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Introduction Gastric cancer is a leading cause of cancer mortality worldwide. The burden of this disease is highest in developing countries of East Asia, Eastern Europe, and parts of Central and Southern America. Africa, despite having a similar high profile of Helicobacter pylori infection with East Asia, has a reported low prevalence of gastric cancer. There is a paucity of data on the natural history and endoscopic presentation of gastric cancer in West Africa. Aim To study the topography and morphology of gastric cancer from two institutions in Southern Nigeria. Methods A cross-sectional retrospective study of 622 consecutive cases of upper gastrointestinal (GI) endoscopy performed in two referral endoscopy facilities in Port Harcourt, Rivers State, Nigeria from February 2012 to January 2021. Variables collated from centre records included age, sex, ethnicity, symptoms, site, endoscopic classification, and histology of gastric cancers. Statistical analysis was performed using IBM SPSS version 20 (IBM Corp., Armonk, NY). Results There were 17 (2.7%) cases of histologically confirmed gastric cancer. The age range of patients was from 34 years to 99 years (mean 60.7 ± 14.6 years). There were nine males and eight females (M:F ratio of 1.1:1). Antrum and cardia were predominantly affected in 10 (60.0%) and seven (6.7%) cases, respectively. Borrmann type 1 advanced gastric tumor was seen in seven (53.8%) and adenocarcinoma, the predominant histology, in 14 (82.4%) cases. Helicobacter pylori was detected in a sole case of gastric cancer. Conclusion Gastric cancer is uncommon in our environment and with a delayed presentation. A predominance of gastric antrum topography and exophytic growth morphology is the pattern.
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PURPOSE: To determine the causes of death and associated risk factors among women of reproductive age (WRA) in a tertiary institution in Port Harcourt, Nigeria. PATIENTS AND METHODS: This was a retrospective survey of all deaths in women aged 15-49 years at the University of Port Harcourt Teaching Hospital that occurred from January 1, 2013 to December 31, 2015. Data retrieved from ward registers, death registers, and death certificates were analyzed with Epi Info version 7. Comparison of socioeconomic and demographic risk factors for maternal and nonmaternal deaths was done using a multivariate logistic regression model. RESULTS: There were 340 deaths in the WRA group over the 3-year period. The majority (155 [45.6%]) of the women were aged 30-39 years. There were 265 (77.9%) nonmaternal deaths and 75 (22.1%) maternal deaths. Among the nonmaternal deaths, 124 (46.8%) had infectious diseases, with human immunodeficiency virus being the most common cause of infection in this group. Breast cancer (13 [4.9%]), cervical cancer (12 [4.5%]), and ovarian cancer (11 [4.2%]) were the most common malignant neoplasms observed. Hypertensive disorders of pregnancy (31 [41.3%]) and puerperal sepsis (20 [26.7%]) were the most common causes of maternal deaths. Age and occupation were significantly associated with deaths in WRA (p<0.05). Older women aged >30 years (odd ratio =1.86, 95% CI =1.07-3.23) and employed women (odds ratio =2.55, 95% CI =1.46-4.45) were more likely to die from nonmaternal than maternal causes. CONCLUSION: Most of the deaths were nonmaternal. Infectious diseases, diseases of the circulatory system, and malignant neoplasms were the major causes of death among WRA, with maternal deaths accounting for approximately a quarter. Public health programs educating women on safer sex practices, early screening for cancers, benefits of antenatal care, and skilled attendants at delivery will go a long way to reducing preventable causes of deaths among these women.
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BACKGROUND: Like many countries in Africa, Nigeria is improving the quality and coverage of its cancer surveillance. This work is essential to address this growing category of chronic diseases, but is made difficult by economic, geographic and other challenges. PURPOSE: To evaluate the completeness, comparability and diagnostic validity of Nigeria's cancer registries. METHODS: Completeness was measured using children's age-specific incidence (ASI) and an established metric based on a modified Poisson distribution with regional comparisons. We used a registry questionnaire as well as percentages of death-certificate-only cases, morphologically verified cases, and case registration errors to examine comparability and diagnostic validity. RESULTS: Among the children's results, we found that over half of all cancers were non-Hodgkin lymphoma. There was also evidence of incompleteness. Considering the regional completeness comparisons, we found potential evidence of cancer-specific general incompleteness as well as what appears to be incompleteness due to inability to diagnose specific cancers. We found that registration was generally comparable, with some exceptions. Since autopsies are not common across Nigeria, coding for both them and death-certificate-only cases was also rare. With one exception, registries in our study had high rates of morphological verification of female breast, cervical and prostate cancers. CONCLUSIONS: Nigeria's registration procedures were generally comparable to each other and to international standards, and we found high rates of morphological verification, suggesting high diagnostic validity. There was, however, evidence of incompleteness.
