delGA (rs67491583) variant and colorectal cancer risk in an indigenous African population.

BACKGROUND: A recent study showed a higher frequency of GA deletion at rs67491583 in African American colorectal cancer (CRC) patients compared to controls, suggesting a likely contribution of this allele to racial disparity in CRC risk predisposition. We conducted a pilot study in an indigenous African population to evaluate this potential CRC risk variant. METHODS: We collected epidemiological data and biological specimen from consenting consecutive CRC cases and controls presenting at the Oncology Clinic of University College Hospital, Ibadan from 2001 to 2007. We examined germline DNA for delGA by PCR-amplification of two overlapping fragments using standard primers. The products were directly sequenced using Applied Biosystems BigDye v3.1 sequencing chemistry and AB 13730 automatic DNA sequencer. RESULTS: There were 45 cases and 45 controls of which genotyping was successful in 39 cases and 38 controls. There were 5 heterozygous and 2 homozygous GA deletions with frequency of 11.54% (9/78) among cases whereas there were 8 heterozygous and 1 homozygous GA deletions among controls with frequency of 13.15% (10/76). (p= 0.79, OR 0.88, 95% CI 0.34-2.28). CONCLUSION: This study suggests that there is no association between the delGA (rs67491583) variant and CRC risk in this indigenous African population. However our sample size was small and the participants were not ethnically homogenous. Further studies are required to evaluate this marker in African CRC.

Office based muscle biopsy using Vacora vacuum assisted biopsy system.

INTRODUCTION: Muscle biopsy is a minor surgical procedure that has been conducted over several decades in clinical practice. Over the years, the technique to implement this procedure has been modified to make it easier to perform and more tolerable for the patient. This study aimed to assess the feasibility of muscle biopsy as an office based procedure, by using a vacuum Assisted Biopsy System. METHOD: The procedure was successfully carried out on 57 individuals with/without diabetes, currently involved in the African American Diabetes Mellitus Study. One specimen was collected percutaneously from the vastus lateralis, under local anesthesia. A 16-gauge needle was used. RESULTS: Muscle biopsies were successfully carried out on all study participants. The study participants reported no complications after the procedure. CONCLUSION: The findings from our study show that muscle biopsy can be feasibly implemented as an office based procedure, involving minimal muscle invasion, less trauma, hospital stay time, and expenses.

Cancer in Africa: opportunities for collaborative research and training.

Cancer is a worldwide public health problem causing increasing morbidity and mortality, particularly in the developing world. Underlying trends are changing the pattern of cancer and this is also being influenced by the HIV/AIDS pandemic, particularly in Sub-Saharan Africa. Even though the pattern of cancer varies across Africa, there are identifiable trends. Breast and cervical cancers, and Kaposi sarcoma are the commonest cancers in women, while Kaposi sarcoma, liver and prostate cancers are the commonest in men. Cancer causes more morbidity and mortality in Africa compared to other parts of the world. Infections account for a disproportionate amount of cancers in Africa. The HIV epidemic is contributing to increased prevalence of many cancers particularly those associated with Herpes and Papilloma viruses. Tobacco use, another major carcinogen, is increasing, particularly among the young. Dietary factors, alcohol use, physical inactivity and environmental pollution are also important aetiological factors of cancer in Africa. In developing countries, poverty, limited government health budget and poor health care systems complicate cancer prevention, treatment and outcomes. Coordinated response by international agencies and NGOs is needed to help developing countries and several successful models exist. More action is also needed on ensuring safety and quality of chemotherapy and the price needs to be reduced. Responses advocated for cancer control in Africa include banning tobacco use, better regulation of alcohol sale, better environmental planning and immunization against cancer associated viruses. Training of health care workers to diagnose cancer and treat it effectively within limited budgets is needed. Research to develop these new treatments and others, particularly from natural products is urgently needed and this can be done safely within established health research ethics regulatory frameworks. Several opportunities for collaborative research and training include an update of the epidemiology of cancers in African females; the relationship between HIV and other carcinogenic viruses; biological factors making cancers in Africa more lethal; cheaper vaccines that will be more available and easier to store and hence can be included in the immunization programme in African countries and development of vaccines like the HPV against other uncommon serotypes of the virus.