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


OBJECTIVE
To determine the prevalence, histological features and associated factors for CAE among patients referred to the endoscopic unit of Mulago hospital, Kampala, Uganda.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Department of Medicine, Makerere University, Uganda. pocama@idi.co.ug
Ponsiano
P
Ocama
Magid M
MM
Kagimu
Michael
M
Odida
Henry
H
Wabinga
Christopher K
CK
Opio
Britt
B
Colebunders
Sabrina
S
van Ierssel
Robert
R
Colebunders
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D004945:Esophagoscopy / Q000009:adverse effects; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology