Gastric Adenocarcinoma in Zambia: a Case-control Study of HIV, Lifestyle Risk Factors, and Biomarkers of Pathogenesis

Overview

Journal S Afr Med J

Specialty General Medicine

Date 2013 Apr 4

PMID 23547703

Citations 18

Authors

V Kayamba

A W Asombang

V Mudenda

M M Lisulo

E Sinkala

S Mwanamakondo

I Mweemba

P Kelly

Affiliations

Soon will be listed here.

Abstract

Background: Gastric cancer is a leading cause of cancer deaths worldwide but there are few data from Africa. We recently observed a trend towards diagnosis in younger patients.

Objective: To test the hypothesis that HIV might have altered risk factors for acquisition of gastric cancer, in a case-control study in the University Teaching Hospital, Lusaka, Zambia.

Methods: Patients (n=52) with confirmed gastric adenocarcinoma and controls (n=94) undergoing endoscopy but with no macroscopic gastric pathology. Established risk factors and HIV status were compared.

Results: HIV status did not differ significantly between cases and controls (odds ratio 1.03; 95% CI 0.2 - 4.3; p=1.00) and seroprevalence in cases was similar to that of the Zambian population. Smoking, regular alcohol intake, and gastric atrophy were all associated with cancer in univariate and multivariate analysis. Helicobacter pylori serology was positive in 84% of patients studied and cagA serology in 66%; neither serological marker was associated with cancer. Atrophy was common in cases (57%) and controls (30%) and associated with both smoking and alcohol use. Intestinal metaplasia was present in 17% of the controls, but was not associated with atrophy.

Conclusions: HIV was not associated with gastric cancer and does not explain the apparent younger age distribution. Atrophy was common and was not essential for the development of intestinal metaplasia, suggesting that gastric carcinogenesis in Africa does not always follow the pathway from atrophy to intestinal metaplasia to gastric carcinoma (the so-called Correa pathway).

Citing Articles

Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: a retrospective analysis.

Kayamba V, Mubbunu M, Kelly P BMC Gastroenterol. 2024; 24(1):122.

PMID: 38561688 PMC: 10983744. DOI: 10.1186/s12876-024-03187-x.

Gastric Malignancy Survival in Zambia, Southern Africa: A Two Year Follow up Study.

Asombang A, Kayamba V, Turner-Moss E, Banda L, Colditz G, Mudenda V Med J Zambia. 2023; 41(1):13-18.

PMID: 37731812 PMC: 10511215.

Analysis of the proportion of university teaching hospital gastric cancer data included in the Zambia national cancer registry.

Shumba S, Kayamba V Afr Health Sci. 2023; 23(1):438-443.

PMID: 37545961 PMC: 10398468. DOI: 10.4314/ahs.v23i1.46.

Serum antibodies to selected antigens are associated with active gastritis in patients seen at the University Teaching Hospital in Lusaka, Zambia.

Kayamba V, Butt J, Varga M, Shibemba A, Piazuelo M, Wilson K Malawi Med J. 2023; 34(1):17-24.

PMID: 37265823 PMC: 10230586. DOI: 10.4314/mmj.v34i1.4.

Introducing the Sanguis-Filum for Detection of Gastric Mucosal Lesions Prior to Endoscopy: A Study Protocol.

Kayamba V, Kelly P Diagnostics (Basel). 2022; 12(5).

PMID: 35626320 PMC: 9139864. DOI: 10.3390/diagnostics12051160.

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