Burden of cancer in Kenya: types, infection-attributable and trends. A national referral hospital retrospective survey

Abstract

Background: Cancer in Africa is an emerging health problem. In Kenya it ranks third as a cause of death after infectious and cardiovascular diseases. Approximately 15% of the global cancer burden is attributable to infectious agents, with higher percentages in developing countries. Therefore, this study aimed to provide comprehensive hospital based data to inform policies Method: A retrospective survey was conducted at Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH) from 2008 to 2012.  Data was obtained from the patients files using a pre-designed data collection form. The study was approved by the KNH/University of Nairobi and MTRH Ethics and Research Committees. Results : In KNH, the five most common cancers in females (n=300) were cervical 62 (20.7%), breast 59 (19.7%), ovarian 22 (7.3%), chronic leukemia 16 (5.3%), endometrial and gastric both with 15 (5%). In males (n=200) they were prostate 23 (11.5%), laryngeal 19 (9.5%), colorectal 17 (8.5%), esophageal 14 (7.0%) and nasopharyngeal carcinoma 12 (6%). The top infection-attributable cancers were: cervical 62 (12.4%), colorectal 31 (6.2%), gastric 26 (5.2%), prostate 23 (4.6%) and nasopharyngeal carcinoma 17 (3.4%). In contrast, in MTRH the five most common cancers in females (n=282) were breast cancer 74 (26.2%), cervical 41 (14.5%), Kaposi’s sarcoma 38 (13.5%), non-Hodgkin’s lymphoma 15(5.3%) and ovarian 14 (5%) while in males (n=218) they were Kaposi’s sarcoma 55 (25.2%), non-Hodgkin’s lymphoma 22 (10.1%),  chronic leukemia 17 (7.8%), colorectal and esophageal cancers both with 16 (7.3%). The top infection-attributable cancers were: Kaposi’s sarcoma 93 (18.6%), cervical 41 (8.2%), non-Hodgkin’s lymphoma 37 (7.4%), colorectal 27 (5.4%) and liver cancer 16 (3.2%). Conclusion: This study presents a picture of the burden of cancer and infection-attributable cancer from two referral hospitals in Kenya. Reducing the burden of infection-attributable cancers can translate to a reduction of the overall cancer burden.