Abstract
The aim of this study was to assess the magnitude, socio-demographic, and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia. A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. A structured data extraction tool was used to extract data from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 to 2017. During the study period, a total of 777 oesophageal cancer cases were identified, and the median age of these patients was 55 years, with an interquartile range of 19. More than half (55.1%, n = 428) of the cases were males, and the majority of them were reported from Oromia (49.9%, n = 388) and Somali (25.9%, n = 202) regional states. The highest numbers of oesophageal cancer cases were recorded in 2016 (23.8%, n = 185), while the lowest were in 2012 (12.6%, n = 98). Eighty per cent of oesophageal cancer cases were diagnosed in later stages of the disease. More than one-fourth (27.0%, n = 210) of patients had surgical procedures where the majority (74.3%, n = 156) required insertion of a feeding tube followed by transhiatal oesophagectomy (10.9%, n = 23). Of the 118 patients for which there was histology data, squamous cell carcinoma (56.7%, n = 67) and adenocarcinoma (36.4%, n = 43) were the predominant histologic type. One-fourth (25.0%, n = 194) of the patients were alive, and more than two-thirds (71.7%, n = 557) of the patients’ current status was unknown at the time of the review. In these referral hospitals of Ethiopia, many oesophageal cancer patients presented during later stages of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali hospitals by far exceeded hospitals of the other regions, thus postulating possibly unique risk factors in those geographic areas.
Highlights
Oesophageal cancer is the leading cause of cancer-related mortality due to its subtle disease course and poor prognosis [1]
A study from the largest referral hospital in Ethiopia indicated that oesophageal cancer was more common among patients from Arsi and Bale when compared to other regions [6]
Data were collected from 10 referral hospitals located in seven regional states and one city administration: Amhara, Oromia, Southern Nations’ Nationality People Region (SNNPR), Tigray, Afar, Harari, Somali, and Dire Dawa
Summary
Oesophageal cancer is the leading cause of cancer-related mortality due to its subtle disease course and poor prognosis [1]. Oesophageal cancer incidence varies globally, with its highest across the ‘oesophageal cancer belt’, namely East and South African countries, and Asia [3, 4]. Squamous cell carcinoma is more common in central, eastern, and southern parts of Africa, with the African oesophageal squamous cell carcinoma (ESCC) corridor stretching from the southern part of Sudan to the Eastern Cape Province of South Africa [6, 7]. Ethiopia is one of the countries along the oesophageal belt. A study from the largest referral hospital in Ethiopia indicated that oesophageal cancer was more common among patients from Arsi and Bale when compared to other regions [6]
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