The Pattern of Urological Cancers in Zambia

Objective: To examine the pattern of urological malignancies; particularly cancer of the bladder; seen at the University Teaching Hospital (UTH) in Lusaka and to compare the findings with previous studies on the same parameters done at UTH. Material and Methods: A retrospective study of urological cancers in Zambia was performed; based on histopathology reports of specimens reviewed at the UTH Pathology Laboratory in Lusaka; Zambia; between January 1990 and December 2005. The parameters studied were the histological type of the cancer; patient age and trends over a 15-year period. Results: In total; 8829 cancers were diagnosed during the study period; of which 749 (8.5) were urological malignancies affecting the kidney; bladder; prostate; testis or penis. The maleto- female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6); followed by bladder cancer (21.1) and penile cancer (18.6). The histological type of bladder cancer was mainly squamous cell carcinoma (46.2); transitional cell carcinoma (23.4) and adenocarcinoma (22.2); other types (8.2) included rhabdomyosarcoma; small cell carcinoma and lymphoma. The majority of patients (79) with bladder cancer were between 56 and 65 years of age. Whereas 20 years ago prostate cancer comprised only 26of urological malignancies; it accounted for 55of urological cancers diagnosed in Zambia between 1990 and 2005. In contrast; cancer of the penis; kidney and testis have shown no change in frequency distribution compared to 20 years ago. Conclusion:Over the last 15 years there has been an increasing proportion of cancer of the prostate and squamous cell carcinoma of the bladder. This is associated with high levels of schistosomiasis; cystitis (some of which is HIV-related) and bladder stones. It may also be due to the extension of urological services and the diagnostic armamentarium (PSA; cystoscopy and histological diagnosis) to indigent rural populations; where the incidence of squamous cell carcinoma is likely to be higher than in affluent urban populations

A Review of Outcome of Postgraduate Medical Training in Zambia

The University of Zambia School of Medicine was opened in 1966. Since inception; over 1200 undergraduate students have graduated with Bachelor of Medicine and Bachelor of Surgery. The postgraduate Master of Medicine (M.Med)programme was started in 19822 with the intention of providing district specialists in the rural and semi urban communities of Zambia. Additional hope was to stem the brain drain to other countries. This is a study to describe the deployment of graduates of the M.Med training programs at the University of Zambia School Of Medicine in relation to the objectives defined by the University of Zambia senate in 1981. It was found that the School of Medicine has produced 118 Master of Medicine graduates in 5 clinical programs over a period of 22 years. The average graduation rate is 5 students per annum. The largest specialist group has been in General surgery with 34 (29) of all graduates. The ratio of men to women was 3 to 1. The ratio of Zambian to Non Zambian ratio was 10:1. Of all students who have graduated over this period 13 (11) have gone abroad and 7(6) have died.; Eighty-eight (75) of the graduates are working along the line of rail in the 5 most urbanized towns in the country. Twenty-five ( 21) are doing non clinical jobs which involve health programs administration and 12 (10) are working in private practice. We concluded that external migration is not a major problem and; overall; the creation of a local postgraduate training program has reduced brain drain. The key challenge is internal brain drain

The Changing Pattern of Urological Cancers in Zambia

The university teaching hospital Lusaka (UTH) is the main reference hospital and national reference laboratory in Zambia it has a referral areas of 1.3 million people objectives :the purpose of the study was to examine the pattern of urological malignancies seen at the UTH in Lusaka .in particular the pattern of cancer of the bladder. Method :A retrospective study of urological cancers in Zambia was done ; which the IDC(10) classification .Results: a total 8829 cancers were diagnosed over the 15years study period; 749(8.4) were urological maligical cancer was 10.7 to 1. cancer of the prostate was the most common urological malignancy (54;6) ; followed by cancer of the bladder (21;1) and cancer of the penis (18.6) the histological type of bladder cancer was squamous celle carcinoma (46.2); transitional cell carcinoma (23.4); adenocarcinoma (22;2) and other types (82) . the majority of patients (79) with bladder .cancer were between and 65years of age .There was an increasing incidence of squamous celle cancers of the bladder over last 15 tears.Conclusion:twenty years ago prostate cancer comprised only 26of urological malignancies ;it now makes up 55of the urological cancers diagnosed in Zambia over the last 15 years.In contrast; cancer of the penis; kidney and testis have shown so change in frequency distribution compared to 20 years ago.There has been has an increase in squamous cell type of bladder observed over the last 15 years