The Epidemiology of Cancers at Lusaka University Teaching Hospital in Zambia

Background: The pattern of malignancy in Zambia has not been well studied¹. The high HIV prevalence of 16% is known both to have increased the number of HIV related cancers seen in Zambia as well as to have significantly changed the pattern of malignancies².
Methods: This was a retrospective study based on pathology reports of specimens reviewed at the University Teaching Hospital (UTH) pathology laboratory in Lusaka from January 1997 to December 2005. UTH is the main reference hospital in Zambia and has a catchment area of 1.3 million people³.
Results: A total of 6672 pathology specimens were reported over this period. The male to female ratio was 1: 1.5. The most common cancer among men was Kaposi sarcoma which represented 20.9% of all male cancers seen. This was followed by cancer of the eye (14.3%), soft tissue sarcomas (10.9%) and cancer of the prostate (9.2%). The most common cancer in women was cancer of the cervix which represented 41.5% , followed by cancer of the eye (9%), cancer of the Breast (8.6%) and Kaposi Sarcoma 7.6%. Non-Hodgkin's Lymphoma was the fifth most common cancer in both men and women accounting for 6.3% and 5%, respectively. The study revealed an increase in HIV related malignancies up to 2001 and a small gradual decline after this period. This may be attributed to high HIV and HPV infection in the population prior to the introduction of Anti retroviral therapy and the effect following it's introduction.
Conclusion: There has been a significant change in the pattern of malignancies at the UTH over the last 20years, with an increase the proportional incidence of Kaposi's sarcoma, cancer of the Cervix and Cancer of the Eye.