Factors associated with carcinoma of the oesophagus at Mulago Hospital, Uganda

Department of Medicine, Makerere University, Uganda.
African health sciences (Impact Factor: 0.72). 07/2008; 8(2):80-4.
Source: PubMed


In Uganda, as in many other parts of the world cancer of the oesophagus (CAE) is on the rise. Squamous cell carcinoma and adenocarcinoma are the common subtypes. Risk factors for this cancer have been identified but not studied systematically in Uganda. Identification of these factors would enable establishment of preventive measures.
To determine the prevalence, histological features and associated factors for CAE among patients referred to the endoscopic unit of Mulago hospital, Kampala, Uganda.
We performed a 1-year cross-sectional study in 2004 and 2005 of all patients presenting for oesophageal-gastro-duodenoscopy (EGD) at Mulago Hospital. Demographic characteristics, behavioural practices, endoscopy findings and histology results where biopsies were performed were collected using a study tool. Data analysis was done using STATA 8 statistical package.
Two hundred nineteen patients were enrolled in the study, three were excluded because they could not tolerate the endoscopy procedure. Fifty five (19%) of the 287 had histologically proven CAE. Squamous cell carcinoma was found in 100% of tumours of the upper third, 91% middle third, and 73% lower third of the oesophagus. Four patients had a histological diagnosis of adenocarcinoma of the oesophagus. Factors that were associated with CAE included age (OR 1.63, CI 1.34-1.98, p value <0.001), smoking (OR 3.63, CI 1.82-7.23, p value <0.001) and gender (OR 2.17, CI 1.07-4.41, p value 0.032).
Many patients referred for EGD in Uganda had esophageal cancer most of which were.squamous cell type. Smoking, male gender and older age were risk factors. Preventive measures should target stopping smoking.

Download full-text


Available from: Robert Colebunders
  • Source
    • "SCC developed in flat cells that lined the esophagus. Similar pattern of esophageal cancer has been reported [27, 28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Esophageal cancer at Moi Teaching and Referral Hospital (MTRH) is the leading cancer in men with a poor prognosis. A case control study (n = 159) aimed at the histology type, gender, and risk indicators was carried out at MTRH. Mantel Haenszel chi-square and logistic regression were employed for analysis. Squamous-cell carcinoma was the common histological type occurring in the middle third portion of the oesophagus. The occurrence of the cancer in males was 1.4 times that of females. The mean age was 56.1 yrs. Low socioeconomic, smoking, snuff use, alcohol, tooth loss, cooking with charcoal and firewood, hot beverage, and use of mursik were independently associated with esophageal cancer (P < 0.05). Using logistic regression adjusted for various factors, alcohol consumption was associated with the increased risk of esophageal cancer. AHR was 0.45 and 95% CI: 0.205-0.985, P = 0.046. A societal component of low socioeconomic conditions, a lifestyle component with specific practices such as the consumption of mursik, chang'aa, busaa, snuff, smoking, hot tea, poor oral hygiene, and an environmental component with potential exposure to high levels of nitrosamines, passive smoking, and cooking with coal, could be involved. The increase in experts at MTRH capable of diagnosing could be responsible for the increase in reporting this neoplasm.
    Full-text · Article · Dec 2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectif Répertorier les différentes pathologies digestives observées dans une unité de gastroentérologie de l’hôpital Joseph Raseta Befelatanana, du CHU d’Antananarivo afin de déterminer leur morbidité et leur mortalité respectives. Matériels et méthodes Il s’agit d’une étude rétrospective ayant inclus toutes les pathologies digestives diagnostiquées dans l’unité de gastroentérologie de l’hôpital Joseph Raseta Befelatanana du CHU d’Antananarivo entre le 1er juin 2007 et le 30 juin 2009. Résultats Les maladies digestives représentaient 16,03 % des motifs d’admission. Trois cent vingt-huit cas de maladies digestives étaient répertoriés, soit 276 patients. Le sexe masculin était plus exposé aux maladies digestives entre 30 et 70 ans (n = 139, soit 42,37 %). La cirrhose était la plus fréquente des maladies digestives (n = 110, soit 33,54 %) suivie des ulcères duodénaux (n = 32, soit 9,76 %). Elle était responsable du taux de mortalité le plus élevé (n = 25, soit 22,73 %). Conclusion Les maladies digestives constituent un motif d’hospitalisation fréquent en service de médecine à Madagascar. La cirrhose est la plus fréquente et la plus meurtrière.
    No preview · Article · Jun 2012 · Journal Africain d?Hépato-Gastroentérologie
  • Source

    Preview · Article · Jul 2008 · African health sciences
Show more