Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi
Purpose: Cancer surveillance provides a critical evidence base to guide cancer control efforts, yet population-based coverage in Africa is sparse. Hospital-based registries may help fill this need by providing local epidemiologic data to guide policy and forecast local health care needs. We report t...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2018-06-01
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| Series: | Journal of Global Oncology |
| Online Access: | http://ascopubs.org/doi/10.1200/JGO.17.00174 |
| _version_ | 1818446321247322112 |
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| author | Marie-Josèphe Horner Ande Salima Chrissie Chilima Matthews Mukatipa Wiza Kumwenda Coxcilly Kampani Fred Chimzimu Bal Mukunda Tamiwe Tomoka Maurice Mulenga Richard Nyasosela Steady Chasimpha Charles Dzamalala Satish Gopal |
| author_facet | Marie-Josèphe Horner Ande Salima Chrissie Chilima Matthews Mukatipa Wiza Kumwenda Coxcilly Kampani Fred Chimzimu Bal Mukunda Tamiwe Tomoka Maurice Mulenga Richard Nyasosela Steady Chasimpha Charles Dzamalala Satish Gopal |
| author_sort | Marie-Josèphe Horner |
| collection | DOAJ |
| description | Purpose: Cancer surveillance provides a critical evidence base to guide cancer control efforts, yet population-based coverage in Africa is sparse. Hospital-based registries may help fill this need by providing local epidemiologic data to guide policy and forecast local health care needs. We report the epidemiology of patients with cancer recorded by a de novo hospital-based cancer registry at Kamuzu Central Hospital, Malawi, the sole provider of comprehensive oncology services for half the country and location of a high-volume pathology laboratory. Methods: We conducted active case finding across all hospital departments and the pathology laboratory from June 2014 to March 2016. Patient demographics, tumor characteristics, treatment, and HIV status were collected. We describe epidemiology of the cancer caseload, registry design, and costs associated with registry operations. Results: Among 1,446 registered patients, Kaposi sarcoma and cervical cancer were the most common cancers among men and women, respectively. Burkitt lymphoma was most common cancer among children. The current rate of pathology confirmation is 65%, a vast improvement in the diagnostic capacity for cancer through the hospital’s pathology laboratory. Among leading cancer types, an alarming proportion occurred at young ages; 50% of Kaposi sarcoma and 25% of esophageal, breast, and cervical cancers were diagnosed among those younger than 40 years of age. A systematic, cross-sectional assessment of HIV status reveals a prevalence of 58% among adults and 18% among children. Conclusion: We report a high caseload among typically young patients and a significant burden of HIV infection among patients with cancer. In low- and middle-income countries with intermittent, sparse, or nonexistent cancer surveillance, hospital-based cancer registries can provide important local epidemiologic data while efforts to expand population-based registration continue. |
| first_indexed | 2024-12-14T19:45:52Z |
| format | Article |
| id | doaj.art-feac31078e0742a5a30964deeda067cd |
| institution | Directory Open Access Journal |
| issn | 2378-9506 |
| language | English |
| last_indexed | 2024-12-14T19:45:52Z |
| publishDate | 2018-06-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | Journal of Global Oncology |
| spelling | doaj.art-feac31078e0742a5a30964deeda067cd2022-12-21T22:49:34ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062018-06-01411110.1200/JGO.17.001741Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in MalawiMarie-Josèphe HornerAnde SalimaChrissie ChilimaMatthews MukatipaWiza KumwendaCoxcilly KampaniFred ChimzimuBal MukundaTamiwe TomokaMaurice MulengaRichard NyasoselaSteady ChasimphaCharles DzamalalaSatish GopalPurpose: Cancer surveillance provides a critical evidence base to guide cancer control efforts, yet population-based coverage in Africa is sparse. Hospital-based registries may help fill this need by providing local epidemiologic data to guide policy and forecast local health care needs. We report the epidemiology of patients with cancer recorded by a de novo hospital-based cancer registry at Kamuzu Central Hospital, Malawi, the sole provider of comprehensive oncology services for half the country and location of a high-volume pathology laboratory. Methods: We conducted active case finding across all hospital departments and the pathology laboratory from June 2014 to March 2016. Patient demographics, tumor characteristics, treatment, and HIV status were collected. We describe epidemiology of the cancer caseload, registry design, and costs associated with registry operations. Results: Among 1,446 registered patients, Kaposi sarcoma and cervical cancer were the most common cancers among men and women, respectively. Burkitt lymphoma was most common cancer among children. The current rate of pathology confirmation is 65%, a vast improvement in the diagnostic capacity for cancer through the hospital’s pathology laboratory. Among leading cancer types, an alarming proportion occurred at young ages; 50% of Kaposi sarcoma and 25% of esophageal, breast, and cervical cancers were diagnosed among those younger than 40 years of age. A systematic, cross-sectional assessment of HIV status reveals a prevalence of 58% among adults and 18% among children. Conclusion: We report a high caseload among typically young patients and a significant burden of HIV infection among patients with cancer. In low- and middle-income countries with intermittent, sparse, or nonexistent cancer surveillance, hospital-based cancer registries can provide important local epidemiologic data while efforts to expand population-based registration continue.http://ascopubs.org/doi/10.1200/JGO.17.00174 |
| spellingShingle | Marie-Josèphe Horner Ande Salima Chrissie Chilima Matthews Mukatipa Wiza Kumwenda Coxcilly Kampani Fred Chimzimu Bal Mukunda Tamiwe Tomoka Maurice Mulenga Richard Nyasosela Steady Chasimpha Charles Dzamalala Satish Gopal Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi Journal of Global Oncology |
| title | Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi |
| title_full | Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi |
| title_fullStr | Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi |
| title_full_unstemmed | Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi |
| title_short | Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi |
| title_sort | frequent hiv and young age among individuals with diverse cancers at a national teaching hospital in malawi |
| url | http://ascopubs.org/doi/10.1200/JGO.17.00174 |
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