Demographic, clinical and pathological characterisation of patients with colorectal and anal cancer followed between 2013 and 2016 at Maputo Central Hospital, Mozambique.

Carlos Selemane,Moshin Sidat,Luisa Jamisse,Jorge Arroz,Prassad Modcoicar,Carla Carrilho,Lúcio Lara Santos,Mamudo Ismail,Daniel Moreira-Gonçalves,António Gudo Morais,Satish Tulsidas,Jessica Rodrigues

doi:10.3332/ecancer.2021.1205

Abstract

PurposeThe aim of this study was to investigate colorectal cancer (CRC) data and anal cancer data from Maputo Central Hospital (MCH), the largest hospital and a reference for oncological diseases in Mozambique, with the aim of characterising the disease profile in view to define an appropriate control programme.MethodsMCH records from the Pathology and Surgery Services and MCH Cancer Registry database were assessed to obtain retrospective clinical and pathologic data of patients with CRC or anal cancer admitted to and treated between 13 December 2013 and 23 March 2016.ResultsThe female gender was more prevalent (54.8%), even when anal cancers were excluded. Median age was 54 years (20–99). Most patients (51.6%) lived in the city of Maputo. The most common presenting symptom was found to be rectal bleeding. Adenocarcinoma was the most frequent histological type, and the most prevalent anatomical site was the rectum. Most of the cases were diagnosed at MCH in advanced stages. Colostomy was the most frequent surgical procedure and performed in 38.7% of the patients. Most cases of anal cancer occurred in human immunodeficiency virus-infected patients. Most patients had a poor prognosis due to advanced stage at first diagnosis.ConclusionWe observed an increase in cases of CRC and anal cancer in Mozambique and mostly diagnosed at advanced stages, which anticipates a dismal prognosis. Our data supports the urgent need of a comprehensive public health programme dedicated to solving this growing concern.

Highlights

Colorectal cancer (CRC) is the third most deadly type of cancer worldwide, with approximately 881,000 estimated deaths in 2018, but data concerning cancer rates in Sub-Saharan Africa (SSA) is extremely poor [1]
Radiotherapy is available in Maputo Central Hospital (MCH), these series of patients did not benefit from this therapeutic option since at that time the system was being assembled
We observed in our series and in the data of the cancer registry of Mozambique mentioned above, that the incidence increases with age (CRC and anal cancer)

Summary

Introduction

Colorectal cancer (CRC) is the third most deadly type of cancer worldwide, with approximately 881,000 estimated deaths in 2018, but data concerning cancer rates in Sub-Saharan Africa (SSA) is extremely poor [1]. The population-based cancer registry of Mozambique, with data from the city of Beira and the city of Maputo, revealed that CRC has low age-standardised incident rates (ASIR) (Table 1) [3]. The rates of cancer (including CRC) are dramatically increasing partly because of the ageing of the population, and partly due to the rapid ‘globalisation’ and the adoption of the associated risk factors within these populations [7]. These risk factors include physical inactivity, smoking and alcohol consumption and poor nutrition [8]. This study reviews CRC data and anal cancer data from the Maputo Central Hospital (MCH), the largest hospital and a reference for oncological diseases in Mozambique, with aim of characterising the disease profile in view to define an appropriate control programme

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Conclusion