Five-year Single-centre Experience of Carcinoma of the Oesophagus from Blantyre, Malawi

Overview

Journal BMJ Open Gastroenterol

Specialty Gastroenterology

Date 2018 Nov 7

PMID 30397505

Citations 6

Authors

John David Chetwood

Peter J Finch

Anstead Kankwatira

Jane Mallewa

Melita A Gordon

Leo Masamba

Affiliations

Soon will be listed here.

Abstract

Background: Oesophageal squamous cell carcinoma (OSCC) is increasing worldwide and has an exceptionally high prevalence in certain distinct geographical locations such as the African oesophageal SCC corridor. Despite this, there is a paucity of evidence to characterise the disease particularly in the Malawian context.

Method: We retrospectively audited our endoscopy database over 5 years, including for patient demographics, endoscopy findings, therapeutic intervention and recommendations for treatment.

Results: 1586 patients with oesophageal cancer were identified from a total of 5882 endoscopy records from 2013 to 2017. Our cohort showed a larger proportion of oesophageal cancers found higher in the oesophagus compared with other African studies and a female preponderance in this upper-oesophagus disease subset though a male preponderance overall. 39% of patients with oesophageal cancer underwent bougie dilatation and 11% underwent palliative stent placement, which likely reflects local availability of resources.

Conclusion: This study validates the observation that OSCC predominates in sub-Saharan Africa in Malawi over other forms of oesophageal carcinoma, though our cohort appears to have subtly distinct demographics and disease-specific data. This highlights the need to prioritise preventative and therapeutic strategies for OSCC in this and similar settings.

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