Hubert Yeargan Center for Global Health, Duke University, Durham, NC, USA; Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Bugando Medical Centre, Mwanza, Tanzania.
Cancer Epidemiol. 2020 Aug;67:101772. doi: 10.1016/j.canep.2020.101772. Epub 2020 Jul 10.
To describe cancer incidence and treatment utilization patterns at the regional cancer referral center for the Lake Zone of northwestern Tanzania from 2008 to 2016.
This descriptive, retrospective study reviewed all cancer cases recorded in the Bugando Cancer Registry (BCR), a clinical and pathology based registry at the only cancer referral hospital in the region. Primary tumor site, method of diagnosis, HIV status, and cancer treatment were reported. Using census data, the 2012 GLOBOCAN estimates for Tanzania were scaled to the Lake Zone and adjusted for 2016 population growth. These estimates were then compared to BCR cases using one-sample tests of proportion.
A total of 2772 cases were reported from 2008-2016. Among these, the majority of cases (82.5 %, n = 2286) were diagnosed among adults. Most cases (85 %, n = 1923) were diagnosed by histology or cytology. Among adults, the most common cancers diagnosed were cervix (22.7 %, n=520), breast (12.6 %, n=288), and prostate (8.5 %, n=195). Among children, the most common cancers were non-Burkitt non-Hodgkin lymphoma (17.3 %, n=84), Burkitt lymphoma (16.5 %, n=80), and Wilms tumor (14.6 %, n=71). The 1116 BCR cases represent 12.2 % of the 9165 expected number of cancer cases for the Lake Zone (p < 0.001). 1494 cases (53.9 %) received some form of treatment - surgery, chemotherapy, radiation, or hormone therapy - while 1278 cases (46.1 %) had no treatment recorded.
This comprehensive report of the BCR reveals cancer epidemiology and treatment utilization patterns typical of hospitals in low-resource settings. Despite being the only cancer center in the Lake Zone, BMC evaluates a small percentage of the expected number of cancer patients for the region. The BCR remains an important resource to guide clinical care and academic activities for the Lake Zone.
描述 2008 年至 2016 年期间，位于坦桑尼亚西北部湖区的区域癌症转诊中心的癌症发病率和治疗利用模式。
本研究为描述性、回顾性研究，对该地区唯一癌症转诊医院布甘达癌症登记处（BCR）记录的所有癌症病例进行了审查。报告了原发肿瘤部位、诊断方法、艾滋病毒状况和癌症治疗情况。利用人口普查数据，将 2012 年全球癌症统计数据按比例调整到湖区，并根据 2016 年人口增长进行调整。然后使用单样本比例检验将这些估计值与 BCR 病例进行比较。
2008 年至 2016 年期间共报告了 2772 例病例。其中，大多数病例（82.5%，n=2286）为成人诊断。大多数病例（85%，n=1923）通过组织学或细胞学诊断。在成人中，诊断最常见的癌症为宫颈癌（22.7%，n=520）、乳腺癌（12.6%，n=288）和前列腺癌（8.5%，n=195）。在儿童中，最常见的癌症是非伯基特非霍奇金淋巴瘤（17.3%，n=84）、伯基特淋巴瘤（16.5%，n=80）和威尔姆斯瘤（14.6%，n=71）。BCR 的 1116 例病例占湖区预期癌症病例数（9165 例）的 12.2%（p<0.001）。1116 例病例中有 1494 例（53.9%）接受了某种形式的治疗-手术、化疗、放疗或激素治疗，而 1278 例（46.1%）未记录治疗情况。
本研究全面报告了布甘达癌症登记处的情况，揭示了癌症流行病学和治疗利用模式，这些模式与资源匮乏环境下的医院典型情况相似。尽管是湖区唯一的癌症中心，但 BMC 评估的癌症患者人数仅占该地区预期人数的一小部分。BCR 仍然是指导湖区临床护理和学术活动的重要资源。
