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  • Title: Pattern of adult malignancies in Zambia (1980-1989) in light of the human immunodeficiency virus type 1 epidemic.
    Author: Patil P, Elem B, Zumla A.
    Journal: J Trop Med Hyg; 1995 Aug; 98(4):281-4. PubMed ID: 7636927.
    Abstract:
    This study analysed histopathological and haematology records of 7836 neoplasms seen during the period 1980-1989 at the University Teaching Hospital, Lusaka, Zambia. The crude incidence rate of each malignancy per 100,000 adults per year was calculated and the patterns of malignancies were compared for the periods 1980-1983 and 1984-1989, the later coinciding with the advent of the human immunodeficiency virus (HIV) epidemic. The six most common tumours were carcinoma of the cervix (19.6%), Kaposi's sarcoma (7%), bladder carcinoma (6.3%), hepatoma (5.8%), lymphoma (4.6%) and carcinoma of the breast (4.4%). Significant increases in the crude incidence rates of Kaposi's sarcoma (KS) and carcinoma of the breast were observed during the last 6 years of the study period (P = 0.001). Nodal KS showed the most significant rise from a crude incidence rate of 0.25 per 100,000 adults per year in the 1980-1983 period to 1.11 during the 1984-1989 period. In contrast to findings from Europe and the USA, no significant increase in non-Hodgkin's lymphoma was detected in Zambia following the HIV epidemic. In the West, Kaposi's sarcoma and non-Hodgkin's lymphoma have been closely associated with HIV-induced immunosuppression. To date, however, there has been no published account of the impact of HIV infection upon malignancies prevalent in Africa where the HIV epidemic is widespread. The authors describe the pattern of malignant disorders among adult indigenous Zambians over the period 1980-89 in the attempt to discern the impact of HIV infection upon the prevailing malignancies. Histopathological and hematology records of 7836 neoplasms seen during 1980-89 at the University Teaching Hospital in Lusaka, Zambia, were analyzed. The crude incidence rate of each malignancy per 100,000 adults per year was calculated and the patterns of malignancies compared for the periods 1980-83 and 1984-89. The latter period corresponds to the advent of the HIV epidemic. Carcinoma of the cervix, Kaposi's sarcoma, bladder carcinoma, hepatoma, lymphoma, and carcinoma of the breast were the six most commonly observed tumors, occurring, respectively, among 19.6%, 7%, 6.3%, 5.8%, 4.6%, and 4.4% of cases. The crude incidence rates of Kaposi's sarcoma and carcinoma of the breast increased significantly during the last six years of the study period, with nodal KS exhibiting the most significant rise from a crude incidence rate of 0.25 per 100,000 adults per year during 1980-83 to 1.11 during 1984-89. In contrast to findings from Europe and the US, no significant increase in non-Hodgkin's lymphoma was detected in Zambia following the arrival of the HIV epidemic.
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