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Corneo-conjunctival carcinoma in Uganda.
K M Waddell1, R G Downing, S B Lucas
1Ruharo Eye Hospital, Mbarara, Uganda. aim-uganda@aimint.net
Eye (London, England)
|February 4, 2006
Summary
Surgery for corneo-conjunctival squamous neoplasia in Uganda showed a low recurrence rate and minimal complications. Human immunodeficiency virus (HIV) infection was prevalent, but not all cases were associated with HIV.
Area of Science:
- Ophthalmology
- Oncology
- Infectious Diseases
Background:
- Conjunctival neoplasia incidence has tripled in Uganda since 1990.
- Associated factors include ultraviolet radiation exposure and human immunodeficiency virus (HIV) infection.
- Effective treatment strategies remain under-investigated.
Purpose of the Study:
- To report surgical outcomes for corneo-conjunctival squamous neoplasia in Uganda.
- To investigate the role of HIV infection in the aetiology of this cancer.
- To identify other potential contributing factors.
Main Methods:
- Country-wide participant enrollment.
- Surgical removal and histological examination of suspect lesions.
- HIV counseling, testing, and participant follow-up via home visits.
Main Results:
- 476 participants enrolled between 1995-2001; 97% underwent eye-conserving surgery.
- Histology confirmed squamous neoplasia in 414 cases (184 invasive carcinoma, 230 intraepithelial).
- HIV prevalence was 64% among cases; 13 (3.2%) experienced recurrence after a median 32-month follow-up.
Conclusions:
- Eye-conserving surgery demonstrates a low recurrence rate and minimal complications.
- Elevated HIV prevalence in cases suggests a link, though a significant proportion were HIV-negative.
- No novel cofactors for the neoplasia were identified in this study.