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. 2010 Feb;23(2):128-35.
doi: 10.1111/j.1442-2050.2009.00977.x. Epub 2009 May 15.

Frequent occurrence of esophageal cancer in young people in western Kenya

R K Parker  1 , S M Dawsey, C C Abnet, R E White
Affiliations

Frequent occurrence of esophageal cancer in young people in western Kenya

R K Parker et al. Dis Esophagus. 2010 Feb.

Abstract

Esophageal cancer has a strikingly uneven geographical distribution, resulting in focal endemic areas in several countries. One such endemic area is in western Kenya. We conducted a retrospective review of all pathology-confirmed malignancies diagnosed at Tenwek Hospital, Bomet District, between January 1999 and September 2007. Tumor site, histology, sex, age, ethnicity, and location of residence were recorded. Cases were analyzed within and outside a traditional catchment area defined as < or = 50 km from the hospital. Since 1999, the five most common cancer sites were the esophagus, stomach, prostate, colorectum, and cervix. Esophageal cancer accounted for 914 (34.6%) of the 2643 newly diagnosed cancers and showed increasing trends within and outside the catchment area. Fifty-eight (6.3%) patients were < or = 30 years old and 9 (1%) were < or = 20 years old; the youngest patient was 14 years at diagnosis. Young cases (< or = 30) were more common among patients of Kalenjin ethnicity (9.2%) than among other ethnicities (1.7%) (odds ratio [95% confidence interval] 5.7 [2.1-15.1]). This area of western Kenya is a high-risk region for esophageal cancer and appears unique in its large proportion of young patients. Our findings support the need for further study of both environmental and genetic risk factors for esophageal cancer in this area.

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Figures

Figure 1
Figure 1
Pathology-confirmed cancer cases diagnosed at Tenwek Hospital, 1989–2006
Figure 2
Figure 2
Age distribution of Kalenjin and non-Kalenjin EC patients at Tenwek Hospital, 1999–2007
Figure 3
Figure 3
Residences of EC patients on a province-level map of Kenya, showing Tenwek Hospital (star) and the 50 km traditional catchment area. 3a: October 1993–December 1998; 3b: January 1999–August 2007
Figure 3
Figure 3
Residences of EC patients on a province-level map of Kenya, showing Tenwek Hospital (star) and the 50 km traditional catchment area. 3a: October 1993–December 1998; 3b: January 1999–August 2007
Figure 4
Figure 4
Age distribution of EC patients seen at Tenwek Hospital (1999–2007) and reported to SEER registries in the United States (1995–2002)
See this image and copyright information in PMC

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