There are limited population‐based survival data for colorectal cancer (CRC) in sub‐Saharan Africa. Here, 1707 persons diagnosed with CRC from 2005 to 2015 were randomly selected from 13 population‐based cancer registries operating in 11 countries in sub‐Saharan Africa. Vital status was ascertained from medical charts or through next of kin. 1‐, 3‐ and 5‐year overall and relative survival rates for all registries and for each registry were calculated using the Kaplan‐Meier estimator. Multivariable analysis was used to examine the associations of 5‐year relative survival with age at diagnosis, stage and country‐level Human Development Index (HDI). Observed survival for 1448 patients with CRC across all registries combined was 72.0% (95% CI 69.5‐74.4%) at 1 year, 50.4% (95% CI 47.6‐53.2%) at 3 years and 43.5% (95% CI 40.6‐46.3%) at 5 years. We estimate that relative survival at 5 years in these registry populations is 48.2%. Factors associated with poorer survival included living in a country with lower HDI, late stage at diagnosis and younger or older age at diagnosis (<50 or ≥70 years). For example, the risk of death was 1.6 (95% CI 1.2‐2.1) times higher for patients residing in medium‐HDI and 2.7 (95% CI 2.2‐3.4) times higher for patients residing in low‐HDI compared to those residing in high‐HDI countries. Survival for CRC remains low in sub‐Saharan African countries, though estimates vary considerably by HDI. Strengthening health systems to ensure access to prevention, early diagnosis and appropriate treatment is critical in improving outcomes of CRC in the region.

Trends in the incidence of cancer in the population of Kyadondo County, Uganda—which comprises the city of Kampala and a peri‐urban hinterland—are presented for a period of 25 years (1991‐2015) based on data collected by the Kampala Cancer Registry. Incidence rates have risen overall—age‐adjusted rates are some 25% higher in 2011 to 2015 compared with 1991 to 1995. The biggest absolute increases have been in cancers of the prostate, breast and cervix, with rates of some 100% (prostate), 70% (breast) and 45% (cervix) higher in 2010 to 2015 than in 1991 to 1995. There were also increases in the incidence of cancers of the esophagus and colon‐rectum (statistically significant in men), while the incidence of liver cancer—the fifth most common in this population—increased until 2007, and subsequently declined. By far the most commonly registered cancer over the 25‐year period was Kaposi sarcoma, but the incidence has declined, consistent with the decreasing population‐prevalence of HIV. Non‐Hodgkin lymphomas, also AIDS‐related, increased in incidence until 2006/2007 and then declined—possibly as a result of availability of antiretroviral therapy. The trends reflect the changing lifestyles of this urban African population, as well as the consequences of the epidemic of HIV/AIDS and the availability of treatment with ARVs. At the same time, it highlights the fact that the decreases in cancer of the cervix observed in high and upper‐middle income countries are not a consequence of changes in lifestyle, but demand active intervention through screening (and, in the longer term, vaccination).

BackgroundThe prevalence and distribution of histologically diagnosed breast disease are not well documented in low income countries, Uganda inclusive. Although the greater majority of breast lesions globally are benign, breast cancer is the most frequently diagnosed cancer all over the world. We aimed at documenting the prevalence of different breast diseases histologically diagnosed at the histopathology laboratory of the Department of Pathology of the Makerere University College of Health Sciences (MakCHS Lab) over a decade (2005–2014). We also describe the demographic characteristics of the patients in Uganda diagnosed with breast disease at the MakCHS Lab during the same period.MethodsThis was a 10 year retrospective study of histologically diagnosed breast disease between 2005 and 2014 inclusive at the MakCHS Lab. We extracted information from hard copies of all 2510 histopathology reports retrieved from archives of the Department of Pathology at the MakCHS Lab. 640 records that were either damaged beyond recognition of key details, were duplicated, were implausible or had no conclusive diagnosis made were excluded. Information to be analyzed was then entered into Epidata (version 3.1) on a password protected laptop. Data analysis was done using SPSS software (v16 for Windows × 64).ResultsFrom the 1870 patients’ records eventually analyzed, breast disease was most diagnosed in female patients (97.1%). The overall mean age for breast disease diagnosis was 33 years (S.D ± 16.46) and median age 26 years (IQR: 20–43). Fibroadenoma (40.1%) was the most diagnosed breast disease overall. We noticed steadily increasing frequency of diagnosis of cancerous breast diseases over the last half of the study period. Invasive ductal carcinoma was the most diagnosed breast cancer (326 cases, 55.6%). A high female to male breast cancer ratio of 48:1 was observed. The highest regional breast cancer proportion was from the Western region of the Country.ConclusionsThere is need for more research into the picture of breast disease in the country, covering various demographic characteristics of the country’s population for all regions and informing about its incidence rates and prevalence and also the breast cancer risk estimate for benign breast disease.

Ovarian cancer (OC) is one of the commonest cancers of women in sub‐Saharan Africa (SSA), although to date no data have been available on time trends in incidence to better understand the disease pattern in the region. We estimate time trends by histological subtype from 12 population‐based cancer registries in 11 countries: Kenya (Nairobi), Mauritius, Seychelles, Uganda (Kampala), Congo (Brazzaville), Zimbabwe (Bulawayo and Harare), Cote d'Ivoire (Abidjan), The Gambia, Mali (Bamako), Nigeria (Ibadan) and South Africa (Eastern Cape). The selected registries were those that could provide consistent estimates of the incidence of ovarian cancer and with quality assessment for periods of 10 or more years. A total of 5423 cases of OC were included. Incidence rates have been increasing in all registries except Brazzaville, Congo, where a nonsignificant decline of 1% per year was seen. Statistically significant average annual increases were seen in Mauritius (2.5%), Bamako (5.3%), Ibadan (3.9%) and Eastern Cape (8%). Epithelial ovarian cancer was responsible for the increases observed in all registries. Statistically significant average annual percentage changes (AAPC) for epithelial OC were present in Bamako (AAPC = 5.9%), Ibadan (AAPC = 4.7%) and Eastern Cape (AAPC = 11.0%). Creating awareness among professionals of the growing importance of the disease is surely an important step to improving availability of, and access to, diagnosis and treatment of OC in SSA. Support must be given to the cancer registries to improve the availability of good‐quality data on this important cancer.

Background Fine needle aspiration cytology of the thyroid gland has proven to be effective in the categorization of thyroid lesions into benign, atypical, suspicious and malignant categories. However only scanty data has been available regarding the prevalence of thyroid lesions in Uganda. This study aimed at classifying thyroid lesions cytologically and to determine their correlation with the social demographic characteristics. Methodology: A laboratory based retrospective study involving a review of 170 cases was conducted at MAKCHS pathology department between 2012 and 2016. FNA results were independently categorized into 4 groups in accordance to Bethesda system for reporting thyroid cytopathology. The data collected was entered using Epidata software and exported to SPSS for analysis. Results Out of the 170 cases reviewed, 148 (87.1%) were benign, 3 (1.8%) were suspicious for Follicular Neoplasm, 5 (2.9%) were suspicious of malignancy & 14 (8.2%) were malignant. Colloidal nodule (41.2%) was most prevalent lesion among the benign cases, followed by Follicular adenoma (25.3%). Malignant category was dominated by papillary carcinoma (7.1%). The peak age group for benign lesions was 40–49 years whereas the peak age group for malignant lesions was 40–49 years & 50-59years age group. Conclusion The present findings are consistent with those published in other literature with benign lesions showing predominance over the malignant lesions. Sex and age were found to be associated with a specific diagnosis with the females being most affected as well as those in the older groups.