The Epidemiological Profil of Digestive Cancers in Secondary and Tertiary Health Care Facilities in Cameroon

Background: Cancers have been a major public health problem in developing countries in recent years. The aim of this study was to determine the epidemiological profile of digestive cancers in secondary and tertiary health care facilities in Cameroon. Methodology: This was a cross sectional and descriptive study conducted over a period of 12 months in 14 health structures over the national territory. Included in our study were patients aged 15 and above with a histologically proven digestive cancer, patients with a clinical, biological and morphologic evidence of a digestive cancer. Socio-demographic (age, gender, region of origin, profession), clinical (symptoms on diagnosis, personal and family past history, consumption habits, tumour location) and paraclinical data were recorded on a pretested questionnaire. Data was analysed using SPSS version 20.0. Quantitative data was expressed as means with their corresponding standard deviations. Chi square was used for correlation between variables. A P value 0.05 was considered statistically significant. Results: Five hundred and eighty-two cases of digestive cancers were recorded out of 37,780 consultations/admissions during the study period giving a prevalence of 1.5% with a male predominance (58.1%). The mean age was 53.11 ± 17.26 years (15 - 99) with 33.8% of them below 45 years of age. Tumours were predominantly localized in the liver (43.5%) and colon (24.9%). Adenocarcinoma was the most common histological type in 44.5% of all cases. Alcohol consumption was found to be associated with colorectal cancer (p = 0.028) while tobacco consumption was found to be significantly associated with oesophageal cancer (p ≤ 0.001) and gastric cancer (p = 0.0047). Conclusion: A third of patients with digestive cancers were aged less than 45 years suggesting an early onset of these cancers in our setting. Relatively low prevalence with the liver being the most common site of localisation in our setting.

Chemoprevention of neuroblastoma: progress and promise beyond uncertainties

Neuroblastoma is the most common extracranial solid tumor in children and comprises one-tenth of all childhood cancer deaths.The current clinical therapy for this deadly disease is multimodal,involving an induction phase with alternating regimens of high-dose chemotherapeutic drugs and load reduction surgery;a consolidation phase with more intensive chemotherapy,radiotherapy,and stem cell transplant;and a maintenance phase with immunotherapy and immune-activating cytokine treatment.Despite such intensive treatment,children with neuroblastoma have unacceptable life quality and survival,warranting preventive measures to regulate the cellular functions that orchestrate tumor progression,therapy resistance,metastasis,and tumor relapse/recurrence.Globally,active efforts are underway to identify novel chemopreventive agents,define their mechanism(s)of action,and assess their clinical benefit.Some chemoprevention strategies(e.g.,retinoids,difluoromethylornithine)have already been adopted clinically as part of maintenance phase therapy.Several agents are in the pipeline,while many others are in preclinical characterization.Here we review the classes of chemopreventive agents investigated for neuroblastoma,including cellular events targeted,mode(s)of action,and the level of development.Our review:(i)highlights the pressing need for new and improved chemopreventive strategies for progressive neuroblastoma;(ii)lists the emerging classes of chemopreventive agents for neuroblastoma;and(iii)recognizes the relevance of targeting dynamically evolving hallmark functions of tumor evolution(e.g.,survival,differentiation,lineage transformation).With recent gains in the understanding of tumor evolution processes and preclinical and clinical efforts,it is our strong opinion that effective chemopreventive strategies for aggressive neuroblastoma are a near reality.