Kampala Cancer Registry Research Articles

Cancer in Kampala, Uganda, in 1989–91: Changes in incidence in the era of aids

Re-establishment of the cancer registry in Kyadondo County, Uganda, has allowed estimation of incidence rates for the period September 1989 to December 1991. The results are compared with earlier data from the same area, and from other African cancer registries. The most striking feature is the emergence of Kaposi's sarcoma as the leading cancer in males (almost half of all registered cases) and the second most frequent (17.9%) in females. This parallels the evolution of the epidemic of AIDS. There were also marked increases in the incidence of both oesophageal and prostatic carcinoma, while the incidence of cancer of the penis and the urinary bladder declined, possibly as a result of improved standards of hygiene. In females, the incidence of cancer of the cervix has more than doubled since the 1950s, and is now among the highest recorded in the African continent.

The distribution of non‐burkitt, non‐Hodgkin's lymphomas in Uganda in relation to malarial endemicity

Biopsies of malignant lymphomas collected from all districts of Uganda, filed in the Kampala Cancer Registry for the 8-year period 1966-1973, were reviewed. This review confirmed a relatively low frequency of follicle-centre-cell lymphomas with a follicular growth pattern and the geographical co-distribution between malaria and Burkitt's lymphoma (BL). It also showed a similar, though less marked, association between non-Burkitt, non-Hodgkin's lymphoma (NBNHL) and malarial endemicity, and a correlation in the regional incidence between BL and NBNHL. In both comparisons, these associations were strong for high-grade lymphomas and weak for low-grade neoplasms. BL and other NHL may therefore share, to a varying degree, some common pathogenesis. The excess in frequency of NBNHL of high-grade malignancy in malarial endemic areas appears to be in contrast to Western countries where most non-Hodgkin's lymphomas are of low-grade malignancy.

Bias in an African cancer registry.

AbstractThe returns of the Kampala Cancer Registry, Uganda, which registers cases diagnosed in the whole of the country, have been analysed to discover if changes in patterns of registration have occurred over a 20‐year period. The age distribution has remained surprisingly constant. Comparison with the best data available in the country, from a relatively small area adjacent to the main teaching hospital, suggests that in the first years of study deeply placed tumours were only half as likely to be diagnosed as more superficially placed lesions. Registration of cancer in females was about half as efficient as in males. Registration bias has diminished as social patterns have evolved and as hospitals have become more accessible but it still considerable. Similar changes occurred in all regions in Uganda which vary markedly in social, ethnic and climatic backgrounds and it is highly likely, therefore, that a similar bias is operating in cancer studies elsewhere in Africa.

HEPATOMA IN UGANDA: A Study in Geographic Pathology

The incidence of hepatoma in Uganda was studied over a 3-year period, 1964-66. 403 cases were collected from the Kampala Cancer Registry, the Makerere biopsy service, and personal visits to hospitals around the country. The age peak was 35-45 years, and the male-female ratio was 3.3 to 1. Tribal rates indicated a significantly higher incidence in the immigrants of the Bantu tribes from Rwanda and Burundi and 2 Nilohamitic tribes of the North-East than in neighbouring and racially related tribes. Rates in other Bantu, Nilotic, and Nilohamitic tribes were remarkably similar, despite different dietary patterns and other ecological variables. Among possible environmental factors, fungal contamination with carcinogenic metabolites, known to occur in significant amounts, is suggested as a factor contributing to the high incidence of hepatoma.

Malignant tumors in African children: With special reference to malignant lymphoma

Summary 1. The incidence and histologic classification of malignant tumors in African children as recorded by the Kampala Cancer Registry from 1952 to 1958 are reported. 2. The infrequency of leukemia in African children, previously observed, is confirmed. 3. Malignant lymphomas are the most common tumors recorded and constituted almost 50 per cent of the total malignant growths in this series. 4. The incidence and distribution of malignant lymphoma as well as a marked reversal of the leukemia to lymphoma ratio suggests a significant difference in the natural history of lymphopoietic tumors in African children. 5. The very frequent and apparant primary origin of lymphoma in the jaw indicates an unusual affinity and suggests a local causative factor.