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World J Gastroenterol. Apr 14, 2014; 20(14): 3875-3879
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.3875
Gastric cancer in Africa: Current management and outcomes
Akwi W Asombang, Rubayat Rahman, Jamal A Ibdah
Akwi W Asombang, Rubayat Rahman, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
Author contributions: Asombang AW wrote the manuscript; Rahman R was involved in reviewing the literature; Ibdah JA provided the overall conceptual design and edited the manuscript.
Correspondence to: Jamal A Ibdah, MD, PhD, Professor, Director, Division of Gastroenterology and Hepatology, University of Missouri-Columbia, 5 Hospital Drive, Columbia, MO 65212, United States. ibdahj@health.missouri.edu
Telephone: +1-573-8827349 Fax: +1-573-8844595
Received: October 27, 2013
Revised: January 10, 2014
Accepted: February 17, 2014
Published online: April 14, 2014
Abstract

Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide. Globally, gastric cancer poses a significant public health burden - both economically and socially. In 2008, the economic burden from premature cancer deaths and disability was $895 billion and gastric cancer was the second highest cancer responsible for healthy life lost. With the expected increase in cancer deaths and non-communicable diseases, these costs are expected to rise and impact patient care. World Health Organization, estimates a 15% increase in non-communicable disease worldwide, with more than 20% increase occurring in Africa between 2010 and 2020. Mali, West Africa, is ranked 15th highest incidence of gastric cancer worldwide at a rate of 20.3/100000, yet very scarce published data evaluating etiology, prevention or management exist. It is understood that risk factors of gastric cancer are multifactorial and include infectious agents (Helicobacter pylori, Epstein-Barr virus), genetic, dietary, and environmental factors (alcohol, smoking). Interestingly, African patients with gastric cancer are younger, in their 3rd-4th decade, and present at a late stage of the disease. There is sparse data regarding gastric cancer in Africa due to lack of data collection and under-reporting, which impacts incidence and mortality rates. Currently, GLOBOCAN, an International Agency for Research on Cancer resource, is the most comprehensive available resource allowing comparison between nations. In resource limited settings, with already restricted healthcare funding, data is needed to establish programs in Africa that increase gastric cancer awareness, curtail the economic burden, and improve patient management and survival outcomes.

Keywords: Gastric cancer, Africa, Cancer outcomes, Cancer survival, Cancer management, Non-communicable diseases

Core tip: There is a paucity of published data regarding gastric cancer in Africa and a need for more research to elucidate etiology and management. There is a growing opportunity for partnerships between African nations and more developed nations to advance the understanding and management of gastric cancer and thus improve overall patient outcomes. Such partnerships would provide a bilateral learning opportunity and help set a platform for training opportunity amongst healthcare providers.