Pattern of cutaneous neoplasms and associated factors at a tertiary teaching hospital pathology center in Ethiopia: An eight-year histopathological review

Abstract

Background: Cancer is the leading cause of death globally and is on the rise in Africa. Cutaneous neoplasms are becoming increasingly common worldwide. Understanding the pattern of this disease is essential for developing data-driven preventive, screening, and treatment services. However, there are limited studies in Ethiopia so far. Therefore, the study aimed to assess the pattern and associated factors of cutaneous neoplasm among patients with histopathologically confirmed biopsy results at a tertiary teaching hospital in Ethiopia from March 2014 to October 2022.
Methods: A retrospective record review study was conducted among 1006 patients with histopathologically confirmed cutaneous neoplasms from the biopsies that were assessed at St. Paul’s Hospital Millennium Medical College. Data was summarized using frequencies, percentages, median (interquartile range), and graphs. To identify significant factors associated with malignant cutaneous neoplasm, a multivariable binary logistic regression model was fitted, where Adjusted Odds ratio (AOR), 95% CIs for AOR, and p-values were used for interpretation of results.
Result: From the 1006 cases, 265 (26.3%, 95%CI=23.5%-29.3%) were malignant, of which sarcoma (26.0%) and squamous cell carcinoma (25.7%) were the most frequent and found to be prevalent in younger (19-29 years) and older (≥60 years) patients, respectively. The trunk was the commonest site (54.2%) for all the malignancies, especially sarcoma (80.4%). Age was found to be a significant exposure that is associated with the development of malignant cutaneous neoplasm for those ≥30 years as compared with those ≤18 years, with the odds increasing with age (AOR=2.66, 95% CI=1.10,6.45 for 30-39 years, AOR=4.98, 95% CI= 2.01,12.36 for 40-49 years, AOR=5.33, 95% CI=2.15,13.22 for 50-59 years and AOR= 6.62, 95% CI=2.79,15.66 for ≥60).
Conclusion: The prevalence of malignant cutaneous neoplasm is higher than previously reported in the country and the malignancy pattern and distribution are different from what is known so far. This could signal a shift in disease epidemiology, and the findings should be factored into clinical decision making and program design for disease prevention, screening, and treatment. It also calls for further prospective research to learn more about the conditions in the context of additional relevant personal and clinical characteristics