Characteristics of Esophageal cancer among symptomatic patients referred for endoscopy in Eldoret, Kenya

Abstract

Background: Esophageal cancer (EC) ranks number 8 in incidence among all cancers worldwide and was the 6th. most common cause of cancer mortality in 2020. In Kenya, EC is the fourth most common cancer. EC has uneven geographical, age and gender distribution and establishing local characteristics would contribute to the overall management. Objective: To describe the characteristics of Esophageal cancer among Kenyans. Design: Retrospective chart review. Setting(s): Institutions offering endoscopy services in Eldoret. Participants: Patients who had undergone upper gastrointestinal tract (GI) endoscopy between May 1993 and April 2003. Methods: Records of patients who underwent upper GI endoscopy between May 1993 and April 2003 in Eldoret were reviewed. Information on age, gender, endoscopic diagnosis, site of esophageal lesion, biopsy and histology report was abstracted. STATA statistical software was used for analysis. Means and proportions were calculated to describe the patients. Results: Of the 1,690 patients who underwent endoscopy, 199 (11.8%), mean age of 58.87 + 14.89 (18 – 91 years), 56.8% (113) males had lesions consistent with EC. Reasons for referral for endoscopy were: dysphagia; 127 (63.8%) and clinical diagnosis of cancer of esophagus; 40 (20.1%). Fifty three percent of the lesions were situated between 25 - 33 centimeters and 30.6 % between 34- 42 centimeters of the esophagus. Biopsy reports were available for 158 patients, which showed squamous cell carcinoma in 99 (62.7%); and adenocarcinoma in 5 (3.2%) participants. Conclusion: Squamous cell carcinoma is the commonest histopathological type in these patients and mainly affects the lower 2/3 of the esophagus.