Pattern of upper gastrointestinal tumors at Tikur Anbessa Teaching Hospital in Addis Ababa, Ethiopia: a ten-year review.

BACKGROUND: Due to lack of public awareness and cancer surveillance, patients in developing countries usually present with advanced and terminal malignancies. The absence of early diagnostic facilities and standard chemotherapeutic and radiotherapy services in low-income countries further confound the problem in the care of such patients. Moreover, the prevalence of cancers (including upper GI malignancies) is unknown in Ethiopia due to lack of national cancer registry.

OBJECTIVE: To assess the type and the pattern of upper GI tumors among the patients whose upper GI tract biopsies were seen at the Tikur Anbessa Hospital (TAH) during September 1, 1992 through August 31, 2002.

METHODOLOGY: A ten-year retrospective analysis of upper gastrointestinal tract (UGIT) biopsy reports of adult patients was made at the Tikur Anbessa teaching Hospital.

RESULTS: There were 608 UGIT biopsy specimens submitted to the pathology department of Addis Ababa University Medical Faculty, from different hospitals and clinics in the country for histological studies. There were 369 males (67.7%) and 239 (39.3%) females with a male to female ratio of 1.5:1. The mean age for males was 50 years while 48 years for females. Although most of biopsies were submitted from Addis Ababa and Shewa, esophageal squamous cell carcinoma and adenocarcinoma were apparently predominant among the patients from Arsi and Bale areas as compared to Addis Ababa and other regions. The mean duration of major presenting symptoms was 4-6 months both for esophageal and gastric cancers. In this study, upper GI endoscopy had a 90% correlation with the histological diagnosis.

CONCLUSION: Esophageal cancers were observed to be relatively common among the patients from Arsi and Bale zones while gastric cancers were apparently predominant among patients referred from Addis Ababa. Upper GI endoscopic diagnosis was also noted to correlate well with the histological diagnosis.