1. COLORECTAL CANCER: Global Trends & Implications for Uganda
Discussant
Charles L.M. Olweny MD, FRACP

2. CAUSES OF DEATH AFTER 1ST FIVE YEARS
HEART DISEASE
ACCIDENTS
CANCER

3. WHAT IS CANCER?
Uncontrolled, purposeless growth of cells, tissues, which if left un attended to may lead to death of cells, tissues and the individual

4. FACTS ABOUT CANCER 1/3 CAN BE PREVENTED 1/3 CAN BE CURED
1/3 CAN BENEFIT FROM PALLIATION

5. GOALS OF CANCER TREATMENT
CURE
PROLONG LIFE
PALLIATION

6. KYADONDO CANCER REGISTRY
You cannot improve anything you cannot measure;
Kyadondo cancer registry was founded in 1951;
Reduced activity in 1980’s;
Re-activated in 1989;
One of few African registries in 3 volume “Cancer in Five Continents”

7. TOP 10 MALE CANCERS IN KCR 2007-2009
Kaposi’s sarcoma
Prostate cancer
Non-Hodgkin’s lymphoma
Cancer of oesophagus
Liver cancer
LARGE BOWEL CANCER
Eye
Leukemia
Stomach
Skin Cancers

8. TOP 10 FEMALE CANCERS IN KCR 2007-2009
Cancer of the Cervix
Kaposi’s sarcoma
Breast cancer
Non-Hodgkin’s lymphoma
Liver cancer
LARGE BOWEL CANCER
Oesophagus
Eye
Ovary
Leukemia

9. COLORECTAL CANCER IN UGANDA
In US colorectal cancer affects mostly >50 year olds, BUT in Uganda 50% of population is under the age 15, and colorectal cancer affects year olds;
Colorectal cancer is 3rd commonest cancer. In Uganda it is 6th commonest and 20 years ago it did not feature at all in top 10;
Risk factors include high fat, low fibre, lack of physical activity , obesity , tobacco, alcohol; ”Disease of life style”

10. COLORECTAL CANCER Lower survival for Africans &Hispanics
More aggressive disease ? As in HD
Present late. It can’t be cancer; Traditional healer’s role
Lack of appropriate treatment facilities; All diagnostic tests including tumour markers CEA, CA19-9 are available

11. HIGH RISK
First and 2nd degree relatives need close surveillance from years onwards
To include an an annual check up (physical exam and occult blood);
Colonoscopy every 3-5 years

12. CANCER CURE Attainment of normal life expectancy
Curable malignancies include: Leukemias especially acute childhood leukemia; Lymphomas ie. Burkitt’s lymphoma, Hodgkin’s disease and non-Hodgkin’s lymphoma (DLC) and some solid tumours eg. Early stage colon cancer, Germ cell tumour and ??? Early breast cancer

13. CANCER CURE BY TREATMENT MODALITIES
SURGERY :-skin, colon, ???early breast
Radiotherapy:- lymphomas, head and neck
Chemotherapy:- Hodgkin’s disease, Burkitt’s lymphoma, leukemia and germ cell tumour
Combined modality:- ??Early breast carcinoma

14. PERSONAL THANKS Thank you all for listening to me
Thank Francis &Kathryn Omaswa for spearheading this venture
Thank Clem Kiire for his insight and willingness to share it all with us
Thank UCS for willingness to embrace this venture.