Author(s)

Felicien Shikama^1*, Steve P. Bensen², Robert Giraneza¹, Prosper Ndayisaba³, Elisée Hategekimana⁴, Eric Rutaganda⁵, Aloys Tuyizere⁶, Tindoho Nkakyekorera⁷, Benoit Seminega⁵, Francois Ngabonziza⁵, Placide Kamali⁵, Vincent Dusabejambo⁵, Dirk J. van Leeuwen², Martin Munyaneza⁸, Frederick L. Makrauer⁹, Audrey H. Calderwood²

¹Centre Hospitalier Universitaire de Butare (CHUB), Department of Gastroenterology, Kigali, Rwanda.
²Dartmouth Hitchcock Medical Center (DHMC), Section of Gastroenterology and Hepatology, New Hampshire, USA.
³Department of Internal Medicine, Ruhango District Hospital, Kigali, Rwanda.
⁴Centre Hospitalier Universitaire de Butare (CHUB), Department of Pathology, Kigali, Rwanda.
⁵Centre Hospitalier Universitaire de Kigali (CHUK), Department of Gastroenterology, Kigali, Rwanda.
⁶Centre Hospitalier Universitaire de Butare (CHUB), Department of Internal Medicine, Kigali, Rwanda.
⁷Centre Hospitalier Universitaire de Butare (CHUB), Department of Radiology, Kigali, Rwanda.
⁸Centre Hospitalier Universitaire de Butare (CHUB), Department of General Surgery, Kigali, Rwanda.
⁹Section of Gastroenterology and Hepatology, Brigham and Women’s Hospital, Boston, USA.

Background: Scant data on upper gastrointestinal cancers in Rwanda exist to guide potential prevention efforts. We evaluated the epidemiological, clinical and histopathological data among patients with gastric and esophageal tumors at a tertiary Referral Hospital in Rwanda. Methodology: We performed a retrospective review of histologically-confirmed esophageal and gastric cancers in adults age ≥ 18 yrs. old presenting to a university teaching hospital (Centre Hospitalier Universitaire de Butare) from 2014-2019. Variables included age at diagnosis, sex, clinical presentation, tumor location and histopathological type. Results: There were 149 upper gastrointestinal cancers, of which 137 (92%) were gastric and 12 (8%) were esophageal. Gastric cancer patients had a mean age at presentation of 56.9 ± 12.3 years (range 21 - 87). Presenting symptoms were epigastric pain (78.8%), weight loss (53.3%), post-prandial vomiting (52.6%), early satiety (29.9%), epigastric mass (24.8%), hematemesis (19.7%) and melena (16.8%). The location was antrum 50.3%, corpus 21.8%, fundus 8%, and cardia 8%. Tumor type was adenocarcinoma in 94.1%. Helicobacter pylori infection was present in 108 (78.8%). Esophageal cancer patients had a mean age of 54.4 ± 9.5 years (range 35 - 72). Presenting symptoms were dysphagia (100%) and weight loss (83%). The most common site was lower third esophagus (9/12), and adenocarcinoma cancer subtype accounted for 5/12 (41.6%) cases. Conclusion: Gastric adenocarcinoma was the most commonly diagnosed upper gastrointestinal cancers and was associated with a high prevalence of H. pylori infection. This study lays the foundation for future work to improve cancer outcomes in Rwanda.

Epidemiology, Upper Gastrointestinal Cancer, H. pylori, Rwanda

Shikama, F. , Bensen, S. , Giraneza, R. , Ndayisaba, P. , Hategekimana, E. , Rutaganda, E. , Tuyizere, A. , Nkakyekorera, T. , Seminega, B. , Ngabonziza, F. , Kamali, P. , Dusabejambo, V. , van Leeuwen, D. , Munyaneza, M. , Makrauer, F. and Calderwood, A. (2022) Upper Gastrointestinal Cancers in Rwanda: Epidemiological, Clinical and Histopathological Features in Patients Presenting to a Tertiary Referral Hospital. Open Journal of Gastroenterology, 12, 286-298. doi: 10.4236/ojgas.2022.1210029.