A 10-year retrospective study of lung cancer in Uganda

Naghib Bogere,Blair Andrew Omaido,Andrew Katende,Elizabeth Namukwaya,Victoria Walusansa,Harriet Mayanja-Kizza,Felix Bongomin

doi:10.1186/s12885-022-09300-1

Abstract

BackgroundLung cancer is a leading cause of cancer-related deaths in Uganda. In this study, we aimed to describe the baseline characteristics and survival of patients with lung cancer at the Uganda Cancer Institute (UCI).MethodsWe retrospectively reviewed medical records of all patients with a histological diagnosis of lung cancer registered at UCI between January 2008 and August 2018. Data on demographic, clinical, and treatment characteristics, and vital status were abstracted and analyzed. Patients with undocumented vital status on the medical records were contacted through phone calls. We determined survival as time from histological diagnosis to death. The Kaplan-Meier survival analysis was performed to estimate the median survival time and the 5-year overall survival rate.ResultsOf the 207 patients enrolled, 56.5% (n = 117) were female, median age was 60 years (range: 20–94), 78.7% (n = 163) were never-smokers and 18 (8.7%) were living with HIV. Presumptive anti-tuberculosis treatment was given to 23.2% (n = 48). Majority had non-small cell lung cancer (96.6%, n = 200) with 74.5% (n = 149) adenocarcinoma and 19% (n = 38) squamous cell carcinoma. All had advanced (stage III or IV) disease with 96.1% (n = 199) in stage IV. Chemotherapy (44.9%, n = 93) and biological therapy (34.8%, n = 72) were the commonest treatments used. Overall survival at 6 months, 1-, 2- and 5-years was 41.7, 29.7, 11.8, and 1.7%, respectively. The median survival time of 4.4 months was not statistically significantly different between participants with NSCLC or SCLC (4.5 versus 3.9 months, p = .335).ConclusionIn Uganda, adenocarcinoma is the predominant histologic subtype of lung cancer and patients are predominantly females, and non-smokers. Patients present late with advanced disease and poor overall survival. Public awareness should be heightened to facilitate early detection and improve outcomes.

Highlights

Lung cancer is the most cancer worldwide, with most cases diagnosed in less developed countries [1, 2]
Forty-eight (23.2%) patients were presumptively treated for pulmonary tuberculosis (PTB) for a median duration of 12 weeks (2–32 weeks) before a diagnosis of lung cancer was made
Our lung cancer population is middle-aged with a higher proportion of females, never smokers, adenocarcinoma, and advanced stage at diagnosis

Summary

Introduction

Lung cancer is the most cancer worldwide, with most cases diagnosed in less developed countries [1, 2]. In these countries, essential information guiding action on prevention and treatment of lung cancer is either unavailable or of insufficient quality at best. In Uganda, lung cancer is the 13th most common cancer and its incidence is increasing which threatens to exert heavy morbidity, mortality, and economic cost to the country [3, 4]. In this study, we set Bogere et al BMC Cancer (2022) 22:204 out to describe the characteristics of patients with lung cancer and their survival. We aimed to describe the baseline characteristics and survival of patients with lung cancer at the Uganda Cancer Institute (UCI)

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Conclusion