A prospective ascertainment of cancer incidence in sub-Saharan Africa: The case of Kaposi sarcoma

Cancer Medicine
Aggrey SemeereJeffrey Martin

Abstract

In resource-limited areas, such as sub-Saharan Africa, problems in accurate cancer case ascertainment and enumeration of the at-risk population make it difficult to estimate cancer incidence. We took advantage of a large well-enumerated healthcare system to estimate the incidence of Kaposi sarcoma (KS), a cancer which has become prominent in the HIV era and whose incidence may be changing with the rollout of antiretroviral therapy (ART). To achieve this, we evaluated HIV-infected adults receiving care between 2007 and 2012 at any of three medical centers in Kenya and Uganda that participate in the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium. Through IeDEA, clinicians received training in KS recognition and biopsy equipment. We found that the overall prevalence of KS among 102,945 HIV-infected adults upon clinic enrollment was 1.4%; it declined over time at the largest site. Among 140,552 patients followed for 319,632 person-years, the age-standardized incidence rate was 334/100,000 person-years (95% CI: 314-354/100,000 person-years). Incidence decreased over time and was lower in women, persons on ART, and those with higher CD4 counts. The incidence rate among patients on ART with a CD4...Continue Reading

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Citations

Oct 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·UNKNOWN Cancer Project Working Group for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in Eu
Jan 25, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Mina C HosseinipourUNKNOWN A5264/AMC-067 REACT-KS Team
Feb 21, 2018·Current Opinion in HIV and AIDS·Julia BohliusAnna Turkova
Feb 27, 2019·American Journal of Clinical Dermatology·Khatiya ChelidzeEsther Ellen Freeman
Mar 16, 2017·The Cochrane Database of Systematic Reviews·Hannah RyanPadmapriya Darsini
Sep 9, 2016·Current Opinion in HIV and AIDS·Lameck ChinulaSatish Gopal
Mar 23, 2017·American Journal of Clinical Dermatology·Johann W Schneider, Dirk P Dittmer
May 23, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·UNKNOWN AIDS-defining Cancer Project Working Group for IeDEA and COHERE in EuroCoord
Apr 14, 2020·Journal of Oncology·Miriam Laker-OkettaJeffrey Martin
Nov 22, 2018·International Journal of Dermatology·Christa SlaughtKarolyn A Wanat
Jan 7, 2021·Journal of the International AIDS Society·Jessica L CastilhoUNKNOWN Caribbean, Central, South America network for HIV Epidemiology (CCASAnet)
Nov 12, 2020·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·For Yue TsoCharles Wood
Apr 20, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Esther E FreemanJeffrey Martin

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Methods Mentioned

BETA
ISS
biopsy
a

Software Mentioned

IeDEA
AMPATH
LOWESS
Stata

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