Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2016; 8(3): 314-320
Published online Mar 15, 2016. doi: 10.4251/wjgo.v8.i3.314
Clinical and epidemiologic variations of esophageal cancer in Tanzania
Jaime V Gabel, Robert M Chamberlain, Twalib Ngoma, Julius Mwaiselage, Kendra K Schmid, Crispin Kahesa, Amr S Soliman
Jaime V Gabel, Robert M Chamberlain, Amr S Soliman, Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States
Robert M Chamberlain, M. D. Anderson Cancer Center, University of Texas, Houston, TX 78712, United States
Twalib Ngoma, Julius Mwaiselage, Crispin Kahesa, Ocean Road Cancer Institute, Dar es Salaam 3592, Tanzania
Kendra K Schmid, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States
Author contributions: All authors contributed substantially to this work; Gabel JV collected and analyzed data and drafted the manuscript; Schmid KK contributed with overall analytical expertise and manuscript revision; all other authors contributed to design, supervision, and manuscript writing and revising; all authors approve of the final version to be published.
Institutional review board statement: The study was approved by the University of Nebraska Medical Center IRB and the ORCI Academic, Research, Publications and Ethics Committee.
Informed consent statement: Because this study utilizes medical records of those who gave permission for their records to be used for research purposes, most of whom were deceased at the time of the study, the IRB waivered informed consent.
Conflict-of-interest statement: No authors for this manuscript have any conflicts of interest for this project.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amr S Soliman, MD, PhD, Professor and Chair, Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, United States. amr.soliman@unmc.edu
Telephone: +1-402-5593976 Fax: +1-402-5523863
Received: November 2, 2015
Peer-review started: November 4, 2015
First decision: December 11, 2015
Revised: December 25, 2015
Accepted: January 16, 2016
Article in press: January 19, 2016
Published online: March 15, 2016
Processing time: 125 Days and 12.6 Hours
Abstract

AIM: To estimate the incidence of esophageal cancer (EC) in Kilimanjaro in comparison to other regions in Tanzania.

METHODS: We also examined the clinical, epidemiologic, and geographic distribution of the 1332 EC patients diagnosed and/or treated at Ocean Road Cancer Institute (ORCI) during the period 2006-2013. Medical records were used to abstract patient information on age, sex, residence, smoking status, alcohol consumption, tumor site, histopathologic type of tumor, date and place of diagnosis, and type and date of treatment at ORCI. Regional variation of EC patients was investigated at the level of the 26 administrative regions of Tanzania. Total, age- and sex-specific incidence rates were calculated.

RESULTS: Male patients 55 years and older had higher incidence of EC than female and younger patients. Of histopathologically-confirmed cases, squamous-cell carcinoma represented 90.9% of histopathologic types of tumors. The administrative regions in the central and eastern parts of Tanzania had higher incidence rates than western regions, specifically administrative regions of Kilimanjaro, Dar es Salaam, and Tanga had the highest rates.

CONCLUSION: Further research should focus on investigating possible etiologic factors for EC in regions with high incidence in Tanzania.

Keywords: Esophagus, Cancer, Tanzania, Epidemiology, Distribution

Core tip: In the manuscript “Clinical and epidemiologic variations of esophageal cancer in Tanzania”, the authors describe the geographic distribution of esophageal cancer in Tanzania. The regions of Dar es Salaam and Kilimanjaro have higher incidences of esophageal cancer in comparison to other regions of Tanzania. There were also higher incidences found in the eastern and central parts of Tanzania compared to Western Tanzania. The authors did not find any differences in the age, sex, and histopathologic distribution of esophageal cancer when grouping the regions based on incidence rates.