Magnitude and pattern of gastroenterological malignancies among patients at Muhimbili National Hospital, Tanzania

Abstract

ABSTRACT Background: Gastroenterological malignancies in 2012 were highest in incidence and mortality, globally, with 4 of the top 8, and 4 of the top 6 respectively, being from this system. Developing countries including Tanzania were noted to be experiencing an increased frequency of these cancers, possibly due to adoption of a western lifestyle. There is limited data regarding the latest clinicopathological presentation and possible associated factors of these malignancies. Objective: To evaluate the magnitude, patterns and possible associated factors of gastroenterological malignancies among patients attended at Muhimbili National Hospital, Tanzania. Methodology: This was a cross sectional study carried out at the surgical wards and the gastrointestinal clinic at Muhimbili National Hospital, between June and December 2017. The study involved patients with malignancies in the esophagus, stomach, colon, rectum and anus. Data on the demographics, clinical presentation and exposure to suspected risk factors was collected from patients using a structured questionnaire and clinical information was sourced from their files. The data was cleaned, coded and then analyzed by SPSS computer software version 20.0. Results: 270 participants were recruited, giving a magnitude of 15.1% all patients being attended to for a diagnosis of cancer. The participants had a male predominance of 182(67.4%) & a mean age (SD) of 56.4 (±14.6) years old. The study found that esophageal cancer 175(64.8%) was the most common gastroenterological malignancy, while Small bowel cancer was the least 4(1.5%). Alcohol consumption 211(78%) and an Age group of 40 – 70 years 194(72%), were the most prevalent associated factors of gastrointestinal cancer, while smoking was more common among patients diagnosed with esophageal cancer 96(55%) and HIV infection/AIDS was more common among patients diagnosed with small bowel 1(33.4%) and anal cancer 2(13.3%). Conclusion: Gastroenterological Malignancies have a significant magnitude among patients at MNH and they present with a unique profile. Lack of awareness of these diseases and their associated factors poses a great challenge in the prevention and subsequent management of these patients. Addressing these challenges will help reverse the trend of an increasing incidence of these malignancies in Tanzania.