Cancer of the oesophagus in Africans in sub-Saharan Africa: any hopes for its control?
Oesophageal cancer, a highly lethal tumour, occurs to a variable extent in Africans in sub-Saharan African countries. In many, its incidence remains low, as in the Ivory Coast, Mali and the Gambia. However, in other African countries, the incidence rate has risen considerably, especially in city populations, as in Durban, South Africa, in Kyadondo, Uganda, and in Harare, Zimbabwe, rising to levels far higher than those reported in white populations. As to risk factors, in some African settings, smoking is a factor, and in others, alcohol consumption. Nutritionally, one enquiry, made in Durban, indicated the use of less-refined cereal products, with higher consumptions of vegetables and fruit, to be protective. In developed populations, protective factors are considered to be those characteristic of a "prudent" lifestyle. However, known risk factors largely fail to explain the high variability in the disease's occurrence. In seeking to combat the disease, it is thought unlikely that most Africans, especially urban dwellers, are willing to alter their lifestyle appropriately, even with the understanding that the changes would confer other protective benefits. This suggests that further rises, especially in the contexts of high incidence rates, are inevitable.
Walker
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Human Biochemistry Research Unit, School of Pathology, National Health Laboratory Service, University of the Witwatersrand, Johannesburg 2000, South Africa. alexw@mail.saimr.wits.ac.za
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Walker
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D017954:Africa South of the Sahara / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology