The Human Papilloma Virus (HPV) is a necessary cause of cervical cancer and is associated with other cancers including vulval, vaginal, anal, penile and oropharyngeal cancers. In this study, we ...evaluate the burden of HPV associated cancers using data from population based cancer registries (PBCR) in Nigeria. We obtained data on cancers that are considered to be associated with HPV based on the IARC monograph 100b including cancers of the Cervix (C.53), Vulva (C.51), Vagina (C.52), Anus (C.21), Penis (C.60) and Oropharynx (C.01, C.09, C.10) from PBCR in Abuja (Central Nigeria), Enugu (Eastern Nigeria) and Calabar (South Eastern Nigeria). Previous literature using prevalence data and relative risks suggest that the Population Attributable Fractions (PAFs) for HPV associated cancers in developing countries were Cervical (100%) Vulval and Vaginal (40%), Anal (90%), Oropharynx (12%) in women and, Penile (40%) Anal (90%) Oropharynx (12%) in men. Among women, the 3 PBCR reported a total of 2,986 cases of cancer between 2012 and 2014 with 493 HPV associated cancers contributing 16.5% of the total cancers. Of the 493 HPV associated cancers, 430 were cervical cancers, 27 vulva cancers, 20 anal cancers, 8 vaginal cancers and 8 oropharyngeal cancers. Of these 463 (94%) were attributable to HPV infection. The PBCR reported 1875 cancers in men between 2012 and 2014. Of these, 40 were HPV associated cancers including 22 anal cancers, 16 oropharyngeal cancers and 2 penile cancers constituting (2%) of all cancers in men. Some 23 (57.5%) of the 40 HPV associated cancers were attributable to HPV infection. Cervical and vulva cancers were the most common HPV associated cancers among Nigerian women and anal cancers was the commonest HPV associated cancer in Nigerian men. Our findings suggest that approximately 57.5% of all HPV associated cancers in men and over 90% of all HPV associated cancers in women can be prevented if HPV infection is eliminated.
Africa accounts for 70% of all PLWHIV about 35% of those needing ART in Africa are currently on it. 1 HIV+ are at increased risk of cancers. 2 Active screening programs are required otherwise they ...will present in advanced stages. 3 Early diagnosis depends on high levels of awareness. There is need to provide contextual, culturally sensitive health education in LMIC. 4 We evaluated knowledge, practice and attitude of PLWHIV in Nigeria in order to provide foundation for client education. Random sample of HIV+ and HIV- participants at 4 randomly selected hospitals in Nigeria who consented to participate were invited to FGD on AIDS Associated Malignancies. Each FGD consisting of 10 persons, was managed by a researcher using a discussion guide. Data was recorded, transcribed and analyzed. Results: In northern Nigeria most participants had heard about cancer and considered it a fatal disease, but they had poor knowledge of the causes. None had heard of any of the common cancers that occur in PLWHIV and the few that knew about CC did not associate it with HIV. They did not believe it is possible to have HIV and cancer. Most think cancer is incurable or treatable by traditional means only. No respondents had ever heard about screening and none has ever been screened. They emphasized respect in order to earn trust before introduction of screening. Some will not like to be screened but rather not know about cancer if present. They emphasized use of mass media, community engagement, pre-test counseling and confidentiality as issues that need to be addressed. In the South, all participants in the FGD had heard about cancer, usually through the mass media and considered it to be fatal, but they had poor knowledge of its risk factors. Many believed that AIDS is associated with cancers but were not certain of which. This study showed that levels of awareness of cancer among PLWHIV varied across the country and may be related to different levels of education and socio-economic parameters.
Abstract Background Like many countries in Africa, Nigeria is improving the quality and coverage of its cancer surveillance. This work is essential to address this growing category of chronic ...diseases, but is made difficult by economic, geographic and other challenges. Purpose To evaluate the completeness, comparability and diagnostic validity of Nigeria's cancer registries. Methods Completeness was measured using children's age-specific incidence (ASI) and an established metric based on a modified Poisson distribution with regional comparisons. We used a registry questionnaire as well as percentages of death-certificate-only cases, morphologically verified cases, and case registration errors to examine comparability and diagnostic validity. Results Among the children's results, we found that over half of all cancers were non-Hodgkin lymphoma. There was also evidence of incompleteness. Considering the regional completeness comparisons, we found potential evidence of cancer-specific general incompleteness as well as what appears to be incompleteness due to inability to diagnose specific cancers. We found that registration was generally comparable, with some exceptions. Since autopsies are not common across Nigeria, coding for both them and death-certificate-only cases was also rare. With one exception, registries in our study had high rates of morphological verification of female breast, cervical and prostate cancers. Conclusions Nigeria's registration procedures were generally comparable to each other and to international standards, and we found high rates of morphological verification, suggesting high diagnostic validity. There was, however, evidence of incompleteness.
Abstract 60
Background:
Infections by certain viruses, bacteria, and parasites have been identified as risk factors for some cancers. In 2008, there were 12.7 million new cancer cases worldwide. ...About 2 million of these new cases were attributable to infections, which represent 16.1% of new cancer cases. The majority of these cancers occurred in less-developed regions of the world, where the Population Attributable Fraction (PAF) was estimated to be 23%. We carried out this study to evaluate the numbers of cancers in Nigeria from 2012-2014 that are attributable to infections using data from Population Based Cancer Registries (PBCR) in Nigeria.
Methods:
We considered cancers associated with Epstein-Barr virus (EBV), Human Papilloma Virus (HPV), Hepatitis B and C Virus (HBV/HCV), Human Immunodeficiency Virus and Human Herpes Virus 8 (HIV/HHV8), Helicobacter pylori, and Schistosoma haematobium that have been classified as oncogenic by IARC. We obtained data on the infection-associated cancers from registry databases of 3 PBCRs in Nigeria: Abuja, Enugu, and Calabar cancer registries. We used PAF for infectious agents associated cancers in developing countries, which were calculated using prevalence data and relative risk estimates in previous studies: EBV and Nasopharyngeal (90%), and Hodgkin's Lymphoma (80%); HPV and Cervical (100%), Vulval and Vaginal (40%), Anal (90%) and Oropharyngeal cancer (12%) in women; Penile (40%), Anal (90%) and Oropharyngeal cancer (12%) in men; HBV/HCV and Liver (92%), HIV/HHV8 and Kaposi sarcoma (100%), Non Hodgkin Lymphoma (100%); H. pylori and stomach (74%) and S. haematobium and Bladder cancer (56.6%).
Results:
The 3 PBCRs reported 4,861 cancer cases from 2012-2014: 1,875 male cases and 2,986 female cases. There were 412 infection-associated cancers in males accounting for 22% of total cancers in males, and 351 (85%) of these were attributable to infections. In females, there were 727 infection-associated cancers accounting for 24% of total cancers in females, and 674 (93%) of these were attributable to infections. Cancers of the Cervix (n=430), Liver (n=152), and Non-Hodgkin's Lymphoma (n=129) were the most common infection-associated cancers in both sexes. The most common infectious agents associated with cancers were HPV (n=453), HIV/HHV8 (n=199), HBV/HCV (n=143) and EBV (n=125).
Conclusion:
Our findings suggest that 85% of infection-associated cancers in males and 93% infection-associated cancers in females in Nigeria can be prevented with vaccination, safer risk behaviors, or anti-infective treatments.
AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:
Michael Kolawole Odutola No relationship to disclose Elima Jedy-Agba No relationship to disclose Emmanuel Oga No relationship to disclose Festus Igbinoba Travel, Accommodations, Expenses: AstraZeneca Theresa Otu No relationship to disclose Emmanuel Ezeome Honoraria: Roche Travel, Accommodations, Expenses: Roche Ima-Obong Ekanem No relationship to disclose Ramatu Hassan No relationship to disclose Clement Adebamowo Speakers' Bureau: Merck
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