Gastrointestinal malignancies at fve regional referral hospitals in Uganda.

Siraji Obayo1, Luswa Lukwago2, Jackson Orem3, Ashley L Faulx4, Christopher S Probert5
1. Mbarara University Teaching Hospital, Mbarara, Uganda and the Uganda Cancer Institute, Kampala, Uganda.
2. Ministry of Health Department of Epidemiology, Kampala Uganda.
3. The Uganda Cancer Institute, Kampala, Uganda
4. University Hospitals Cleveland Medical Center, Ohio, USA.
6. Institute of Translational Medicine, University of Liverpool United Kingdom.

Abstract:
Background: There is a paucity of published data regarding the trend and distribution of gastrointestinal malignancies in
Uganda.

Objectives: To study the trend and distribution of gastrointestinal malignancies over a 10 year period at fve regional referral
hospitals in Uganda.

Methods: Patient’s charts with histologically confrmed diagnoses of gastrointestinal malignancies for the period 2002-2011
were identifed. Case information, which included age at diagnosis, sex, and year of diagnosis, primary anatomic site of the tumour and hospitals attended, was retrospectively abstracted. Patient’s clinical and demographic features were compared.

Results: Oesophageal cancer was the most common (28.8%) followed by liver (25.8%), stomach (18.4%) and colorectal (14.3%). The mean age at diagnosis for all the cancers was not signifcantly different in both sexes 54.1, (SD16.1) versus 53.6, (SD 14.7). The highest mean annual number of cases of oesophageal and stomach cancers was 21.8, (SD 15.5) and 16.6, (SD 13.0) respectively from Mbarara Hospital; Lacor had the highest mean annual number of liver cancer cases (21, SD 17.7) followed by Mbale (11.4,SD 8.3). The mean annual number of colorectal cancers was highest in Mbale Hospital (10.3, SD 8.1) followed by Lacor (4.9, SD 3.9). The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the fve referral hospitals was different, P<0.001.

Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and
their rate is increasing in Uganda. There is a need for awareness, endoscopic and radiological assessment of symptomatic individuals and a need for screening of high index patients.

Keywords: Gastrointestinal malignancies, Uganda Regional Referral Hospitals, 10-year trend