e13079 Background: The recent epidemiology of cancers in Haiti is poorly understood, since there is no functional national cancer registry. The data from GLOBOCAN 2012 and 2018 are estimations that do not reflect the actual cancer burden in Haiti. The aim of this study was to present the three-year epidemiology of cancer cases managed by a cancer program in Port-au-Prince, Haiti. Methods: A retrospective study was conducted on patients aged 15 years old or more with pathological and/or clinical diagnosis at the cancer clinic of Innovating Health International (IHI) from January 2016 to December 2018. The chart review collected variables such as age, gender, date of diagnosis, cancer type and outcome to present this epidemiological profile of cancers. Results: One thousand four hundred and eighty-one (1481) cancer cases were managed during this study period, respectively 282 in 2016, 513 in 2017 and 686 in 2018 (p < 0.001). 84% of the patients were female and 16% male. The mean age of the study population was 51.8 years [15 –92], ranging from 51.7 years in 2016 to 52.1 years in 2018 (p = 0.56). Adolescents and young adults (15-39 years old) represented 20.9% of this cohort and geriatric cases (≥ 65 years old) 19.6%. Breast cancer was the most common type (n = 686, 46.3%), followed by gynecological cancers (n = 330, 22.3%) with cervical cancer representing 70.9% of the cases, gastrointestinal cancers (n = 138, 9.3%), hematological malignancies (n = 75, 5.1%), head and neck cancers (n = 64, 4.3%), sarcomas (n = 40, 2.7%), urological cancers (n = 32, 2.2%), skin cancers including melanoma (n = 29, 2%), lung cancer (n = 13, 0.9%), thyroid cancer (n = 10, 0.7%) and central nervous system (CNS) cancers (n = 2, 0.1%). 4.2% of the patients (n = 62) had a cancer of unknown primary (CUP). Breast cancer was the most common type among women (54.7%) and gastrointestinal cancers the most diagnosed among men (25.3%). There was a predominance of women for most of the cancer types. The overall mortality rate was 31% and 8.6% of the patients were lost to follow-up. Conclusions: There was a significant increase of cancer cases in our cancer clinic from 2016 to 2018, likely due to a combination of our cancer awareness campaign, increased diagnosis and referral. Cancer mainly affects Haiti’s young, feminine and active population. Breast and cervical cancers were the most prevalent in this retrospective cohort. The under-representation of prostate and other urological cancers, lung cancer, acute leukemias and CNS cancers was likely due to underdiagnosis, misdiagnosis, under-referral or early mortality.
e13589 Background: The epidemiology of cancer among adolescents and young adults (AYA) has been a relatively neglected topic, particularly in the developing countries. The main objective of this study was to present the epidemiology of cancer among this subpopulation in Haiti’s largest cancer program. Methods: A retrospective study was conducted on patients aged 15 to 39 years old with pathological and/or clinical diagnosis of cancer at the cancer clinic of Innovating Health International (IHI) in Port-au-Prince, Haiti from January 2016 to December 2019. The chart review collected variables such as age, gender, date of diagnosis, cancer type and outcome to present this epidemiological profile of AYA cancers. Results: Among the two thousand two hundred and ninety-eight (2298) cancer cases managed during this study period, 20.1% (n = 461) were adolescents and young adults. 82% of these patients were female and 18% male. 25.2% (n = 116) were less than 30 years old. Breast cancer was the most common type (n = 222, 48.2%%), followed by gynecological cancers (n = 70, 15.1%) with cervical cancer representing 61.4% of the cases (n = 43), hematological malignancies (n = 44, 9.5%) with lymphomas (n = 31) as the most common type, sarcomas (n = 43, 9.3%), head and neck cancers (n = 24, 5.2%), gastrointestinal cancers (n = 22, 4.8%), cutaneous cancers (n = 10, 2.2%), urological cancers (n = 5, 1.1%), thyroid cancer (n = 5, 1.1%) and CNS tumors (n = 2, 0.4%). 3.0% of the AYA patients (n = 14) presented with a cancer of unknown primary (CUP). In the < 30 y/o subgroup blood cancers, breast cancer, sarcomas, and head and neck malignancies were respectively the most common types, while in the ≥ 30 y/o subgroup, breast and gynecological cancers were the most common, followed by sarcomas, GI and blood cancers. No case of lung cancer was received for the AYA population. The overall mortality rate was 30.6% and 12.8% of the patients were lost to follow-up. Conclusions: Cancers among AYA patients represented 20.1% of the cancer population, with a different epidemiological profile for the < 30 y/o and ≥ 30 y/o subgroups. The CNS tumors, leukemias and urological cancers were most likely under-represented due to low referral, misdiagnosis or early mortality.
e23515 Background: Sarcomas are among the least described cancers diagnosed in Haiti. Suboptimal surgery and the unavailability of radiation therapy make their management challenging. The main objective of this study was to present the epidemiology, clinical features and histopathology of sarcomas in the Haitian setting. Methods: A seven-year retrospective study was conducted in the cancer program of Innovating Health International (IHI). We included all patients with clinical or histological diagnosis of sarcoma enrolled from January 1, 2014 to December 31, 2020. Date of first visit, age, gender, stage, anatomical site, histology, outcome as of December 31, 2020 and date of death were the main variables selected for this chart review. Mortality rate and overall survival were also evaluated. Results: One hundred and twenty-two (122) patients with sarcomas were diagnosed and treated during the study period. Their mean age was 43.3 years [range: 15-88] and the sample was 62.3% women and 37.7% men. 49.2% of the patients were less than 40 years of age. Among the cases of sarcomas, 86.9% were soft tissue sarcomas and 13.1% bone sarcomas. The lower limbs (36.9%), abdomen (14.8%), head and neck (13.1%), upper limbs (12.3%) and breasts (7.4%) were the most common locations of the sarcomas. 81% of abdominal/pelvic sarcoma cases (n=21) were in women. The most common histological types (n=94) were fibrosarcoma (15.2%), liposarcoma (10.9%), dermatofibrosarcoma protuberans (8.7%), malignant histiocytofibroma (6.5%), rhabdomyosarcoma (5.4%) and gastrointestinal stromal tumor (5.4%). 19.6% of the patients had metastatic disease. The mortality rate for the study period was 53.3% and 17.2% of the patients were lost to follow-up. The median overall survival was 7.2 months for the cohort and 18.4 months for the treated patients (n=70). Conclusions: The sarcomas seen in this Haitian medical clinic mainly affect the soft tissues of limbs, abdomen and head and neck. There is a strong predominance of female patients and about half of the patients are aged less than 40. Despite a low metastatic presentation rate, the prognosis is poor, likely reflecting both the aggressiveness of this group of diseases and the disparities of outcomes between high-income and low-and-middle-income countries.
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