Childhood cancers in a referral hospital in northern Nigeria

Abstract

Background:We undertook this study to determine the relative frequencies of childhood malignancies and their age – sex distribution in this environment.Materials and Methods:Hospital-based data of histological and cytologically confirmed cases of malignancies in children, aged ≤ 15 years, was collated over a period of 11 years, from the Cancer Registry.Results:A total of 329 children aged ≤ 15 years, with confirmed malignant disease, was recorded. This constituted 8.44% of all malignancies diagnosed in the same period with a Male : Female ratio of 1.5:1. Burkitt’s lymphoma accounted for 27.01% of the cases followed by retinoblastoma (17.02%), non-Hodgkin’s non-Burkitt’s Lymphoma (9.42%), and Rhabdomyosarcoma (9.42%). Others were Nephroblastoma (8.81%), Hodgkin’s lymphoma (6.69%), Neuroblastoma (3.34%), Colorectal carcinoma (2.43%), Osteosarcoma (2.13%), and Unspecified lymphomas (1.82%). Burkitt’s lymphoma was most prevalent in the 5–9 and 10–15 year age groups, retinoblastoma in the 0–4 year age group, and Non–Hodgkin’s lymphoma, Hodgkin’s lymphoma, and unspecified carcinomas were more prevalent in the 10–15 year age group.Conclusion:Lymphomas were the most prevalent malignancies of childhood seen in this region and the majority were of the Burkitt type, in contrast to the predominant leukemic and central nervous system trend seen in developed nations.

A review of the literature on childhood Burkitt lymphoma in Nigeria

“…Burkitt lymphoma was the commonest in eight of the centres namely Enugu, Zaria, Jos, Ekiti, Calabar, Sagamu, Abia and Gwagwalada with prevalence ranging from 18.3 to 65.0% of malignant tumours of child hood in the various centers [9][10][11][18][19][20][21][22] . These centres are spread across the FCT and five geopolitical zones but excluding the north east geopolitical zone.…”

“…Out of the fifteen studies on children, fourteen spread across all geopolitical zones reported peak ages of 5-10 years (10,11,(13)(14)(15)(16)19,22,23,25,27,30,(39)(40)(41) . Only one study on children, from Sagamu reported a peak age of 1-5 years (18).…”

“…Fifteen studies from nine centres across northern and southern Nigeria described the sex distribution of patients with Burkitt lymphoma and all reported male predominance with a male: female ratio ranging from 1.2-2.7: 1 (10,(13)(14)(15)(16)19,22,23,27,30,(39)(40)(41)(42)44,45).…”

“…Burkitt lymphoma is therefore expected to be common in Nigeria, given its geographical location. Studies from several states of the country report Burkitt Lymphoma to be the most common type of cancer in children [9][10][11] but a few have reported the contrary 12,13 . A centre within the country has reported a downward trend in the relative frequency of Burkitt Lymphoma with respect to other tumours but this has not been appraised in most parts of the country 12 .…”

Childhood malignant tumours in owerri

“…Furthermore, other studies demonstrated that neuroblastoma constituted 5.3%, 5.1%, 4.8%, 3.34% and 1.9% in Lagos, Kano, Uyo, Zaria and Enugu respectively. [4][5][6][7][8] Osteosarcoma is the eighth common cancer of childhood and its incidence is 4 cases in a million of children younger than 14 years. [26] Osteogenic sarcoma contributed (3 cases)11.11% of all childhood tumors in this study with a mean age of 8.67±1.15 years, peak age in the 6-10 years age groups and age range of 7 to 10 years.…”