A historical perspective of registered cases of malignant ocular tumors in Zimbabwe (1990 to 1999). Is HIV infection a factor?

INTRODUCTION: Anecdotal and published reports suggest that ocular tumours are on the increase in Zimbabwe. OBJECTIVES: To determine the trends in incidence rates of common malignant ocular tumours registered with the Zimbabwe Cancer Registry during the last decade (1990 to 1999). DESIGN: Retrospective study. SETTING: Data were collected from the Zimbabwe National Cancer Registry, the Zimbabwe National Census 1992 and 2002 Reports, and patient records from hospitals. SUBJECTS: All cases of malignant ocular tumours registered with the Zimbabwe National Cancer Registry between 1 January 1990 and 31 December 1999. MAIN OUTCOME MEASURES: Age standardized annual incidence rates for registered cases of common ocular tumours. RESULTS: The age-adjusted annual incidence rates of squamous cell carcinoma of the conjunctiva had a more than 10-fold increase from 0.17 to 1.8 per 100,000 people during periods 1990 and 1999 respectively. Retinoblastoma dropped by more than half from 0.8 to 0.34 per 100,000 during the same period. The annual age standardised incidence rates for all ocular tumours showed a significant upward linear trend (chi2: 362.78, df=9 and p < 0.001). There was no significant gender difference in the distribution of these tumours amongst the study population. CONCLUSION: The increasing trend in the age-adjusted annual incidence rates of ocular surface squamous neoplasms could be attributed to the worsening HIV and AIDS pandemic in Zimbabwe or improved access/utilization of health services by the public.

Cancer incidence in the African population of Harare, Zimbabwe: second results from the cancer registry 1993-1995.

The data of the population-based cancer registry in Harare, Zimbabwe, for 1993-1995 are presented and compared with those from 1990-1992. The most significant change in rates is the striking increase in the incidence of Kaposi's sarcoma (KS) in both men and women, compatible with the evolution of the AIDS epidemic in sub-Saharan Africa. The incidence of KS doubled in both sexes and now accounts for 31.1% of registered cancers. It has overtaken breast cancer to become the second most common tumour in African women, after cervical cancer, and is now one of the leading childhood tumours, accounting for 10. 3% of cancers recorded in children (ages 0-14). With the exception of KS, the incidence and pattern of occurrence of the other malignant neoplasms changed little during the observed 6 years.

Aids and cancer in Africa: the evolving epidemic in Zimbabwe.

BACKGROUND: Zimbabwe is severely affected by the AIDS epidemic, and many cancers in African populations are related to infectious agents. OBJECTIVE: To study the current pattern, and short-term changes in incidence, of cancers related to infectious agents (and especially to HIV), with respect to the evolving epidemic of AIDS. METHODS: Analysis of data on the African population of Harare, Zimbabwe, from the Zimbabwe Cancer Registry, for the period 1990-1995. Comparison with data on prevalence of HIV seropositivity, and notifications of AIDS. RESULTS: Comparing results from 1993-1995 with those for 1990-1992 shows a continuing increase in the incidence of Kaposi's sarcoma with a doubling of the rates in both men and women. A dramatic increase in the incidence of squamous cell tumours of the conjunctiva was also observed, as well as a significant increase in the incidence of non-Hodgkin's lymphoma in women. There was no apparent increase in risk for Hodgkin's disease, myeloma, liver cancer, or cancer of the cervix. CONCLUSIONS: The AIDS epidemic has had a dramatic effect on the profile of cancer. The changes in incidence involve several cancers previously linked to AIDS in North America and Europe.