Gastric cancer: aetiological, clinicopathological and management patterns in Nigeria

Abstract

Background: Gastric cancer is a major cause of cancer death worldwide with a widely variable incidence and is of multifactorial aetiology.

Aim: To highlight aetiological, clinicopathological and management patterns of gastric cancer in Nigeria.

Method: All available literature on gastric cancer in Nigeria were sourced from both Medline and library search, and a review was undertaken.

Results: Gastric cancer is relatively uncommon in Nigeria and other African countries compared with South-East Asian and South American countries. The peak age group of patients is in the fifth decade and the male:female sex ratio is between 1.6:1 and 4.1:1. There is a high sero-prevalence of between 80% to 85% of Helicobacter pylori infection among healthy individuals in the southern and northern parts of the country despite a relatively low incidence of gastric cancer. The relative contributions of some of the known dietary factors to its prevalence in Nigeria are yet to be explored. Intestinal type adenocarcinoma predominates at histology over the diffuse type and this seems to correlate with the prevalence of H. pylori. The prognosis of gastric cancer has remained poor over the decades in Nigeria due to a high percentage of advanced stage presentation, while the rate of surgical procedures performed is encouraging, the resection rate is disappointingly low.

Conclusion: Control measures therefore need to be put in place to include health education of the populace on the value of seeking medical attention early; primary prevention strategies directed at eradicating H. pylori infection while clinicians should be enjoined to minimize delay in treating patients evaluated for dyspepsia because of the risk of underlying gastric malignancy.