Infection-related and lifestyle-related cancer burden in Kampala, Uganda: projection of the future cancer incidence up to 2030

Judith Asasira; Sanghee Lee; Thi Xuan Mai Tran; Collins Mpamani; Henry Wabinga; So-Youn Jung; Yoon Jung Chang; Yikyung Park; Hyunsoon Cho

doi:10.1136/bmjopen-2021-056722

Infection-related and lifestyle-related cancer burden in Kampala, Uganda: projection of the future cancer incidence up to 2030

BMJ Open. 2022 Mar 16;12(3):e056722. doi: 10.1136/bmjopen-2021-056722.

Authors

Judith Asasira^{1

2}, Sanghee Lee¹, Thi Xuan Mai Tran¹, Collins Mpamani², Henry Wabinga³, So-Youn Jung⁴, Yoon Jung Chang^{1

5}, Yikyung Park⁶, Hyunsoon Cho^{7

8}

Affiliations

¹ Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, South Korea.
² Directorate of Research and Training, Uganda Cancer Institute, Kampala, Uganda.
³ Department of Pathology, Kampala Cancer Registry, Makerere University, Kampala, Uganda.
⁴ Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.
⁵ Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, South Korea.
⁶ Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
⁷ Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, South Korea hscho@ncc.re.kr.
⁸ Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea.

Abstract

Objectives: In Uganda, infection-related cancers have made the greatest contribution to cancer burden in the past; however, burden from lifestyle-related cancers has increased recently. Using the Kampala Cancer Registry data, we projected incidence of top five cancers, namely, Kaposi sarcoma (KS), cervical, breast and prostate cancer, and non-Hodgkin's lymphoma (NHL) in Uganda.

Design: Trend analysis of cancer registry data.

Setting: Kampala Cancer Registry, Uganda.

Main outcome measure: Cancer incidence data from 2001 to 2015 were used and projected to 2030. Population data were obtained from the Uganda Bureau of Statistics. Age-standardised incidence rates (ASRs) and their trends over the observed and projected period were calculated. Percentage change in cancer incidence was calculated to determine whether cancer incidence changes were attributable to cancer risk changes or population changes.

Results: It was projected that the incidence rates of KS and NHL continue to decrease by 22.6% and 37.3%, respectively. The ASR of KS was expected to decline from 29.6 per 100 000 population to 10.4, while ASR of NHL was expected to decrease from 7.6 to 3.2. In contrast, cervical, breast and prostate cancer incidence were projected to increase by 35.3%, 57.7% and 33.4%, respectively. The ASRs of cervical and breast were projected to increase up to 66.1 and 48.4 per 100 000 women. The ASR of prostate cancer was estimated to increase from 41.6 to 60.5 per 100 000 men. These changes were due to changes in risk factors and population growth.

Conclusion: Our results suggest a rapid shift in the profile of common cancers in Uganda, reflecting a new trend emerging in low/middle-income countries. This change in cancer spectrum, from infection-related to lifestyle-related, yields another challenge to cancer control programmes in resource-limited countries. Forthcoming cancer control programmes should include a substantial focus on lifestyle-related cancers, while infectious disease control programmes should be maintained.

Keywords: epidemiology; health policy; oncology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Incidence
Life Style
Male
Neoplasms* / epidemiology
Prostatic Neoplasms* / epidemiology
Registries
Sarcoma, Kaposi* / epidemiology
Uganda / epidemiology