTS Bcl-xL, LDH, IPF, and MMP-9 in the observation group were significantly higher than those in the control group (P < 0.05). The operation time was longer and the levels of Bcl-xL, LDH, IPF, and MMP-9 were significantly higher in patients with sepsis than in those without (P < 0.05). The levels of Bcl-xL, LDH, IPF, and MMP-9 were positively correlated with APACHE II score (P < 0.05). Logistic regression analysis showed that the risk of sepsis was 1.174, 2.883, 2.562, and 1.948 times lower in patients with Bcl-xL, LDH, IPF, and MMP-9 expression higher than the averages than in those with Bcl-xL, LDH, IPF, and MMP-9 expression lower than the average (P < 0.05). ROC analysis showed that the AUC of Bcl-xL protein, LDH, IPF, and MMP-9 combined to predict sepsis was 0.964, which was greater than those of any index alone (P < 0.05).
CONCLUSION The levels of Bcl-xL protein, LDH, IPF, and MMP-9 in patients with chest infection after EC operation are elevated, which are closely related to the progression of the disease. They have good predictive performance in predicting sepsis secondary to chest infection after EC operation, which is convenient for guiding clinical prevention and treatment programs.
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Affiliation(s)
- Dong Lian
- Department of Laboratory Medicine, Second People's Hospital of Lishui, Lishui 323000, Zhejiang Province, China
| | - Bei Jin
- Department of Laboratory Medicine, Second People's Hospital of Lishui, Lishui 323000, Zhejiang Province, China
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Asombang AW, Kasongo N, Muyutu J, Montiero JFG, Chishinga N, Chipaila J, Banda L. Descriptive analysis of esophageal cancer in Zambia using the cancer disease hospital database: young age, late stage at presentation. Pan Afr Med J 2021; 39:12. [PMID: 34394803 PMCID: PMC8348283 DOI: 10.11604/pamj.2021.39.12.23357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION published data on oesophageal cancer (EC) in Zambia is limited and our study is the only study in Zambia evaluating the demographics and clinicopathologic features of patients presenting with EC at time of diagnosis. METHODS a retrospective analysis of data from Cancer Diseases Hospital (CDH) database was conducted on EC patients diagnosed between 2007 and December 2018. Medical records of EC patients were manually retrieved and reviewed using medical record numbers identified from the CDH database. Demographics, clinicopathologic features and modes of treatment were extracted. A coding sheet was created a priori, and data analysed in SAS version 9.3. RESULTS two hundred and seventy eight (278) complete EC medical records were included in the analysis, 183 (66%) were males, mean age was 55 years (range 21-89). One hundred and fifty six (156) (56%) resided in Lusaka, the location of CDH. The age-standardized incidence for EC was 5.5 per 100,000 people (95% CI, 4.3-6.6). The commonest symptom was dysphagia (83%), 97% were diagnosed endoscopically, squamous cell carcinoma and adenocarcinoma accounted for 90% and 8.3% respectively, 65% received treatment. One hundred and twenty four (124) medical records had missing cancer staging. Of 154 medical records with complete cancer staging, 98 (35%) were diagnosed at stage 4 of which 33% were between 40 and 49 years. CONCLUSION the age-standardized incidence for EC is high at CDH. Patients with EC are predominantly male, reside in Lusaka and present with late stage EC at time of diagnosis; mostly between the ages of 40-49 years. Robust prospective research and improved data recording is needed.
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Affiliation(s)
- Akwi Wasi Asombang
- Division of Gastroenterology, Hepatology, Warren Alpert Medical School of Brown University, Rhode Island 02903, United States
| | - Nancy Kasongo
- School of Medicine, Copperbelt University, Ndola, Zambia
| | - John Muyutu
- School of Medicine, Copperbelt University, Ndola, Zambia
| | | | | | - Jackson Chipaila
- Department of Surgery, University Teaching Hospital - Adult Hospital, Lusaka, Zambia
| | - Lewis Banda
- Hematology, Oncology, Cancer Disease Hospital, Lusaka, Zambia
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Parkin DM, Chingonzoh T, Vuma S, Liu B, Chokunonga E, Ndlovu N, Borok M. Changes in the Incidence of Cancer in Bulawayo, Zimbabwe over a 50-Year Period. Cancer Epidemiol Biomarkers Prev 2021; 30:867-873. [PMID: 33619023 DOI: 10.1158/1055-9965.epi-20-0669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/14/2020] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The cancer registry of Bulawayo (Zimbabwe) operated for 15 years in the preindependence period (1963-77), and was restarted in 2011. This allows comparison of incidence of cancers over a period of almost 50 years. METHODS Age-standardized rates, with SEs, were calculated for 1963-1972 and 2011-2015. Detailed results are presented for those cancers for which there was a significant (P < 0.05) change in the rates between the two periods. RESULTS There were declines in the rates of those cancers previously known to be common in East and Southern Africa (esophagus, liver, bladder), and the emergence of cancers associated with "westernization" of lifestyles (breast, prostate, large bowel). Cancers related to infection with HIV-AIDS (Kaposi sarcoma, non-Hodgkin lymphoma, eye cancers) have come to comprise a much larger proportion of the total burden, and cancer of the cervix (also AIDS-related) has shown a large increase in incidence-as elsewhere in sub-Saharan Africa (SSA). More surprising is the decline in cancer of the lung-formerly very high, but by 2011-2015, despite little change in the prevalence of smoking, rates were low-close to the average for SSA. This may relate, in part, to a decline in the numbers of miners, and ex-miners, residing in the city. CONCLUSIONS The changes in incidence are largely explained by differences in past exposure to environmental risk factors. IMPACT Few datasets from SSA can document temporal changes in the cancer epidemic on the continent. There are some anticipated observations, as well as unexpected findings meriting further investigation.
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Affiliation(s)
- Donald Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
- African Cancer Registry Network, Prama House, Oxford, United Kingdom
- International Agency for Research on Cancer, Lyon, France
| | | | - Samkeliso Vuma
- Radiotherapy Centre, Mpilo Central Hospital, Bulawayo, Zimbabwe
| | - Biying Liu
- African Cancer Registry Network, Prama House, Oxford, United Kingdom
| | - Eric Chokunonga
- Zimbabwe National Cancer Registry, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - Ntokozo Ndlovu
- Zimbabwe National Cancer Registry, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
- Radiotherapy Centre, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - Margaret Borok
- Zimbabwe National Cancer Registry, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
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Deybasso HA, Roba KT, Nega B, Belachew T. Clinico-Pathological Findings and Spatial Distributions of Esophageal Cancer in Arsi Zone, Oromia, Central Ethiopia. Cancer Manag Res 2021; 13:2755-2762. [PMID: 33790649 PMCID: PMC8001180 DOI: 10.2147/cmar.s301978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/12/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Arsi Zone is one of the esophageal cancer endemic areas and is reported to have a high incidence of esophageal cancer in Ethiopia. This study assessed clinicopathological patterns and spatial distributions of esophageal cancer in Arsi Zone, Oromia, Central Ethiopia. METHODS A cross-sectional study design was carried out by abstracting data of 403 patients treated from January 2015 to January 2019. Data were collected by using a structured data collection form and Geographical Positioning System software. The collected data were summarized in the form of tables, figures, means, and standard deviations. Statistical data analysis was done using SPSS software version 21.0 while geospatial analysis was conducted using the Arc-GIS 10.1 software. RESULTS The disease was prominent among individuals aged 50 to 59 years. The mean age of females and males was 52.2 (SD±10.41) and 56.94 (SD ±12.27) years respectively. The vast majority (98.3%) of cases had squamous cell carcinoma. Dysphagia with weight loss accounted for 87.6% of the presenting symptoms. A large proportion (42.9%) of patients had a tumor located at the lower thorax. The majority (62%) of patients were from the eastern and north-eastern parts of the Arsi zone. CONCLUSION Dysphagia with weight loss was the major symptom during the first visit. Squamous cell carcinoma was the predominant histopathological type. Eastern and the northeastern parts of the Zone are the most affected regions. Future studies should focus on the determinants of esophageal cancer and precise areas with high incidences by using the population and/or facility-based cancer registry systems.
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Affiliation(s)
- Haji Aman Deybasso
- Jimma University, Department of Human Nutrition and Dietetics, Jimma, Ethiopia
| | - Kedir Teji Roba
- Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Berhanu Nega
- Addis Ababa University, College of medicine and health sciences, Addis Ababa, Ethiopia
| | - Tefera Belachew
- Jimma University, Department of Human Nutrition and Dietetics, Jimma, Ethiopia
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Understanding health-seeking and adherence to treatment by patients with esophageal cancer at the Uganda cancer Institute: a qualitative study. BMC Health Serv Res 2021; 21:159. [PMID: 33602201 PMCID: PMC7890846 DOI: 10.1186/s12913-021-06163-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In the low- and middle-income countries, most patients with esophageal cancer present with advanced stage disease and experience poor survival. There is inadequate understanding of the factors that influence decisions to and actual health-seeking, and adherence to treatment regimens among esophageal cancer patients in Uganda, yet this knowledge is critical in informing interventions to promote prompt health-seeking, diagnosis at early stage and access to appropriate cancer therapy to improve survival. We explored health-seeking experiences and adherence to treatment among esophageal cancer patients attending the Uganda Cancer Institute. METHODS We conducted an interview based qualitative study at the Uganda Cancer Institute (UCI). Participants included patients with established histology diagnosis of esophageal cancer and healthcare professionals involved in the care of these patients. We used purposive sampling approach to select study participants. In-depth and key informant interviews were used in data collection. Data collection was conducted till point of data saturation was reached. Thematic content analysis approach was used in data analyses and interpretations. Themes and subthemes were identified deductively. RESULTS Sixteen patients and 17 healthcare professionals were included in the study. Delayed health-seeking and poor adherence to treatment were related to (i) emotional and psychosocial factors including stress of cancer diagnosis, stigma related to esophageal cancer symptoms, and fear of loss of jobs and livelihood, (ii) limited knowledge and recognition of esophageal cancer symptoms by both patients and primary healthcare professionals, and (iii) limited access to specialized cancer care, mainly because of long distance to the facility and associated high transport cost. Patients were generally enthused with patient - provider relationships at the UCI. While inadequate communication and some degree of incivility were reported, majority of patients thought the healthcare professionals were empathetic and supportive. CONCLUSION Health system and individual patient factors influence health-seeking for symptoms of esophageal cancer and adherence to treatment schedule for the disease. Interventions to improve access to and acceptability of esophageal cancer services, as well as increase public awareness of esophageal cancer risk factors and symptoms could lead to earlier diagnosis and potentially better survival from the disease in Uganda.
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Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries. Cancers (Basel) 2021; 13:cancers13010141. [PMID: 33466239 PMCID: PMC7795486 DOI: 10.3390/cancers13010141] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Esophageal cancer is the seventh most common cancer globally. Preventive measures and clinical management differ based on histologic subtype. However, information has been lacking on its most recent patterns according to histological subtype, associated risk factors, and epidemiological trends on a global scale. This study is a global analysis of the incidence/mortality trends of esophageal cancer in more than 48 countries/regions based on high quality population-based registries. We conclude that adenocarcinoma has already surpassed squamous cell carcinoma as the most frequent type of esophageal cancer in some western countries and is expected to increase in other countries. It is important to closely monitor and slow down the growing rates of obesity and metabolic syndrome, which are the important risk factors for adenocarcinoma. With the development of more advanced and less invasive technology, population-based targeted screening endoscopy would be recommended for high-risk individuals. Abstract This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality were evaluated by average annual percent change (AAPC) using joinpoint regression. Associations with risk factors were examined by linear regression. The highest incidence of esophageal cancer was observed in Eastern Asia. The highest incidence of adenocarcinoma (AC) was found in the Netherlands, the United Kingdom, and Ireland. A higher AC/squamous cell carcinoma (SCC) incidence ratio was associated with a higher prevalence of obesity and elevated cholesterol. We observed an incidence increase (including AC and SCC) in some countries, with the Czech Republic (female: AAPC 4.66), Spain (female: 3.41), Norway (male: 3.10), Japan (female: 2.18), Thailand (male: 2.17), the Netherlands (male: 2.11; female: 1.88), and Canada (male: 1.51) showing the most significant increase. Countries with increasing mortality included Thailand (male: 5.24), Austria (female: 3.67), Latvia (male: 2.33), and Portugal (male: 1.12). Although the incidence of esophageal cancer showed an overall decreasing trend, an increasing trend was observed in some countries with high AC/SCC incidence ratios. More preventive measures are needed for these countries.
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Xu DD, Chen SH, Zhou PJ, Wang Y, Zhao ZD, Wang X, Huang HQ, Xue X, Liu QY, Wang YF, Zhang R. Suppression of Esophageal Cancer Stem-like Cells by SNX-2112 Is Enhanced by STAT3 Silencing. Front Pharmacol 2020; 11:532395. [PMID: 33390934 PMCID: PMC7772942 DOI: 10.3389/fphar.2020.532395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/16/2020] [Indexed: 01/20/2023] Open
Abstract
Many studies have demonstrated that cancer stem cells (CSCs) or tumor-initiating cells (TICs) are responsible for tumor cell proliferation, chemotherapy resistance, metastasis, and relapse in various cancers. We, and others, have previously shown that the signal transducer and activator of transcription 3 (STAT3) signaling pathway is responsible for CSCs and TICs growth. Recent reports have indicated that the heat shock protein 90 (Hsp90) is also essential for the survival of CSCs and TICs. SNX-2112 is an Hsp90 inhibitor. However, it remains unclear whether proliferation of esophageal cancer stem-like cells (ECSLCs) is suppressed by SNX-2112 with knockdown of STAT3 (shSTAT3). Here, we explored the association between SNX-2112 with shSTAT3 and the suppression of ECSLCs growth. We found that the expression level of both STAT3 and p-STAT3 was higher in clinical esophageal cancer tissue than in the adjacent normal tissue, using western blot and qPCR analysis. Furthermore, differential expression analysis demonstrated that STAT3 was overexpressed in clinical specimens. We demonstrated that SNX-2112 inhibited cancer cell proliferation, decreased ABCB1 and ABCG2 gene expression levels and reduced the colony formation capacity of ECSLCs, which was enhanced by STAT3 silencing. Flow cytometry analysis revealed that the combination of SNX-2112 and shSTAT3 significantly induced apoptosis and cell cycle arrest at G2/M phase in ECSLCs. Levels of proliferation pathway proteins, including p38, c-Jun N-terminal kinase (JNK), and extracellular signal–regulated kinase (ERK) which were also client proteins of Hsp90, were also reduced. In addition, SNX-2112 with shSTAT3 inhibited the proliferation of ECSLCs in vivo. Finally, STAT3 overexpression eliminated the apoptotic and antiproliferative effects of SNX-2112 on ECSLCs. Hence, these results provide a rationale for the therapeutic potential of the combination of SNX-2112 with shSTAT3 in esophageal cancer, and may indicate new targets for clinical intervention in human cancer.
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Affiliation(s)
- Dan-Dan Xu
- Guangdong Food and Drug Vocational College, Guangzhou, China.,College of Life Science and Technology, Jinan University, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, SunYat-Sen University Cancer Center, Guangzhou, China
| | - Su-Hong Chen
- Guangdong Food and Drug Vocational College, Guangzhou, China.,College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Peng-Jun Zhou
- College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Ying Wang
- College of Food Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, China
| | - Zhen-Dong Zhao
- Guangdong Food and Drug Vocational College, Guangzhou, China
| | - Xia Wang
- Guangdong Food and Drug Vocational College, Guangzhou, China
| | - Hui-Qing Huang
- Guangdong Food and Drug Vocational College, Guangzhou, China
| | - Xue Xue
- Guangdong Food and Drug Vocational College, Guangzhou, China
| | - Qiu-Ying Liu
- College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Yi-Fei Wang
- College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Rong Zhang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, SunYat-Sen University Cancer Center, Guangzhou, China
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21
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Come J, Pereira JB, Pinto R, Carrilho C, Pereira L, Lara Santos L. The Upper Digestive Tract Microbiome and Oesophageal Squamous Cell Carcinoma: Epidemiology, Pathogenesis, and Clinical Implications in Africa. Pathobiology 2020; 88:141-155. [PMID: 33291118 DOI: 10.1159/000511422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/07/2020] [Indexed: 12/24/2022] Open
Abstract
The study of the microbiome has significantly contributed to our understanding of complex diseases including cancer, with a profound influence of the microbiota on clinical prognosis and the efficacy of cancer treatments. Oesophageal cancer is positioned amongst the most aggressive malignant diseases, resulting from a complex interaction between anthropometric, genetic, immune response, and environmental factors. Oesophageal squamous cell carcinoma (OSCC) is the most common type of oesophageal cancer and is a serious burden in Eastern Africa, in the area known as the African oesophageal cancer corridor (AOCC). OSCC is often diagnosed at a late stage, with patients already suffering from severe malnutrition and dehydration due to swallowing difficulties, leading to high mortality rates. So far, aetiological factors have been individually analysed with an inappropriate contextualisation. The upper digestive tract microbiome has been proposed to contribute to the onset and progression of OSCC but with limited understanding of the mechanisms behind this interaction. Data on African populations are limited, and the aetiology of AOCC is still poorly understood. This review discusses the current knowledge of the aetiology of OSCC in Africa, with special focus on the probable influence of the upper digestive tract microbiota.
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Affiliation(s)
- Jotamo Come
- Departamento de Cirurgia, Hospital Central de Maputo, Maputo, Mozambique
| | - Joana Barbosa Pereira
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
| | - Ricardo Pinto
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
| | - Carla Carrilho
- Departamento de Patologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.,Departamento de Patologia, Hospital Central de Maputo, Maputo, Mozambique
| | - Luisa Pereira
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
| | - Lúcio Lara Santos
- Grupo de Patologia e Terapêutica Experimental e Departamento de Oncologia do Instituto Português de Oncologia do Porto, Porto, Portugal, .,ONCOCIR - Education and Care in Oncology, PALOP - Lusophone Africa, Porto, Portugal,
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22
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Wondimagegnehu A, Hirpa S, Abaya SW, Gizaw M, Getachew S, Ayele W, Yirgu R, Demeke T, Dessalegn B, Diribi J, Kaba M, Assefa M, Jemal A, Kantelhardt EJ, Addissie A. Oesophageal cancer magnitude and presentation in Ethiopia 2012-2017. PLoS One 2020; 15:e0242807. [PMID: 33259514 PMCID: PMC7707510 DOI: 10.1371/journal.pone.0242807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to assess the magnitude, socio-demographic, and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia. A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. A structured data extraction tool was used to extract data from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 to 2017. During the study period, a total of 777 oesophageal cancer cases were identified, and the median age of these patients was 55 years, with an interquartile range of 19. More than half (55.1%, n = 428) of the cases were males, and the majority of them were reported from Oromia (49.9%, n = 388) and Somali (25.9%, n = 202) regional states. The highest numbers of oesophageal cancer cases were recorded in 2016 (23.8%, n = 185), while the lowest were in 2012 (12.6%, n = 98). Eighty per cent of oesophageal cancer cases were diagnosed in later stages of the disease. More than one-fourth (27.0%, n = 210) of patients had surgical procedures where the majority (74.3%, n = 156) required insertion of a feeding tube followed by transhiatal oesophagectomy (10.9%, n = 23). Of the 118 patients for which there was histology data, squamous cell carcinoma (56.7%, n = 67) and adenocarcinoma (36.4%, n = 43) were the predominant histologic type. One-fourth (25.0%, n = 194) of the patients were alive, and more than two-thirds (71.7%, n = 557) of the patients' current status was unknown at the time of the review. In these referral hospitals of Ethiopia, many oesophageal cancer patients presented during later stages of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali hospitals by far exceeded hospitals of the other regions, thus postulating possibly unique risk factors in those geographic areas.
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Affiliation(s)
- Abigiya Wondimagegnehu
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
- GINGER Research Fellow, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Selamawit Hirpa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Samson Wakuma Abaya
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Muluken Gizaw
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Sefonias Getachew
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Wondimu Ayele
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Robel Yirgu
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamiru Demeke
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Berhe Dessalegn
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Jilcha Diribi
- Department of Oncology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mirgissa Kaba
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmedin Jemal
- American Cancer Society, Atlanta, Georgia, United States of America
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
- Department of Gynecology, Martin-Luther-University, Halle, Germany
- * E-mail:
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
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23
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Fan J, Liu Z, Mao X, Tong X, Zhang T, Suo C, Chen X. Global trends in the incidence and mortality of esophageal cancer from 1990 to 2017. Cancer Med 2020; 9:6875-6887. [PMID: 32750217 PMCID: PMC7520289 DOI: 10.1002/cam4.3338] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/28/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The incidence and mortality of esophageal cancer are high, with 5.90 new cases and 5.48 deaths per 100 000 people worldwide in 2017. The prognosis of esophageal cancer is poor, with an overall 5-year survival rate of less than 20%. Esophageal cancer in different geographical locations has different etiologies, and the incidence and mortality of esophageal cancer continue to rise in some regions. METHODS We collected incidence and mortality data by age and gender for 195 countries and territories from 1990 to 2017 in the Global Burden of Disease (GBD) database. And we used these data to calculate the estimated annual percentage change (EAPC) to quantify trends in morbidity and mortality. Then we analyzed the gender- and age-specific incidence and mortality in esophageal cancer to targeted high-risk populations. Finally, we analyzed the correlation between the age-standardized mortality rate (ASMR) and both the EAPC and social-demographic index (SDI), and we calculated the Pearson correlation coefficient. RESULTS We found that Malawi, East Asia, and high-middle SDI regions had the highest age-standardized incidence rate (ASIR) and ASMR, and the ASIR and ASMR in western Sub-Saharan Africa showed an upward trend. Our study also showed that the incidence and mortality in esophageal cancer were highest in men and in the 70+ years age group, and they presented a decreasing trend in most regions, but the 15-49 years age groups in Australasia, Caribbean, and Oceania and the 70+ years age group in High-Income North America, Oceania and high-SDI regions presented an increasing trend. There were significant negative associations between ASMR at baseline and EAPC and between ASMR and SDI in 2017. CONCLUSION By analyzing the global distribution of incidence and mortality in esophageal cancer, trends over time, and gender and age specificity, we can understand the heterogeneity of its global trends. This heterogeneity can help us to identify high-risk groupsand to provide clues for the exploration of the etiology and early prevention of the disease.
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Affiliation(s)
- Jiahui Fan
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Zhenqiu Liu
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Xianhua Mao
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
| | - Xin Tong
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Chen Suo
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.,Fudan University Taizhou Institute of Health Sciences, Taizhou, China.,State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, China
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24
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Asombang AW, Chishinga N, Nkhoma A, Chipaila J, Nsokolo B, Manda-Mapalo M, Montiero JFG, Banda L, Dua KS. Systematic review and meta-analysis of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes. World J Gastroenterol 2019; 25:4512-4533. [PMID: 31496629 PMCID: PMC6710188 DOI: 10.3748/wjg.v25.i31.4512] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/05/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal cancer (EC) is associated with a poor prognosis, particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease. AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity, and socio-economic challenges faced on the African continent. METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology, risk factors, management and outcomes of EC. A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer, and the Cancer in Sub-Saharan reports. We searched EMBASE, PubMed, Web of Science, and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved. Random effects meta-analyses were used to assess heterogeneity between studies and to obtain odds ratio (OR) of the associations between EC and risk factors; and incidence rate ratios for EC between sexes with their respective 95% confidence intervals (CI). RESULTS The incidence of EC is higher in males than females, except in North Africa where it is similar for both sexes. The highest age-standardized rate is from Malawi (30.3 and 19.4 cases/year/100000 population for males and females, respectively) followed by Kenya (28.7 cases/year/100000 population for both sexes). The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old. Meta-analysis shows a strong association with tobacco (OR 3.15, 95%CI: 2.83-3.50). There was significant heterogeneity between studies on alcohol consumption (OR 2.28, 95%CI: 1.94-2.65) and on low socioeconomic status (OR 139, 95%CI: 1.25-1.54) as risk factors, but these could also contribute to increasing the incidence of EC. The best treatment outcomes were with esophagectomy with survival rates of 76.6% at 3 years, and chemo-radiotherapy with an overall combined survival time of 267.50 d. CONCLUSION Africa has high incidence and mortality rates of EC, with preventable and non-modifiable risk factors. Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption. Management requires a multidisciplinary approach, and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy.
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Affiliation(s)
- Akwi W Asombang
- Division of Gastroenterology/Hepatology, Warren Alpert Medical School of Brown University, Providence, RI 02903, United States
| | - Nathaniel Chishinga
- Department for HIV Elimination, Fulton County Government, Atlanta, GA 30303, United States
| | - Alick Nkhoma
- Department of Gastroenterology, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Staffordshire ST4 6QG, United Kingdom
| | - Jackson Chipaila
- Department of Surgery, University Teaching Hospital-Adult Hospital, Lusaka 10101, Zambia
| | - Bright Nsokolo
- Department of Medicine, Levy Mwanawasa University Teaching Hospital, Tropical Gastroenterology and Nutrition Group (TROPGAN), Lusaka 10101, Zambia
| | - Martha Manda-Mapalo
- Department of Medicine, The University of New Mexico, Albuquerque, NM 87106, United States
| | | | - Lewis Banda
- Hematology/Oncology, Cancer Disease Hospital, Lusaka 10101, Zambia
| | - Kulwinder S Dua
- Department of Medicine and Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, United States
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25
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Pilleron S, Soerjomataram I, Charvat H, Chokunonga E, Somdyala NIM, Wabinga H, Korir A, Bray F, Jemal A, Maxwell Parkin D. Cancer incidence in older adults in selected regions of sub-Saharan Africa, 2008-2012. Int J Cancer 2019; 144:1824-1833. [PMID: 30238972 DOI: 10.1002/ijc.31880] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 12/15/2022]
Abstract
Although the countries of Sub-Sharan Africa represent among the most rapidly growing and aging populations worldwide, no previous studies have examined the cancer patterns in older adults in the region as a means to inform cancer policies. Using data from Cancer Incidence in Five Continents, we describe recent patterns and trends in incidence rates for the major cancer sites in adults aged ≥60 years and in people aged 0-59 for comparison in four selected population-based cancer registries in Kenya (Nairobi), the Republic of South Africa (Eastern Cape Province), Uganda (Kyadondo country), and Zimbabwe (Harare blacks). Over the period 2008-2012, almost 9,000 new cancer cases were registered in older adults in the four populations, representing one-third of all cancer cases. Prostate and esophageal cancers were the leading cancer sites in older males, while breast, cervical and esophageal cancers were the most common among older females. Among younger people, Kaposi sarcoma and non-Hodgkin lymphoma were common. Over the past 20 years, incidence rates among older adults have increased in both sexes in Uganda and Zimbabwe while rates have stabilized among the younger age group. Among older adults, the largest rate increase was observed for breast cancer (estimated annual percentage change: 5% in each country) in females and for prostate cancer (6-7%) in males. Due to the specific needs of older adults, tailored considerations should be given to geriatric oncology when developing, funding and implementing national and regional cancer programmes.
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Affiliation(s)
- Sophie Pilleron
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Hadrien Charvat
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | | | - Nontuthuzelo I M Somdyala
- South African Medical Research Council, Burden of Disease Research Unit; Eastern Cape Cancer Registry, Tygerberg, South Africa
| | - Henry Wabinga
- Department of Pathology Kampala Cancer Registry, Makerere University, Kampala, Uganda
| | - Anne Korir
- Nairobi Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - D Maxwell Parkin
- Nuffield Department of Public Health, University of Oxford, Oxford, United Kingdom
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26
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Sheikh M, Poustchi H, Pourshams A, Etemadi A, Islami F, Khoshnia M, Gharavi A, Hashemian M, Roshandel G, Khademi H, Zahedi M, Abedi-Ardekani B, Boffetta P, Kamangar F, Dawsey SM, Pharaoh PD, Abnet CC, Day NE, Brennan P, Malekzadeh R. Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study. Gastroenterology 2019; 156:1416-1427. [PMID: 30611753 PMCID: PMC7507680 DOI: 10.1053/j.gastro.2018.12.024] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/30/2018] [Accepted: 12/17/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Northeast Iran has one of the highest reported rates of esophageal squamous cell carcinoma (ESCC) worldwide. Decades of investigations in this region have identified some local habits and environmental exposures that increase risk. We analyzed data from the Golestan Cohort Study to determine the individual and combined effects of the major environmental risk factors of ESCC. METHODS We performed a population-based cohort of 50,045 individuals, 40 to 75 years old, from urban and rural areas across Northeast Iran. Detailed data on demographics, diet, lifestyle, socioeconomic status, temperature of drinking beverages, and different exposures were collected using validated methods, questionnaires, and physical examinations, from 2004 through 2008. Participants were followed from the date of enrollment to the date of first diagnosis of esophageal cancer, date of death from other causes, or date of last follow-up, through December 31, 2017. Proportional hazards regression models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between different exposures and ESCC. RESULTS During an average 10 years of follow-up, 317 participants developed ESCC. Opium smoking (HR 1.85; 95% CI 1.18-2.90), drinking hot tea (≥60°C) (HR 1.60; 95% CI 1.15-2.22), low intake of fruits (HR 1.48; 95% CI 1.07-2.05) and vegetables (HR 1.62; 95% CI 1.03-2.56), excessive tooth loss (HR 1.66; 95% CI 1.04-2.64), drinking unpiped water (HR 2.04; 95% CI 1.09-3.81), and exposure to indoor air pollution (HR 1.57; 95% CI 1.08-2.29) were significantly associated with increased risk of ESCC, in a dose-dependent manner. Combined exposure to these risk factors was associated with a stepwise increase in the risk of developing ESCC, reaching a more than 7-fold increase in risk in the highest category. Approximately 75% of the ESCC cases in this region can be attributed to a combination of the identified exposures. CONCLUSIONS Analysis of data from the Golestan Cohort Study in Iran identified multiple risk factors for ESCC in this population. Our findings support the hypothesis that the high rates of ESCC are due to a combination of factors, including thermal injury (from hot tea), exposure to polycyclic aromatic hydrocarbons (from opium and indoor air pollution), and nutrient-deficient diets. We also associated ESCC risk with exposure to unpiped water and tooth loss.
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Affiliation(s)
- Mahdi Sheikh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Gholamreza Roshandel
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hooman Khademi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Zahedi
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Behnoush Abedi-Ardekani
- Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, United States
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Paul D Pharaoh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Nicholas E. Day
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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27
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Okongo F, Ogwang DM, Liu B, Maxwell Parkin D. Cancer incidence in Northern Uganda (2013-2016). Int J Cancer 2019; 144:2985-2991. [PMID: 30536374 DOI: 10.1002/ijc.32053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/26/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023]
Abstract
Gulu Cancer Registry was established in 2014 to assess the incidence and survival of cancer in 4 districts of the Acholi Sub-region of northern Uganda. Here we report the results of the first 4 years of registration (2013-2016) in this largely rural population of 771,514. In total there were 1627 cases of cancers registered; 644 among men (corresponding to an ASR of 106.7 per 100,000 population) and 983 cancer cases among women (ASR 118.5 per 100,000). The most common cancers were cancers of the cervix and non-Hodgkin Lymphoma in females, and non-Hodgkin Lymphoma, Kaposi Sarcoma, prostate and liver cancers in men. Incidence rates of Burkitt lymphoma in children were high in comparison to elsewhere in Africa, whilst the incidence of breast cancer in women was rather low. The figures suggest a rather different pattern from that observed in the metropolitan population of Kampala, where there has been a cancer registry since 1951. This helps to provide a more complete picture of the national cancer profile, permitting more targeted interventions in prevention, early detection and treatment services.
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Affiliation(s)
- Francis Okongo
- Gulu Cancer Registry, St. Mary's Hospital Lacor, Gulu, Uganda
| | | | - Biying Liu
- African Cancer Registry Network, Oxford, United Kingdom
| | - Donald Maxwell Parkin
- African Cancer Registry Network, Oxford, United Kingdom.,Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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28
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Come J, Castro C, Morais A, Cossa M, Modcoicar P, Tulsidâs S, Cunha L, Lobo V, Morais AG, Cotton S, Lunet N, Carrilho C, Santos LL. Clinical and Pathologic Profiles of Esophageal Cancer in Mozambique: A Study of Consecutive Patients Admitted to Maputo Central Hospital. J Glob Oncol 2018; 4:1-9. [PMID: 30398947 PMCID: PMC7010456 DOI: 10.1200/jgo.18.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Eastern Africa was recently described as a high-incidence geographic area for esophageal cancer. Mozambique is included in this region. This study aimed to characterize this malignant disease at Maputo Central Hospital (MCH) to develop a global program for esophageal cancer management in Mozambique. METHODS MCH records from between 2012 and 2016 were used to assess the clinical, pathologic, and outcome profiles of esophageal tumors. A descriptive analysis of data collected was performed. Overall survival was evaluated using Kaplan-Meier curves. RESULTS In the study, 522 consecutive patient cases of esophageal cancer were recorded. The median patient age was 56.1 years (range, 27 to 97 years); 291 (55.7%) patients were women, and 230 (44.1%) were men. Regarding tumor site, 113 patients (21.6%) had a tumor in the lower third, 154 (29.5%) in the middle, and 50 (9.6%) in the upper third of the esophagus; in the remaining 196 (37.5%), tumor site was unknown. Squamous cell carcinoma comprised 94.4% of cases with documented histopathology (74.9% of the sample). Surgical treatment was possible in 32 patients (6.1%). Disease stage was documented only in these 32 surgical patients; 28.1%, 53.1%, and 18.8% had stage I, II, and III disease, respectively. The remaining patient cases seemed to involve clinically advanced tumors. The median follow-up time was of 1.6 months. The median survival time was of 3.5 months for all patients; for patients treated with curative intent, it was of 8.7 months. CONCLUSION Esophageal carcinoma is a common malignant tumor at MCH and is diagnosed in the advanced stages resulting in poor prognosis. Therefore, implementation of an Esophageal Cancer Program in Mozambique is essential.
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Affiliation(s)
- Jotamo Come
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Clara Castro
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Atílio Morais
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Matchecane Cossa
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Prassad Modcoicar
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Satish Tulsidâs
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Lina Cunha
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Vitória Lobo
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Alberto Gudo Morais
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Sofia Cotton
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Nuno Lunet
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Carla Carrilho
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
| | - Lúcio Lara Santos
- Jotamo Come, Atílio Morais, Matchecane Cossa, Prassad Modcoicar, Satish Tulsidás, Lina Cunha, Vitória Lobo, Alberto Gudo Morais, and Carla Carrilho, Hospital Central de Maputo; Carla Carrilho, Universidade Eduardo Mondlane, Maputo, Moçambique; Clara Castro, Sofia Cotton, and Lúcio Lara Santos, Instituto Português de Oncologia; Clara Castro and Nuno Lunet, Universidade do Porto; Sofia Cotton, Project ESTIMA-01-0145-FEDER-000027; Sofia Cotton and Lúcio Lara Santos, Grupo de Patologia e Terapêutica Experimental; Lúcio Lara Santos Universidade Fernando Pessoa, Porto, Portugal
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Investigation into the Anticancer Activity and Apoptosis Induction of Brevinin-2R and Brevinin-2R-Conjugated PLA–PEG–PLA Nanoparticles and Strong Cell Cycle Arrest in AGS, HepG2 and KYSE-30 Cell Lines. Int J Pept Res Ther 2018. [DOI: 10.1007/s10989-018-9772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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