Pattern of Esophageal Cancer in Sudan

Ali Adam Elhadi

doi:10.11648/j.ajcem.20160406.12

Abstract

Objectives: Carcinoma of the esophagus is the eights common cancer worldwide causing a lot of morbidity and mortality, defining the risk factors could aid prevention. In the current study, we aimed to explore the pattern of esophageal cancer in Sudan. Methods: Seventy-two patients referred for upper gastrointestinal endoscopy and diagnosed with esophageal cancer were studied in the endoscopy unit of Omdurman Teaching Hospital during the period November 2013 to April 2016. Endoscopy was doneand histopathology reported for all patients. Information collected were: demographic data, symptoms due to esophageal cancer, associated risk factors, type and site of the lesion. Results: Out of the seventy-two patients with esophageal carcinoma their ages ranged from 31-93 years with a mean of 62.57±15.1years, 40.1% were males. The commonest presentation was dysphagia (98.6%) followed by loss of weight (93.1%). The majority were adenocarcinomas [80.6%], 91.6% occur in middle and lower thirds of the esophagus. Reflux esophagitis was reported in 40.3%, achalasia in 29.3%, while hot drinks consumption was reported in 20.8%. A significant statistical difference was evident between adenocarcinoma and squamous cell carcinoma regarding Achalasia presentation P-value< 0.05, no significant differences were found regarding age, sex, reflux esophagitis, hot and spicy food, and obesity P-value> 0.05. Conclusion: Adenocarcinoma was commoner than squamous cell carcinoma, with the lower third of the esophagus more involved. A significant statistical difference was found between squamous cell adenocarcinoma and regarding achalasia., no significant differences were found regarding age, sex, reflux esophagitis, hot and spicy food, and obesity.

Highlights

The incidence of the carcinoma of the esophagus varies considerably across the World with the highest rate observed in Central and East Africa and the lower incidence in South America and West Africa
Reflux esophagitis was diagnosed in 40.3% of patients, while achalasia was diagnosed in 29.2%
The mean age of patients with the carcinoma of the esophagus was 62.5 years with no differences between men and women similar to previous literature from Sudan in which the age of patients with esophageal carcinoma ranged from 50-70 with males and females affected [11]

Summary

Introduction

The incidence of the carcinoma of the esophagus varies considerably across the World with the highest rate observed in Central and East Africa and the lower incidence in South America and West Africa. The Squamous cell carcinoma is the commonest, the frequency of the adenocarcinoma due to Barrette's esophagus is rising [1,2,3]. Worldwide near half million new cases were affected by esophageal cancer in the year 2012, and 400200 deaths occurred [4]. There is a tendency towards the increasing rate of adenocarcinoma with decreasing squamous cell carcinoma in different areas worldwide including the United States of America, Canada, Europe, Australia, and New Zealand attributed to change in various risk factors for each esophageal cancer [6, 7]. Healthier lifestyle (diets with more fruits and vegetables, and regular exercise) could decrease the incidence of both adenocarcinoma and squamous cell carcinoma while smoking and alcohol intake is more associated with squamous cell carcinoma [6, 7]

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Conclusion