Nine years of epidemiological changes of gastrointestinal cancer in Egypt

Abstract

Introduction: Studying the distribution of cancer types within certain regions is essential to winning the battle against cancer. This study investigated the distribution changes of gastrointestinal tract (GIT) cancer within Egypt, considering the Nasser Institute Cancer Center (NICC) as the mainMOHreference. Methods: From 2010 to 2018, 2862 GIT cancer patients were referred to NICC from all over Egypt. Their files were studied by collecting the following data: sex, age, primary tumor site, date of diagnosis, and patient governorate. Results: A total of 2862 patients from 27 governorates were divided according to their referral governorate into Cairo (33.5%, n=959), Lower Egypt (52.7%, n=1507) and Upper Egypt (7.2%, n=206). Lower Egypt included Giza, Qalubia, Alexandria, Port Said, Suez, Damietta, Dakahlia, Sharqia, Kafr Elsheikh, Gharbia, Monufia, Beheira, Ismailia, Matruh and North Sinai. Upper Egypt included Beni Suef, Faiyum, Minya, Asyut, Sohag, Qena, Aswan, Luxor, Red Sea, New Valley, and South Sinai. Other patients (6.6%, n=190) were referred from outside Egypt and were excluded from the study. Patients were 58% male and 42% female. Age distribution: 372 patients (13.9%) <40 years was the rarest group showing its smallest incidence within hepatobiliary cancer =3.2%. Increasing incidence of certain tumor sites through 2011 to 2018 occurred with significant (p<0.0001) in colon ((minimum was on 2013=(87 )26.8% and maximum on 2016=( 118) 34.2%)), less significant gastric( p=0.057) and no significant increase in pancreas (p=0.196) with decrease in rectum and esophagus with (p<0.0001) and less significant decrease of hepatobiliary cancer with (p=0.05) and no significant decrease of anal cancer (p=0.106). Largest number of GIT cases were within Cairo, 33.51% (959) and commonest tumor site was colon through the time from 2011 where there was 11.2% (36) and increases to 14.6% (47) on 2018, followed by gastric cancer where it increased from 8.2%(15) on 2011 to 12% (22) on 2018. By the year 2023, there is predicted to be more increases in gastric, colonic and pancreatic cancer, and a decrease in hepatobiliary cancer with the expected total number of new cases to be 257. Conclusion: Males between ages 40 and 59 are more exposed to gastrointestinal cancer, mainly in Cairo, with an increased incidence of colon cancer and a decreased incidence of esophageal and rectal cancers during the last nine years. The number of cases of GIT cancer is predicted to further increase in the next 5 years.