Saurabh Saluja1, Olusegun I Alatise2, Adisa Adewale2, Justine Misholy1, Joanne Chou3, Mithat Gonen3, Martin Weiser1, T Peter Kingham4. 1. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. 2. Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria. 3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. 4. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: kinghamt@mskcc.org.
Abstract
BACKGROUND: Of the 24 million people predicted to have cancer by 2050, 70% will live in low- and middle-income countries (LMIC). As a result, cancer care is becoming a priority for health care systems in West Africa. This study compares the presentation and pattern of spread of colorectal cancer (CRC) observed in a hospital in West Africa with that of a North American referral center. METHODS: Data on all adults presenting with CRC at a hospital in Nigerian patients (West Africa; 1990-2011) and all adults with stages III or IV CRC at a specialty hospital in (New York City, New York, North America; 2005-2011) were examined retrospectively. Demographic data, stage of disease, site of metastasis, and survival were compared. RESULTS: There were 160 patients identified in West Africa and 1,947 patients identified in North America. Nigerian patients were younger (52 vs 59 years; P < .01) and presented with a later stage of disease (58% stage IV vs 47%; P < .01). Site of disease presentation was different between West African and North American patients (P < .01); 2.2% of West African patients presented with liver metastases only compared with 48.1% of North American patients. Conversely, 61.3% of patients in West Africa presented with peritoneal metastases only compared with 5.4% in North America. Overall survival stratified by stage at presentation (III/IV) showed worse prognosis for patients in either stage subgroup in Nigeria than North America. CONCLUSION: We found differences in the presentation, metastatic pattern, and outcomes of CRC in Nigerian (West Africa) when compared with New York City (North America). Late detection and differential tumor biology may drive the differences observed between the sites. Future studies on early CRC detection and on tumor biology in LMIC will be critical for understanding and treating CRC in this region.
BACKGROUND: Of the 24 million people predicted to have cancer by 2050, 70% will live in low- and middle-income countries (LMIC). As a result, cancer care is becoming a priority for health care systems in West Africa. This study compares the presentation and pattern of spread of colorectal cancer (CRC) observed in a hospital in West Africa with that of a North American referral center. METHODS: Data on all adults presenting with CRC at a hospital in Nigerian patients (West Africa; 1990-2011) and all adults with stages III or IV CRC at a specialty hospital in (New York City, New York, North America; 2005-2011) were examined retrospectively. Demographic data, stage of disease, site of metastasis, and survival were compared. RESULTS: There were 160 patients identified in West Africa and 1,947 patients identified in North America. Nigerian patients were younger (52 vs 59 years; P < .01) and presented with a later stage of disease (58% stage IV vs 47%; P < .01). Site of disease presentation was different between West African and North American patients (P < .01); 2.2% of West African patients presented with liver metastases only compared with 48.1% of North American patients. Conversely, 61.3% of patients in West Africa presented with peritoneal metastases only compared with 5.4% in North America. Overall survival stratified by stage at presentation (III/IV) showed worse prognosis for patients in either stage subgroup in Nigeria than North America. CONCLUSION: We found differences in the presentation, metastatic pattern, and outcomes of CRC in Nigerian (West Africa) when compared with New York City (North America). Late detection and differential tumor biology may drive the differences observed between the sites. Future studies on early CRC detection and on tumor biology in LMIC will be critical for understanding and treating CRC in this region.
Authors: Ahmedin Jemal; Melissa M Center; Carol DeSantis; Elizabeth M Ward Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-07-20 Impact factor: 4.254
Authors: E M V de Cuba; R Kwakman; M van Egmond; L J W Bosch; H J Bonjer; G A Meijer; E A te Velde Journal: Virchows Arch Date: 2012-07-24 Impact factor: 4.064
Authors: Brooke E Sylvester; Dezheng Huo; Andrey Khramtsov; Jing Zhang; Rana V Smalling; Sope Olugbile; Blase N Polite; Olufunmilayo I Olopade Journal: Clin Cancer Res Date: 2011-11-23 Impact factor: 12.531
Authors: Jacques Ferlay; Hai-Rim Shin; Freddie Bray; David Forman; Colin Mathers; Donald Maxwell Parkin Journal: Int J Cancer Date: 2010-12-15 Impact factor: 7.396
Authors: Sheelu Varghese; Monika Burness; Hui Xu; Tatiana Beresnev; James Pingpank; H Richard Alexander Journal: Ann Surg Oncol Date: 2007-09-25 Impact factor: 5.344
Authors: Avinash Sharma; Olusegun I Alatise; Adewale O Adisa; Olukayode A Arowolo; Olalekan Olasehinde; Olusola C Famurewa; Adeleye D Omisore; A O Komolafe; O Olaofe; Aba I Katung; Ayoola D Ibikunle; Ayoola A Egberongbe; Samuel A Olatoke; S O Agodirin; A O Adesiyun; Ademola Adeyeye; K Ibrahim; O A Kolawole; O L Idris; M O Adejumobi; Adebowale I Ajayi; Akinwumi O Olakanmi; Jeremy C Constable; Ken Seier; Mithat Gonen; Murray F Brennan; T Peter Kingham Journal: J Surg Oncol Date: 2019-11-19 Impact factor: 3.454
Authors: Gregory C Knapp; Avinash Sharma; Bolatito Olopade; Olusegun I Alatise; Olalekan Olasehinde; Olujide O Arije; Philip E Castle; T Peter Kingham Journal: World J Surg Date: 2019-11 Impact factor: 3.352
Authors: Bantayehu Sileshi; Mark W Newton; Joash Kiptanui; Matthew S Shotwell; Jonathan P Wanderer; Mary Mungai; Jon Scherdin; Paul A Harris; Sten H Vermund; Warren S Sandberg; Matthew D McEvoy Journal: Anesthesiology Date: 2017-08 Impact factor: 7.892
Authors: Olusegun I Alatise; Gregory C Knapp; Brendan Bebington; Patrick Ayodeji; Anna Dare; Jeremy Constable; Olalekan Olasehinde; T Peter Kingham Journal: World J Surg Date: 2021-09-05 Impact factor: 3.352
Authors: Olusegun Isaac Alatise; Omobolaji O Ayandipo; Ademola Adeyeye; Ken Seier; Akinwunmi O Komolafe; Matthew O Bojuwoye; Oludapo O Afuwape; Ann Zauber; Adeleye Omisore; Samuel Olatoke; Adegboyega Akere; Olusola Famurewa; Mithat Gonen; David O Irabor; T Peter Kingham Journal: Cancer Date: 2018-04-12 Impact factor: 6.860
Authors: Surbhi Grover; Onyinye D Balogun; Kosj Yamoah; Reinou Groen; Mira Shah; Danielle Rodin; Adam C Olson; Jeremy S Slone; Lawrence N Shulman; C Norman Coleman; Stephen M Hahn Journal: Front Oncol Date: 2015-04-08 Impact factor: 6.244
Authors: Joseph M Plummer; Pierre-Anthony Leake; Doreen Ferron-Boothe; Patrick O Roberts; Derek I Mitchell; Michael E McFarlane Journal: Ann Med Surg (Lond) Date: 2016-01-21
Authors: Olusegun I Alatise; Sara E Fischer; Omobolaji O Ayandipo; Akinlolu G Omisore; Samuel A Olatoke; T Peter Kingham Journal: J Glob Oncol Date: 2017-02-01