Is Clinical Research in Oesophageal Cancer in South Africa in Crisis? A Systematic Review.
Oesophageal cancer (OC) is responsible for the second highest number of cancer-related deaths in South Africa (SA). Squamous cell carcinoma is the most prevalent type with an incidence of 46.7/100,000 and 19.2/100,000 for males and females. This is a systematic review of the clinical diagnosis and management of OC within the South African context. This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42016034053) with adherence to PRISMA guidelines. An online search was performed using MEDLINE, EBSCOHost and PubMed. Eligibility criteria for articles included published, original peer-reviewed research addressing clinical management of oesophageal cancer in South Africa. Review articles, case reports, scientific letters and studies published in languages other than English or Afrikaans were excluded. The research terms were 'etiology', 'human', 'esophageal cancer', 'esophageal carcinoma', 'oesophageal cancer', and 'oesophageal carcinoma', 'squamous cell carcinoma', 'Africa' and 'South Africa'. A total of 336 articles were identified. Of these, 146 were immediately excluded and a further 159 were excluded after review. A total of 31 appropriate articles, i.e. 9.2% of searched articles, were included. Thirteen articles addressed chemotherapy and/or radiotherapy, 9 oesophageal luminal therapy, 7 oesophageal surgery and 2 screening. OC research of in SA over the last two decades has mainly been in the form of reviews and opinion papers. Clinical research, auditing and prospectively analysing OC management and outcomes in SA hospitals are sorely needed and should be promoted by both healthcare workers and policy makers alike.
Department of Surgery, Inkosi Albert Luthuli Central Hospital, Durban, South Africa. emilloots@hotmail.com.|Department of Surgery, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, 4013, South Africa. emilloots@hotmail.com.
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Loots
Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.|Gastrointestinal Cancer Research Centre, University of KwaZulu-Natal, Durban, South Africa.
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Sartorius
Department of Surgery, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.|Department of Surgery, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, 4013, South Africa.|Gastrointestinal Cancer Research Centre, University of KwaZulu-Natal, Durban, South Africa.
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Madiba
Department of Hepatogastroenterology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
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Mulder
Department of Surgery, University of KwaZulu-Natal, Private Bag 7, Congella, Durban, 4013, South Africa.|Department of General Surgery, Grey's Hospital, Pietermaritzburg, South Africa.|Department of General Surgery, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
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Clarke
D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D016629:Esophagectomy; D004945:Esophagoscopy; D006801:Humans; D011878:Radiotherapy; D013019:South Africa
D000970:Antineoplastic Agents