Colorectal cancer in South Africa: An assessment of disease presentation, treatment pathways and 5-year survival

Brand, Martin; Gaylard, P; Ramos, Joana

doi:10.7196/samj.2018.v108i2.12338

Cited by 31 publications

(25 citation statements)

References 21 publications

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“…[26][27][28][29][30] The increase in ASMR might be associated with quality of care within the country's health system, for example, ine cient resource allocation (human resources, equipment and medical supplies), lack of access to cancer treatment and or management, and poor health infrastructures may affect mortality rates. [26,[31][32][33][34][35][36][37] Other factors include low or lack of awareness, and screening and early detection to detect and remove precancerous polyps as early as possible before they progress into cancerous lesions, as well as late diagnosis, translating into poor prognosis and ultimately increased mortality rates. [38][39][40][41] Stable ASIR and ASMR were observed among the Asian population group and females of the Coloured population group over the study period.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Incidence and Mortality Trends by Sex and Population Group in South Africa: 2002-2014.

Motsuku

Chen

Muchengeti

et al. 2020

Preprint

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BackgroundSouth Africa (SA) has experienced a rapid transition in the Human Development Index (HDI) over the past decade, which had an effect on the incidence and mortality rates of colorectal cancer (CRC). This study aims to provide CRC incidence and mortality trends by population group and sex in SA from 2002 to 2014.MethodsIncidence data were extracted from the South African National Cancer Registry and mortality data obtained from Statistics South Africa (STATS SA), for the period 2002 to 2014. Age-standardised incidence rates (ASIR) and age-standardised mortality rates (ASMR) were calculated using the STATS SA mid-year population as the denominator and the Segi world standard population data for standardisation. A Joinpoint regression analysis was computed for the CRC ASIR and ASMR by population group and sex.ResultsA total of 33,232 incident CRC cases and 26,836 CRC deaths were reported during the study period. Of the CRC cases reported, 54% were males and 46% were females, and among deaths reported, 47% were males and 53% were females. Overall, there was a 2.5% annual average percentage change (AAPC) increase in ASIR from 2002 to 2014 (95% CI: 0.6- 4.5, p-value <0.001). For ASMR overall, there was 1.3% increase from 2002 to 2014 (95% CI: 0.1- 2.6, p-value <0.001). The ASIR and ASMR among population groups were stable, with the exception of the Black population group. The ASIR increased consistently at 4.3% for black males (95% CI: 1.9- 6.7, p-value <0.001) and 3.4% for black females (95% CI: 1.5- 5.3, p-value <0.001) from 2002 to 2014, respectively. Similarly, ASMR for black males and females increased by 4.2% (95% CI: 2.0- 6.5, p-value <0.001) and 3.4% (, 95%CI: 2.0- 4.8, p-value <0.01) from 2002 to 2014, respectively.ConclusionsThe disparities in the CRC incidence and mortality trends may reflect socioeconomic inequalities across different population groups in SA. The rapid increase in CRC trends among the Black population group is concerning and requires further investigation and increased efforts for cancer prevention, early screening and diagnosis, as well as better access to cancer treatment.

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Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Incidence and Mortality Trends by Sex and Population Group in South Africa: 2002-2014.

Motsuku

Chen

Muchengeti

et al. 2020

Preprint

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“…Based on a comorbidity group comprising 10% of the total sample, with accrual and final follow-up periods of 2.5 years and 0.5 years, respectively, the detection of a hazard ratio of at least 1.8 with 80% power at the 5% significance level required a minimum sample size of 417 patients. [20,21]…”

Section: Sample Sizementioning

confidence: 99%

“…disease at presentation. [20,29,30,33,[35][36][37] However, distant disease at time of presentation is not unique to LMIC settings, and has been extensively described in HICs, albeit in older persons. [8,9,12,14,18] The trend of younger people presenting with advanced disease in our setting may be attributed to a number of contextual factors.…”

Section: Researchmentioning

confidence: 99%

It’s contrary – comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort

et al. 2020

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According to GLOBOCAN, colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancerrelated death, with 1.85 million new cases diagnosed worldwide in 2018. [1,2] The incidence of CRC appears to be increasing in emerging low-and middle-income countries (LMICs) owing to socioepidemiological transitions, including dietary changes, with countries in sub-Saharan Africa (SSA) reporting a notable increase in colorectal, breast and prostate cancer. [3,4] South Africa (SA) is no exception-the incidence of CRC is increasing steadily, and it was the sixth leading cause of cancer-related death in 2018. [1] It is noteworthy that apart from increasing incidence, the average age of CRC patients at the time of diagnosis in SSA is ~10 years younger than that observed in high-income countries (HICs). [5,6] In addition, other non-communicable diseases (NCDs), including diabetes and respiratory and cardiovascular disease, are on the rise, with the prevalence in SA being reported as two to three times higher than in HICs. [7] While there are no published data on comorbidity with CRC from SSA, many CRC cohorts from HICs describe a considerable comorbidity burden that adversely affects short-(30-day) and long-This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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“…The majority of data sets identified arose from prospective cohorts of patients. Several of these studies were performed in single centres 43,65 or single nations 79,81 , with comparisons made with high-income countries. The largest cohort of patients originated from the DATASUS registry in Brazil (428 346 patients), which explored outcomes after hysterectomy 80 .…”

Section: Patients and Studiesmentioning

confidence: 99%

“…Outcomes following cancer surgery were common topics, including breast 19,31,38,45 -47,77 , gastric 16,22,23,61 , colorectal 24,59,76,81 and prostate 18,30 cancer, and hepatocellular carcinoma 56,60 . Cardiac surgery 34,43,65,70 , caesarean section 44,49,69 and genitourinary fistula 27,33,74 were also well represented in included articles, whereas clinical presentations included burn management 55 71 , groin hernias 35 and orthopaedic fracture management 48,73 .…”

Section: Subject Of Studiesmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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Background Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. Methods A PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively. Results A total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited. Conclusion Large volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.

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Colorectal cancer in South Africa: An assessment of disease presentation, treatment pathways and 5-year survival

Cited by 31 publications

References 21 publications

Colorectal Cancer Incidence and Mortality Trends by Sex and Population Group in South Africa: 2002-2014.

Colorectal Cancer Incidence and Mortality Trends by Sex and Population Group in South Africa: 2002-2014.

It’s contrary – comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort

Systematic review of the use of big data to improve surgery in low- and middle-income countries

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