Cancer Research Infrastructure and Epidemiology

Cancer research requires knowledge of the local epidemiology of disease and a support structure to gather information about patients, establish diagnosis and obtain tissue samples. An online database of cancer cases presenting to all departments at Kamuzu Central hospital has been established in collaboration with the UNC Lineberger Comprehensive Cancer Center and Dr Elizabeth Bigger, supported by an NIH Fogarty Fellowship. The database recorded over 2000 cases in 2010. Lindsey Wolf MS3 is a Doris Duke Fellow worked with Michael Owino BS MPH at the UNC Project to perfect the database and analyze the data. Dr Agnes Moses is analyzing data for the co-morbid infections and cancer project. They are supervised locally by Mina Hosseinipour, M.D., M.P.H, UNC Infectious Disease Associate Professor.

Esophageal cancer is very common in eastern Africa and Malawi in particular. In is the second most common cancer in men and women, with Kaposi’s sarcoma the most common in men and cervical cancer in women. Lindsey Wolf MS3 UCSF and Rahim Ibrahim PGY3 KCH have collaborated on a study of EGDs at KCH over the last 2 years, reporting that 27% of the cases had esophageal cancer.

The UNC Project, the MSI, the Lineberger Comprehensive Cancer Center and KCH are collaborating to establish a pathology lab at KCH which opened in July 2011. The pathology lab provides histologic analysis and cancer tissue procurement capabilities for current and future studies.

Ongoing cancer research projects projects include:

  1. An epidemiology study of comorbid infections (HIV, Hep B, schistosomiasis and active malaria) and patient demographics with presentation of cancer at KCH
  2. Evaluation of risk factors and comorbid infections of esophageal cancer in Malawi. This is the most common cancer presenting to the Surgery Department, with >80 cases between January and November 2010.

Publications

    CE Kendig, JC Samuel, AF Tyson, AL Khoury, LP Boschini, C Mabedi, BA Cairns, C Varela, CG Shores, AG Charles (2013).  Cancer treatment in Malawi: a disease of palliation.  World Journal of Oncology, 4(3):142-146.

    S Gopal, R Krysiak, NG Liomba, MJ Horner, CG Shores, N Alide, S Kamiza, C Kampani, F Chimzimu, Y Fedoriw, DP Dittmer, MC Hosseinipour, IF Hoffman (2013).  Early experience after developing a pathology laboratory in Malawi, with emphasis on cancer diagnosis.  PLoS One, 7(8):e70361.

    LL Wolf, R Ibrahim, C Miao, A Muyco, MC Hosseinipour, C Shores (2012).  Esophagogastroduodenoscopy in a public referral hospital in Lilongwe, Malawi: spectrum of disease and associated risk factors.  World Journal of Surgery, 36(5):1074-1082.