Trends in the incidence of cancer in the black population of Harare, Zimbabwe 1991–2010

• Published in: International journal of cancer Vol. 133; no. 3; pp. 721 - 729
• Main Authors: Chokunonga, E., Borok, M.Z., Chirenje, Z.M., Nyakabau, A.M., Parkin, D.M.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 01-08-2013; Wiley Subscription Services, Inc
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - complications; Africa; AIDS; Biological and medical sciences; Black people; Breast Neoplasms - epidemiology; Cancer; cancer registry; Carcinoma, Squamous Cell - epidemiology; Female; Health risk assessment; Human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infectious diseases; Life Style; Lifestyles; Lymphoma, Non-Hodgkin - epidemiology; Male; Medical sciences; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - epidemiology; Prostatic Neoplasms - epidemiology; Risk; Sarcoma, Kaposi - epidemiology; time trends; Tumors; Uterine Cervical Neoplasms - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Zimbabwe - epidemiology; Zimbabwe; Africa; Human; time trends; Immunopathology; cancer registry; Africa; Trend; AIDS; Malignant hemopathy; Malignant tumor; Immune deficiency; Epidemiology; Time variation; Incidence; Infection; Cancerology; Viral disease; Specific registry; 1991; Population; Public health; African American; Cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.28063

Incidence rates of different cancers have been calculated for the black population of Harare, Zimbabwe for a 20‐year period (1991–2010) coinciding with continuing social and lifestyle changes, and the peak, and subsequent wane, of the HIV‐AIDS epidemic. The overall risk of cancer increased during the period in both sexes, with rates of cervix and prostate cancers showing particularly dramatic increases (3.3% and 6.4% annually, respectively). By 2004, prostate cancer had become the most common cancer of men. The incidence of cancer of the esophagus, formerly the most common cancer of men, has remained relatively constant, whereas rates of breast and cervix cancers, the most common malignancies of women, have shown significant increases (4.9% and 3.3% annually, respectively). The incidence of Kaposi sarcoma increased to a maximum around 1998–2000 and then declined in all age groups, and in both sexes The incidence of squamous cell cancers of the conjunctiva is relatively high, with temporal trends similar to those of Kaposi sarcoma. Non‐Hodgkin lymphoma, the fifth most common cancer of men and fourth of women, showed a steady increase in incidence throughout the period (6.7–6.9% annually), although rates in young adults (15–39) have decreased since 2001. Cancer control in Zimbabwe, as elsewhere in sub‐Saharan Africa, involves meeting the challenge of emerging cancers associated with westernization of lifestyles (large bowel, breast and prostate), while the incidence of cancers associated with poverty and infection (liver, cervix and esophagus) shows little decline, and the residual burden of the AIDS‐associated cancers remains significant.
What's new?
As in much of Africa, marked lifestyle changes have been observed in Zimbabwe since the latter part of the 20th century. During that time, Zimbabwe was also severely affected by HIV/AIDS. According to this study, these factors were coincident with changes in cancer risk and incidence in the black population of Harare, Zimbabwe. The findings reveal increased incidence for certain cancers typically associated with the Westernization of lifestyle, including cancers of the breast and prostate, as well as a rise and fall in incidence of Kaposi sarcoma, a pattern that mirrors the peak and subsequent wane of the HIV/AIDS epidemic.