Brachytherapy infrastructure in sub-Saharan Africa and quest for cervical cancer elimination.

Purpose: Sub-Saharan Africa has the highest burden of cervical cancer in the world. The African continent has only 5% of the world's cancer care resources, and brachytherapy is an important part of treatment of cervical cancer. This study explored the availability of brachytherapy units in Africa. Material and methods: We used publicly available data on cervical cancer and brachytherapy from GLOBOCAN 2018 database hosted by IARC and Directory of Radiotherapy Centers (DIRAC) presented by IAEA, respectively. Number of brachytherapy units per 1,000 new cases was calculated as an index for comparison between groups. Results: There are 101 brachytherapy units in 20 African countries, accounting for 3% (101/3,375) of total global units. Sub-Saharan Africa accounts for half of these units (50/101). Egypt has the highest number of units per 1,000 new cases (23.7 units/1,000 new cases), while Nigeria has the least with 0.13 units per 1,000 new cases. No country in central African region has a brachytherapy unit. More than 70% of brachytherapy units are located in five countries (Algeria, Kenya, Egypt, Morocco, and South Africa). Conclusions: In order to treat 90 percent of invasive cervical cancer on the continent, Africa needs a continental political action plan and massive investment in brachytherapy equipment over the next ten years.

Socio-demographic and clinico-pathologic pattern of patients with colorectal cancers seen in Ahmadu Bello University teaching Hospital, Zaria

Introduction: Colorectal cancer is a major cause of morbidity and mortality in the world. It accounts for 10.2% of cancer incidence globally, with a mortality of 9.2%. It ranks third in terms of incidence but second in terms of mortality. Colorectal cancer is not uniformly common throughout the world. Its incidence is increasing in developing countries, probably due to the acquisition of western lifestyle.Aim: The aim of this study was to determine the sociodemographic and clinicopathological pattern of patients with colorectal cancer seen in the Department of Surgery, Radiotherapy, and Oncology Centre, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a 10-year period.Materials and Methods: In this retrospective study, data were collected from the case files and treatment cards of 122 patients with colorectal cancer managed at the Surgical, Radiotherapy, and Oncology Department of ABUTH, Zaria, from January 2006 to December 2015. Data items analyzed included age, sex, residential area, occupation, duration of symptoms, presenting complaints, subsite, histological type, grade, and stage. All analyses were performed by SPSS version 20.Results: An annual incidence of 12.2 cases/annum was seen. Seventy (57.4%) were male and 52 (42.6%) were female. Male:female ratio was 1.3:1 and the age range was between 12 years and 78 years, majority were between 31 and 40 years (24.6%), with a mean age of 42.4 years and median age of 41 years. It was found to be more common among the urban dwellers, with the public/civil servants being the most affected (36.0%). The duration of presenting complain ranged from 3 weeks to 10 years, most patients presenting at 7­10 months with more than one symptom. Bleeding per rectum was the most common symptom seen in 20%. Adenocarcinoma was the predominant histology seen in 73% (n = 89) and 28.7% were well differentiated. The rectum was the most common subsite, while left-sided lesions (20%) were more common than right-sided lesions (17%). About 18% (n = 22) had distant metastasis.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. The most common presenting symptom was bleeding per rectum and majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend.Conclusion: The study showed that colorectal cancer was more common among the younger age group, with a slight male preponderance. They were mostly urban dwellers and civil/public servants. Bleeding per rectum being the most common complaint, majority of the cases presented at an advanced stage. Early detection through public health education, screening programs, affordable and effective treatment, and follow-up will help reverse this trend