Upper Gastrointestinal Tract Cancers at Endoscopy in Kano, North-Western Nigeria

Abstract

Cancer registration in Nigeria is poorly done, this is even so in North-Western Nigeria. It is only of recent that attempts are being made to know the profile of cancers seen in clinical practice in our environment. This study was done to establish the pattern of upper gastrointestinal cancers at Kano, North-Western Nigeria. Records of upper gastrointestinal endoscopy carried out at Aminu Kano Teaching Hospital over a period of 5 years (2002- 2006) were retrieved from the endoscopy register and reviewed. Demographic information and finding at endoscopy were retrieved for all cases of endoscopically diagnosed cancers. Histological findings of all such cases were also retrieved from Histopathology records. Over the five year study period, 1343 patients had diagnostic oesophagogastroduodenoscopy (OGD). The mean age of all patients endoscoped was 38.24 + 13.96 years. There were 592 females (44.1%) and 751 males (55.9%). Thirty two (32) of the 1343 patients endoscoped had upper gastrointestinal tract cancer, hence giving a prevalence of 0.024%. Gastric cancer was found in 19 of the 32 cancer cases, while the remaining 13 had oesophageal cancer. The mean age of patients with gastric cancer was 51.3 + 14.2 years (range 30 to 85), while that of oesophageal cancer was 56.8 + 14.96 years (range 47 to 83). There were significantly more male patients with gastric cancer; 16 (84.2%) than females; 3 (15.8%), P <0.05. Oesophageal cancer was also more prevalent in males, 8 (61.5%) than females, 5 (38.5%), but the difference was not statistically significant P> 0.05. Most gastric cancers were located in the antrum while oesophageal cancers were more in the middle third. Intestinal type adenocarcinoma (89.4%) and squamous cell carcinoma (69.2%) predominated histology in gastric cancer and oesophageal cancer respectively. Helicobacter pylori were present in 94.7 % of gastric cancer cases. Upper gastrointestinal tract cancers are probably not very prevalent in North-Western Nigeria. However, gastric cancer appears to occur at relatively young age groups. Therefore younger patients with dyspepsia who responds poorly to empiric therapy should be endoscoped early.

Key Words: Upper, gastrointestinal tract, cancers, Kano, Nigeria