Epidemiology of Cancers in Zambia: A significant variation in Cancer incidence and prevalence across the nation

BackgroundCancer is one of the leading causes of death worldwide. More than two-thirds of deaths due to cancers occur in low- and middle-income countries where Zambia belongs. This study, therefore, sought to assess the epidemiology of various types of cancers in Zambia.MethodsWe conducted a retrospective observational study using the Zambia National Cancer Registry (ZNCR) population based data from 2007 to 2014. Zambia Central Statistics Office (CSO) demographic data were used to determine catchment area denominator used to calculate prevalence and incidence rates of cancers. Age-adjusted rates and case fatality rates were estimated using standard methods. We used a Poisson Approximation for calculating 95% confidence intervals (CI). ResultsThe seven most cancer prevalent districts in Zambia were Luangwa, Kabwe, Lusaka, Monze, Mongu, Katete and Chipata. Cervical cancer, prostate cancer, breast cancer and Kaposi’s sarcoma were the four most prevalent cancers as well as major causes of cancer related deaths in Zambia. Age adjusted rates and 95% CI for these cancers were: cervix uteri (186.3; CI = 181.77 – 190.83), prostate (60.03; CI = 57.03 – 63.03), breast (38.08; CI = 36.0 – 40.16) and Kaposi’s sarcoma (26.18; CI = 25.14 – 27.22). CFR were: Leukaemia (38.1%); pancreatic cancer (36.3%); lung cancer (33.3%); and brain, nervous system (30.2%). The cancer population was associated with HIV with p- value of 0.000 and a Pearson correlation coefficient of 0.818.ConclusionsThe widespread distribution of cancers with high prevalence observed in the southern zone may have been perpetrated by lifestyle and sexual culture (traditional male circumcision known to prevent STIs is practiced in the northern belt) as well as geography. Intensifying cancer screening and early detection countrywide as well as changing the lifestyle and sexual culture would greatly help in the reduction of cancer cases in Zambia

Epidemiology of Kaposi’s sarcoma in Zambia, 2007 - 2014

BackgroundKaposi’s sarcoma (KS) is the most prevalent HIV and AIDS-associated cancer in the world. Zambia has been considered as part of the “KS belt”, where endemic KS has been prevalent. This study, therefore, aimed to present the descriptive epidemiology of Kaposi’s sarcoma in Zambia from 2007 – 2014.MethodsWe conducted the descriptive epidemiology of Kaposi’s sarcoma in Zambia nested on two data sources; the Zambia National Cancer Registry (ZNCR) Kaposi’s sarcoma (KS) data, and population-based HIV data from the Zambia National AIDS Council (NAC). Central Statistics Office (CSO) demographic data were used to determine the prevalence and annual incidence of KS. KS sample was 2521while HIV data from NAC were already population-based (HIV impact assessment survey). We used Microsoft Excel and SPSS version 21 in graphical computation and statistical analyses.ResultsBoth HIV and KS were highly prevalent in Lusaka, Central, and Southern provinces. ART coverage ranged from 40% - 60%; HIV prevalence was 14.9% in females and 9.5% in males while KS prevalence was 13/100,000 in females and 21/100,000 in males. HIV prevalence was associated with KS prevalence with r = 0.827 and a p-value of 0.001 in males, and r = 0.898 with a p-value of 0.000 in females. There were 61% confirmed HIV seropositive KS, 18% confirmed HIV seronegative KS and 21% unknown HIV status KS.ConclusionsThe high prevalence of KS in Zambia is as a result of the high prevalence of HIV. The identified two key interventions for the reduction of KS morbidity are; reducing HIV infection rate and improving ART coverage across the country