[Epidemiological and Clinical features of colorectal cancer at the hematology and oncology ward of Point G in Bamako, Mali, from 2005 to 2011: 113 cases]. / Particularites epidemiologiques et cliniques du cancer colorectal dans le service d'hematologie oncologie medicale du Point G de Bamako au Mali de 2005 a 2011: 113 cas.

AIMS: Epidemiological, clinical and biological characteristics of colorectal cancer vary across continents probably because of different risk factors that are not yet fully listed in countries with limited resources. This study describes the epidemiological and clinical features of colorectal cancer at a University hospital in Bamako, Mali. PATIENTS AND METHODS: A retrospective study that concerned the period from 2005 to 2011 was carried out. It included records of patients with colorectal cancer histologically documented in the service. Were analyzed epidemiological, clinical and biological data stored in files. RESULTS: One hundred-thirteen (113) cases of colorectal cancer were diagnosed representing 15% of all cancers documented over the 7 years. The number of cases increased year by year. The cases of colorectal cancer are not uncommon in young patients (23% under 30 years of age, 60% under 50). The male is significantly more represented in this population of colorectal carriers with a sex ratio M / F = 2. The time between first the symptom and care is long and the diagnosis is made in 85% of cases at a metastatic stage. Localization of the cancer is more frequent in the colon (56%) than in the rectum (44%). Cancer is an adenocarcinoma in 97% of cases. CONCLUSION: These epidemiological and clinical features invite practitioners to reconsider the concept of rarity of colorectal cancer in Africa and vigilance in front of a digestive disorder, even the patient is young, they also emphasize the need to conduct prospective studies to identify specific risk factors and develop appropriate strategies for the prevention and treatment of colorectal cancer in Mali.

BUT: Les caractéristiques épidémiologiques, cliniques et biologiques du cancer colorectal sont variables selon les continents, probablement à cause de facteurs de risque différents et non encore complètement répertoriés dans les pays à faibles moyens. Cette étude décrit les particularités épidémiologiques et cliniques du cancer colorectal dans un service hospitalier de référence spécialisé de Bamako au Mali. PATIENTS ET MÉTHODES: L'étude rétrospective a concerné la période de 2005 à 2011. Elle a inclus les dossiers des patients atteints de cancer colorectal documenté histologiquement. Ont été analysés, les données épidémiologiques, cliniques et biologiques enregistrées dans les dossiers. RÉSULTATS: Cent-treize (113) cas de cancer colorectal ont été colligés et représentaient 15% de l'ensemble des cancers diagnostiqués sur 7 ans. Ces cas étaient en augmentation d'année en année et s'observaient chez une population souvent jeune (23% avant 30 ans, 60% avant 50 ans). Le sexe masculin était significativement plus représenté, soit 2 hommes pour une femme. Le délai entre le premier symptôme et la prise en charge du malade était long avec dans 85% des cas, un diagnostic porté à un stade métastatique. La localisation était plus souvent colique (56%) que rectale (44%). Le cancer était un adénocarcinome dans 97% des cas. CONCLUSION: Ces particularités épidémiologiques et cliniques invitent à reconsidérer le concept de rareté du cancer colorectal en Afrique et à la vigilance de la part des praticiens devant un trouble digestif même chez un sujet jeune, ils soulignent aussi la nécessité de conduire des études prospectives pour identifier des facteurs de risque particuliers et élaborer les stratégies les mieux adaptées pour la prévention et la prise en charge du cancer colorectal au Mali.

High incidence of triple-negative tumors in sub-saharan Africa: a prospective study of breast cancer characteristics and risk factors in Malian women seen in a Bamako university hospital.

OBJECTIVE: Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. METHODS: Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. RESULTS: Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). CONCLUSION: This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.