TY - JOUR
T1 - Infection-related and lifestyle-related cancer burden in Kampala, Uganda
T2 - Projection of the future cancer incidence up to 2030
AU - Asasira, Judith
AU - Lee, Sanghee
AU - Tran, Thi Xuan Mai
AU - Mpamani, Collins
AU - Wabinga, Henry
AU - Jung, So Youn
AU - Chang, Yoon Jung
AU - Park, Yikyung
AU - Cho, Hyunsoon
N1 - Funding Information:
Funding This work was supported by the National Research Foundation of Korea grant funded by the Korea Ministry of Science ICT (grant no. NRF-2020R1A2C1A01011584), and National Cancer Center, Korea (grant no. NCC-2110450). JA's work was supported by the International Cooperation & Education Program (NCCRI·NCCI 52210-52211, 2019) of the National Cancer Centre, Korea.
Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
PY - 2022/3/16
Y1 - 2022/3/16
N2 - Objectives In Uganda, infection-related cancers have made the greatest contribution to cancer burden in the past; however, burden from lifestyle-related cancers has increased recently. Using the Kampala Cancer Registry data, we projected incidence of top five cancers, namely, Kaposi sarcoma (KS), cervical, breast and prostate cancer, and non-Hodgkin's lymphoma (NHL) in Uganda. Design Trend analysis of cancer registry data. Setting Kampala Cancer Registry, Uganda. Main outcome measure Cancer incidence data from 2001 to 2015 were used and projected to 2030. Population data were obtained from the Uganda Bureau of Statistics. Age-standardised incidence rates (ASRs) and their trends over the observed and projected period were calculated. Percentage change in cancer incidence was calculated to determine whether cancer incidence changes were attributable to cancer risk changes or population changes. Results It was projected that the incidence rates of KS and NHL continue to decrease by 22.6% and 37.3%, respectively. The ASR of KS was expected to decline from 29.6 per 100 000 population to 10.4, while ASR of NHL was expected to decrease from 7.6 to 3.2. In contrast, cervical, breast and prostate cancer incidence were projected to increase by 35.3%, 57.7% and 33.4%, respectively. The ASRs of cervical and breast were projected to increase up to 66.1 and 48.4 per 100 000 women. The ASR of prostate cancer was estimated to increase from 41.6 to 60.5 per 100 000 men. These changes were due to changes in risk factors and population growth. Conclusion Our results suggest a rapid shift in the profile of common cancers in Uganda, reflecting a new trend emerging in low/middle-income countries. This change in cancer spectrum, from infection-related to lifestyle-related, yields another challenge to cancer control programmes in resource-limited countries. Forthcoming cancer control programmes should include a substantial focus on lifestyle-related cancers, while infectious disease control programmes should be maintained.
AB - Objectives In Uganda, infection-related cancers have made the greatest contribution to cancer burden in the past; however, burden from lifestyle-related cancers has increased recently. Using the Kampala Cancer Registry data, we projected incidence of top five cancers, namely, Kaposi sarcoma (KS), cervical, breast and prostate cancer, and non-Hodgkin's lymphoma (NHL) in Uganda. Design Trend analysis of cancer registry data. Setting Kampala Cancer Registry, Uganda. Main outcome measure Cancer incidence data from 2001 to 2015 were used and projected to 2030. Population data were obtained from the Uganda Bureau of Statistics. Age-standardised incidence rates (ASRs) and their trends over the observed and projected period were calculated. Percentage change in cancer incidence was calculated to determine whether cancer incidence changes were attributable to cancer risk changes or population changes. Results It was projected that the incidence rates of KS and NHL continue to decrease by 22.6% and 37.3%, respectively. The ASR of KS was expected to decline from 29.6 per 100 000 population to 10.4, while ASR of NHL was expected to decrease from 7.6 to 3.2. In contrast, cervical, breast and prostate cancer incidence were projected to increase by 35.3%, 57.7% and 33.4%, respectively. The ASRs of cervical and breast were projected to increase up to 66.1 and 48.4 per 100 000 women. The ASR of prostate cancer was estimated to increase from 41.6 to 60.5 per 100 000 men. These changes were due to changes in risk factors and population growth. Conclusion Our results suggest a rapid shift in the profile of common cancers in Uganda, reflecting a new trend emerging in low/middle-income countries. This change in cancer spectrum, from infection-related to lifestyle-related, yields another challenge to cancer control programmes in resource-limited countries. Forthcoming cancer control programmes should include a substantial focus on lifestyle-related cancers, while infectious disease control programmes should be maintained.
KW - epidemiology
KW - health policy
KW - oncology
UR - http://www.scopus.com/inward/record.url?scp=85126696837&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-056722
DO - 10.1136/bmjopen-2021-056722
M3 - Article
C2 - 35296484
AN - SCOPUS:85126696837
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e056722
ER -