The incidence and histo-pathological characteristics of colorectal cancer in a population based cancer registry in Zimbabwe

Katsidzira, Leolin; Chokunonga, Eric; Gangaidzo, Innocent T.; Rusakaniko, Simbarashe; Borok, Margaret; Matsena-Zingoni, Zvifadzo; Thomson, Sandie; Ramesar, Raj; Matenga, Jonathan

doi:10.1016/j.canep.2016.08.001

Cited by 15 publications

(9 citation statements)

References 12 publications

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“…Recent data from Zimbabwe show that the incidence of CRC is increasing, possibly owing to a combination of improved diagnosis and a true increase in new cases. [10,11] These increases have also been reported in several countries across Africa, and SA should be no exception. There is limited knowledge on the pattern of neoplastic RESEARCH polyps in SA and the sub-Saharan African region, which could guide prevention strategies and help to estimate the trajectory of CRC.…”

supporting

confidence: 59%

Prevalence and characteristics of incidental colorectal polyps in patients undergoing colonoscopy at a South African tertiary institution

et al. 2020

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Colorectal cancer (CRC) is the second most common cancer in women, and the third most common in men, and accounts for 10% of all cancers worldwide. [1] Classically, CRCs arise from adenomas, through the adenoma-carcinoma sequence described by Fearon and Vogelstein. [2] The prevalence of adenomas in a population generally correlates with the incidence of CRC. The latter varies widely across the globe, with the USA and Western European countries reporting age-standardised incidence rates per 100 000 population, averaging 29.5 for men and 23.2 for women. [1] This is in sharp contrast to sub-Saharan African countries that report much lower age-standardised incidence rates, ranging from 6.3 in men and 2.7 in women in Mozambique, to the highest rates, i.e. 15.6 in men and 9.5 in women in South Africa (SA). [1,3] Although there are reasonably adequate reports on the epidemiology of CRC in sub-Saharan Africa, data on the prevalence of adenomas are sparse. In an analysis of 91 surgical resections for CRC between 1996 and 1997 in Pretoria, SA (white: n=48; black African: n=43), adenomas were found in 25% of whites and 20% of black Africans. [4] A retrospective review in 1999 reported that of 172 CRC resections in black Africans on the Witwatersrand, SA, 5% This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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confidence: 59%

Prevalence and characteristics of incidental colorectal polyps in patients undergoing colonoscopy at a South African tertiary institution

et al. 2020

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“…50 years on, fibre intake in HICs remains well below the greater than 50 g/day advocated by Burkitt, which is of grave concern; moreover, the number of disease cases are increasing in HICs, and, with the spread of HIC-associated diets, these diseases are making an appearance in middle-income and low-income countries around the world, including African countries (eg, Zimbabwe). 10 In the UK, the average fibre intake is about 18 g/day 11 and in the USA the average intake is 16 g/day. 12 So, why has progress been so slow?…”

Section: The Fibre Hypothesismentioning

confidence: 99%

The association between dietary fibre deficiency and high-income lifestyle-associated diseases: Burkitt's hypothesis revisited

O'Keefe

2019

The Lancet Gastroenterology & Hepatology

126

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In 1969, Denis Burkitt published an article titled "Related disease-related cause?", which became the foundation for Burkitt's hypothesis. Working in Uganda, he noted that middle-aged people (40-60 years old) had a much lower incidence of diseases that were common in similarly aged people living in England, including colon cancer, diverticulitis, appendicitis, hernias, varicose veins, diabetes, atherosclerosis, and asthma, all of which are associated with lifestyles commonly led in high-income countries (HICs; also known as western diseases). Following Cleave's common cause hypothesis-which suggests that if a group of diseases occur together in the same population or individual, they are likely to have a common cause-Burkitt attributed these diseases to the small quantities of dietary fibre consumed in HICs due mainly to the overprocessing of natural foods. Nowadays, dietary fibre intake in HICs is around 15 g/day (well below the amount of fibre Burkitt advocated of >50 g/day-which is associated with diets from rural, southern and eastern sub-Sahalean Africa). Since Burkitt's death in 1993, his hypothesis has been verified and extended by large-scale epidemiological studies, which have reported that fibre deficiency increases the risk of colon, liver, and breast cancer and increases all cancer mortality and death from cardiovascular, infectious, and respiratory diseases, diabetes, and all noncardiovascular, non-cancer causes. Furthermore, mechanistic studies have now provided molecular explanations for these associations, typified by the role of short-chain fatty acids, products of fibre fermentation in the colon, in suppressing colonic mucosal inflammation and carcinogenesis. Evidence suggests that short-chain fatty acids can affect the epigenome through metabolic regulatory receptors in distant organs, and that this can reduce obesity, diabetes, atherosclerosis, allergy, and cancer. Diseases associated with high-income lifestyles are the most serious threat to health in developed countries, and public and governmental awareness needs to be improved to urge an increase in intake of fibre-rich foods. This Viewpoint will summarise the evidence that suggests that increasing dietary fibre intake to 50 g/day is likely to increase lifespan, improve the quality of life during the added years, and substantially reduce health-care costs.

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“…The age standardised incidence of colorectal cancer in sub-Saharan Africa per 100,000 ranges from 3.1 in men and 2.9 in women in Malawi, to 14.9 in men and 14.2 in women in Zimbabwe [ 3 ]. There has been a gradual temporal increase in the incidence of colorectal cancer in Zimbabwe over the past two decades [ 4 , 5 ]. Despite this increase, the incidence of colorectal cancer is still significantly lower than in the developed world, where the rate is approximately three times higher [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary patterns and colorectal cancer risk in Zimbabwe: A population based case-control study

Katsidzira

Laubscher

Gangaidzo

et al. 2018

Cancer Epidemiology

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The incidence and histo-pathological characteristics of colorectal cancer in a population based cancer registry in Zimbabwe

Cited by 15 publications

References 12 publications

Prevalence and characteristics of incidental colorectal polyps in patients undergoing colonoscopy at a South African tertiary institution

Prevalence and characteristics of incidental colorectal polyps in patients undergoing colonoscopy at a South African tertiary institution

The association between dietary fibre deficiency and high-income lifestyle-associated diseases: Burkitt's hypothesis revisited

Dietary patterns and colorectal cancer risk in Zimbabwe: A population based case-control study

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