Gastrointestinal tract cancer: a five year study in a teaching central referral hospital, Ethiopia

Due to lack of national cancer registry, the pattern and outcome of gastrointestinal tract (GIT) cancer is unknown in Ethiopia. In the period 1992-1996, a prospective study was carried out in 534 patients with GIT malignant tumours admitted to the Tikur Anbessa Hospital Department of Surgery, Addis Ababa. Relevant data were recorded on a prepared proforma for specific disease. Of these, 437 cases (82%), 142 oesophageal, 68 pancereato-biliary, 96 gastric, and 131 lower GIT cancers have been included in this study. The mean age was 52 +/- 13 (range 17-88) years. The male to female ratio was 1.7:1.0. The mean duration of the presenting symptoms was 10 months. One hundred and thirty-six patients were not operated because of poor clinical performance status or advanced metastatic disease in 105 patients and refusal to undergo surgery in 31 patients. In nearly 50% of 301 operated cases, the tumours were resected. Clinical staging was defined in 269 cases. Of these, 224 (83.3%) were advanced and only 45 were early cancers. The histopathology in 371 cases showed a predominance of adeno and squamous cell carcinomas. An overall postoperative in-hospital mortality rate was 20%. Of the 241 operative survivals (80%), only 110 (46%) had a limited follow-up of 3 to 12 months. Few cases were followed longer. The diagnosis was late and the follow-up was poor. A high index of suspicion of GIT cancer in all age groups will result in earlier diagnosis and improved survival.