Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes

查看全文 作　　者：Akwi W [1]Asombang;Nathaniel [2]Chishinga;Alick [3]Nkhoma;Jackson [4]Chipaila;Bright [5]Nsokolo;Martha Manda-[6]Mapalo;Joao Filipe G [7]Montiero;Lewis [8]Banda;Kulwinder S [9]Dua

机构地区：[1]Division of Gastroenterology/Hepatology,Warren Alpert Medical School of Brown University,Providence,RI 02903,United States;[2]Department for HIV Elimination,Fulton County Government,Atlanta,GA 30303,United States;[3]Department of Gastroenterology,Royal Stoke University Hospital,University Hospitals of North Midlands NHS Trust,Staffordshire ST4 6QG,United Kingdom;[4]Department of Surgery,University Teaching Hospital-Adult Hospital,Lusaka 10101,Zambia;[5]Department of Medicine,Levy Mwanawasa University Teaching Hospital,Tropical Gastroenterology and Nutrition Group(TROPGAN),Lusaka 10101,Zambia;[6]Department of Medicine,The University of New Mexico,Albuquerque,NM 87106,United States;[7]Department of Medicine,Brown University,Providence,RI 02903,United States;[8]Hematology/Oncology,Cancer Disease Hospital,Lusaka 10101,Zambia;[9]Department of Medicine and Pediatrics,Medical College of Wisconsin,Milwaukee,WI 53226,United States

出　　处：《World Journal of Gastroenterology》索引2019年第25卷第31期,共22页

摘　　要：BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity,and socio-economic challenges faced on the African continent.METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology,risk factors,management and outcomes of EC.A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer,and the Cancer in Sub-Saharan reports.We searched EMBASE,PubMed,Web of Science,and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved.Random effects metaanalyses were used to assess heterogeneity between studies and to obtain odds ratio(OR)of the associations between EC and risk factors;and incidence rate ratios for EC between sexes with their respective 95%confidence intervals(CI).RESULTS The incidence of EC is higher in males than females,except in North Africa where it is similar for both sexes.The highest age-standardized rate is from Malawi(30.3 and 19.4 cases/year/100000 population for males and females,respectively)followed by Kenya(28.7 cases/year/100000 population for both sexes).The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old.Meta-analysis shows a strong association with tobacco(OR 3.15,95%CI:2.83-3.50).There was significant heterogeneity between studies on alcohol consumption(OR 2.28,95%CI:1.94-2.65)and on low socioeconomic status(OR 139,95%CI:1.25-1.54)as risk factors,but these could also contribute to increasing the incidence of EC.The best treatment outcomes were with esophagectomy with survival rates of 76.6%at 3 years,and chemo-radiotherapy with an overall combined survival time of 267.50 d.CONCLUSION Africa has high incidence and mortality rates of EC,with preventable and nonmodifiable risk factors.Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption.Management requires a multidisciplinary approach,and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy. 关键词：ESOPHAGEAL CANCER in AFRICA ESOPHAGEAL SQUAMOUS cell carcinoma CANCER in AFRICA Systematic review

相关文献

参考文献（138）
引证文献（13）
耦合文献（0）

参考文献(138)

引证文献(13)

互联网出版许可证新出网证(渝)字10号全国400电话 - 免长途话费

Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes

参考文献(138)

引证文献(13)

用户提示