title: The shifting epidemiology of colorectal cancer in sub-Saharan Africa.
abstract: The perception that colorectal cancer is rare in sub-Saharan Africa is widely held; however, it is unclear whether this is due to poor epidemiological data or to lower disease rates. The quality of epidemiological data has somewhat improved, and there is an ongoing transition to western dietary and lifestyle practices associated with colorectal cancer. The impact of these changes on the incidence of colorectal cancer is not as evident as it is with other non-communicable diseases such as diabetes. In this Viewpoint, we discuss the epidemiology of colorectal cancer in sub-Saharan Africa. Colorectal cancer in this region frequently occurs at an early age, often with distinctive histological characteristics. We detail the crucial need for hypothesis-driven research on the risk factors for colorectal cancer in this population and identify key research gaps. Should colorectal cancer occur more frequently than assumed, then commensurate allocation of resources will be needed for diagnosis and treatment.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe. Electronic address: KTSLEO002@myuct.ac.za.
authors.forename: Leolin
authors.initials: L
authors.lastname: Katsidzira
authors.affiliation: Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Innocent
authors.initials: I
authors.lastname: Gangaidzo
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Sandie
authors.initials: S
authors.lastname: Thomson
authors.affiliation: Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.affiliation: Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Matenga
authors.affiliation: MRC/UCT Human Genetics Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Raj
authors.initials: R
authors.lastname: Ramesar
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D017668:Age of Onset; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D004032:Diet; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors