A five year trend and histopathological pattern of carcinoma lower esophagus Muhimbili National Hospital and Ocean Road Cancer Institute

Abstract

Background: Esophageal cancer in the world is the eighth most common tumor, accounting for 481,000 new cases in 2008 (3.8% of all cancer cases) and sixth as a cause of tumor death with 406,000 deaths (5.4% of total). However, only few studies on trend are available in developing countries, especially from Asia and Africa. There is no information in Tanzania addressing trend in the occurrence of lower esophageal carcinoma (Esophageal Adenocarcinoma) as there is increased number of admissions, morbidity and mortality to surgical wards especially of lower esophagus. Objective: To describe a five-year trend and histopathological pattern of carcinoma lower esophagus Muhimbili National Hospital and Ocean Road Cancer Institute. Methodology: Hospital based retrospective cross-sectional study. The study was conducted at Muhimbili National Hospital (MNH) and ORCI from April 2013 to April 2017. Patients with histological confirmed of lower EC were taken into the study. A standard tool was used for extraction of data from patient files and database from electronic system such as socio-demographic data, documented risk factors, endoscopic findings, histological type at MNH and ORCI, data were managed and analyzed by using SPSS program version 23. Results: A 341(34.1%) patients diagnosed to have lower esophagheal carcinoma histologically were enrolled during the study period. Mean age of the patients was 58.1+13.8(35 – 92) with no difference in mean age between male and female patients. Male predominant with a ratio of 2:1. Alcohol intake and cigarette smoking were the most reported risk factors by 227 (66.6%) and 200 (58.7%) respectively. History of GERD was reported in 132 (38.71%). A two-fold increment of lower EC was noted, especially between 2015 to 2017 with majority of patients having Squamous cell carcinoma 249 (73.1%) Conclusion: A two-fold increase in lower EC has been noted with squamous cell carcinoma being the predominant histological sub type. Risk factors for this group were similar to that observed in upper and middle esophageal esophagus sub types with fewer patients reported to have GERD. Key words: Trend, lower EC, MNH.