Oesophageal Cancer Magnitude and Presentation in Ethiopia

Abstract Background Although oesophageal cancer is a public health problem in Ethiopia, there are limited data on the magnitude and distribution of the disease in the country. The aim of this study is to assess the magnitude, socio-demographic and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia.Methods A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. Data were extracted from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 - 2017. A structured data extraction tool was used to collect important variables. Descriptive statistics such as median, interquartile range (IQR) and percentages were computed to describe the regional and national distribution of the disease.Results Over the past six years, a total of 777 oesophageal cancer cases were identified and the median age of these patients was 55 years with IQR of 19. More than half 428 (55.1%) of the cases were males and majority of them were reported from Oromia and Somali regional states with 388 (49.9%) and 202 (25.9%) respectively. The highest number of oesophageal cancer cases were recorded in 2016 with a total number of 185 (23.8%) while the lowest 98 (12.6%) was in 2012. Eighty percent of oesophageal cancer cases were diagnosed at late stage of the disease. More than one-fourth 210 (27.0%) of patients were operated with the majority 156 (74.3%) to insert a feeding tube followed by trans-hiatal oesophagostomy 23 (10.9%). Of the 118 results analysed, squamous cell carcinoma and adeno carcinoma were the predominant histologic type with 67(56.7%), and 43(36.4%) respectively. One fourth 194 (25.0%) of the patients were alive and more than two third 557 (71.7%) patients’ current status were unknown at the time of the review.Conclusions In referral hospitals of Ethiopia, many oesophageal cancer patients came at late stage of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali region hospitals by far exceeds hospitals of the other regions thus postulating possibly unique risk factors in those geographic areas.