Descriptive analysis of colorectal cancer in Zambia, Southern Africa using the National Cancer Disease Hospital Database

Abstract

IntroductionColon cancer is preventable. There is a plethora of data regarding epidemiology and screening guidelines, however this data is sparse from the African continent. Objective: we aim to evaluate the trends of colorectal cancer (CRC) in a native African population based on age at diagnosis, gender and stage at diagnosis.MethodsWe conducted a retrospective analysis of the Cancer Disease Hospital (CDH) registry in Zambia, Southern Africa.Results377 charts were identified in the CDH registry between 2007 and 2015, of which 234 were included in the final analysis. The mean age at diagnosis was 48.6 years and 62% are males. Using descriptive analysis for patterns: mode of diagnosis was surgical in 195 subjects (84%), histology adenocarcinoma in 225 (96.5%), most common location is rectum 124 (53%) followed by sigmoid 31 (13.4%), and cecum 26 (11%). 122 subjects (54%) were stage 4 at diagnosis. Using the Spearman rank correlation, we see no association between year and stage at diagnosis (p = 0.30) or year and age at diagnosis (p = 0.92).ConclusionColorectal cancer was diagnosed at a young age and late stage in the Zambian patients.

Incidence of colorectal cancer in Eritrea: Data from the National Health Laboratory, 2011-2017

“…Although, researchers generally agree that the burden of CRC in SSA will increase, the true incidence, prevalence and burden of CRC remain uncertain [2, 3]. This uncertainty has largely been attributed to the dearth of high-quality cancer registries and the limited number of studies [1, 4, 10]. Additional concern includes the possibility that data from existing registries is often suboptimal/partial or conflicting, hence, incomprehensive [4, 10].…”

“…This uncertainty has largely been attributed to the dearth of high-quality cancer registries and the limited number of studies [1, 4, 10]. Additional concern includes the possibility that data from existing registries is often suboptimal/partial or conflicting, hence, incomprehensive [4, 10]. Corroborating this conclusion, trace-back of cancer deaths to obtain the corresponding hospital records has demonstrated that quality of diagnostic information on cancer cases is generally poor [10].…”

“…Additional concern includes the possibility that data from existing registries is often suboptimal/partial or conflicting, hence, incomprehensive [4, 10]. Corroborating this conclusion, trace-back of cancer deaths to obtain the corresponding hospital records has demonstrated that quality of diagnostic information on cancer cases is generally poor [10]. Limited diagnostic infrastructure and late presentation of cases to health care providers also undermine the validity of CRC data from the region.…”

Colorectal Cancer in Northern Tanzania: Increasing Trends and Late Presentation Present Major Challenges

“…With regard to early-onset CRC, CRC in individuals of African origin has been observed to develop at a relatively younger age 5,10,17,18 compared with white people. 19,20 Arguments on the difference in tumor biology and risk factors that place individuals of African descent at a relatively higher risk have been pointed out.…”

“…9 Exploring these factors in our communities may help address the increasing incidence and the observed trend of young individuals being affected by the disease. 5,8,10 Author affiliations and support information (if applicable) appear at the end of this article. We conducted a record review from 1998 to 2018 for patients with CRC in our center, with the aim of describing the burden of the disease, clinical characteristics of patients, and the extent of the disease at diagnosis.…”