Familial clustering of cancer in two tertiary care hospitals in Nairobi, Kenya.

OBJECTIVE: To describe the occurrence of cancers in families of individuals diagnosed cancer. DESIGN: Cross-sectional descriptive study. SETTING: Outpatient cancer clinics at Kenyatta National Hospital (KNH) and Radiotherapy Clinic at Nairobi Hospital. SUBJECTS: Patients with a tissue histological or cytological diagnosis of cancer. MAIN OUTCOME MEASURES: A reported family history of cancer. RESULTS: A total number of 485 cancer patients were recruited, 382, from KNH and 103 from Nairobi Hospital. These index cases had 45 different types of cancer, with the most common being breast and uterine-cervical malignancies. Prevalence of family history of cancer was found to be 18.8% and was highest among 1st degree relatives. Documentary evidence was seen in 48.4% and history of cancer corroborated by medical personnel in an additional 11%. In 18.7% of cases more than one relative was interviewed to confirm the family history of cancer. Educational levels of the index cases correlated with knowledge of family history of cancer, with those of higher educational level having been more informed about their families' medical history. There was a prevalence of familial cancers of 30% at Nairobi Hospital patients and 15.7% at KNH patients. CONCLUSION: We found the prevalence of family history of cancer in our population to be 18.8% and was highest among 1st degree relatives. This has implications for targeted screening and therefore early diagnosis which is beneficial.

Histo and cyto-pathologic diagnoses at a rural hospital in Kenya.

BACKGROUND: Cancer has emerged as one of the common causes of morbidity and mortality in rural areas and as a major cause of premature deaths. OBJECTIVES: To provide histo-pathology and cyto-pathology data in a rural district hospital and highlight on the common malignancies seen in a rural setting in Kenya. DESIGN: Prospective study. SETTING: Histopathology Department, Machakos Provincial Hospital, Machakos district, Kenya. SUBJECTS: Two hundrend and sixty eight patients referred to Machakos laboratory for histopathology, fine needle aspirate or pap smear cyto-pathology were analysed. MAIN OUTCOME MEASURES: Staining with routine stains such Pap stain, Haeomatoxylin and Eosin was effective method of making a primary accurate and definitive histo-pathology and cyto-pathology diagnosis in a rural district hospital setting. RESULTS: Histo-pathology biopsies comprised 71.6% of the total slides seen. Pap smear cervical cytology comprised 13.8% while fine needle aspirate and post- mortem biopsies comprised 12.3%, 2.2% respectively. The commonest histo-pathology biopsies seen were breast comprising 24% of the total cases, followed by endometrium contributing 14.9%, then followed by skin 11.5%, lymph node 11.5%, cervical 11%, and gastrointestinal 6.3%. Most of pap smear cyto-pathology showed evidence of infection comprising 54% while fine needle aspirate infections and malignancy showed equal rate 24% of all cyto-pathology seen during this study. CONCLUSIONS: This is the first time histo-pathology and cyto-pathology data have been provided from a rural district hospital setting in Kenya. The malignant and pre-malignant pattern seen at Machakos General Hospital may be used to gain a broader picture of the common malignant conditions prevalent in any defined population in this country. This also serves as an important cancer epidemiological data in this region during the period of study.