Department of Pathology, Makerere University Medical School, Kampala, Uganda.
Kampala Cancer Registry, Makerere University Medical School, Kampala, Uganda.
Int J Cancer. 2021 May 1;148(9):2129-2138. doi: 10.1002/ijc.33373. Epub 2020 Nov 29.
Trends in the incidence of cancer in the population of Kyadondo County, Uganda-which comprises the city of Kampala and a peri-urban hinterland-are presented for a period of 25 years (1991-2015) based on data collected by the Kampala Cancer Registry. Incidence rates have risen overall-age-adjusted rates are some 25% higher in 2011 to 2015 compared with 1991 to 1995. The biggest absolute increases have been in cancers of the prostate, breast and cervix, with rates of some 100% (prostate), 70% (breast) and 45% (cervix) higher in 2010 to 2015 than in 1991 to 1995. There were also increases in the incidence of cancers of the esophagus and colon-rectum (statistically significant in men), while the incidence of liver cancer-the fifth most common in this population-increased until 2007, and subsequently declined. By far the most commonly registered cancer over the 25-year period was Kaposi sarcoma, but the incidence has declined, consistent with the decreasing population-prevalence of HIV. Non-Hodgkin lymphomas, also AIDS-related, increased in incidence until 2006/2007 and then declined-possibly as a result of availability of antiretroviral therapy. The trends reflect the changing lifestyles of this urban African population, as well as the consequences of the epidemic of HIV/AIDS and the availability of treatment with ARVs. At the same time, it highlights the fact that the decreases in cancer of the cervix observed in high and upper-middle income countries are not a consequence of changes in lifestyle, but demand active intervention through screening (and, in the longer term, vaccination).
乌干达基阿多县（包括坎帕拉市和城郊腹地）的人口中癌症发病率的趋势，根据坎帕拉癌症登记处收集的数据，呈现了 25 年（1991-2015 年）的变化。总的来说，发病率呈上升趋势，与 1991-1995 年相比，2011-2015 年的年龄调整后发病率高出约 25%。绝对增长最大的是前列腺癌、乳腺癌和宫颈癌，2010-2015 年的发病率比 1991-1995 年分别高出 100%（前列腺）、70%（乳腺）和 45%（宫颈）。食管癌和结肠癌-直肠癌的发病率也有所上升（男性具有统计学意义），而肝癌（该人群中第五大常见癌症）的发病率在 2007 年之前一直在上升，此后则下降。在这 25 年期间，最常见的癌症是卡波西肉瘤，但发病率一直在下降，与 HIV 人群流行率的下降相一致。非霍奇金淋巴瘤也是与艾滋病相关的癌症，其发病率一直上升到 2006/2007 年，然后下降-可能是由于抗逆转录病毒治疗的普及。这些趋势反映了这个非洲城市人口生活方式的变化，以及 HIV/AIDS 流行和抗逆转录病毒治疗可及性的后果。同时，它强调了一个事实，即在高收入和中上收入国家观察到的宫颈癌发病率下降并不是生活方式改变的结果，而是需要通过筛查（从长远来看，还需要接种疫苗）进行积极干预。
