Cancer incidence in Malawi: Time trends in Blantyre 1996-2005 and predictions up to 2015

Humphrey Misiri^1,2, Charles Dzamalala³, Abdi Edriss⁶, D Max Parkin⁴, and Freddie Bray^1,5

1 Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

2 Department of Community Health, College of Medicine, Blantyre, Malawi.

3 Department of Pathology, College of Medicine, Blantyre, Malawi.

4 CTSU, University of Oxford, UK

5. Norwegian Cancer Registry, Oslo, Norway

6 Bunda Collage, University of Malawi, Lilongwe, Malawi

*Corresponding author E-mail: hmisiri@gmail.com, humphrey.misiri@medisin.uio.no; Tel/Cell: +265-888-342-864: Fax: +265-1874-700

Accepted 28 June, 2012

Abstract

As in many sub-Saharan countries, communicable diseases have been given greater public health priority in Malawi, although the magnitude of the cancer burden is increasing as a result of demographic changes, as well as the impact of the HIV pandemic. To be able to describe the patterns of cancer between 1996 and 2005 and to predict the incidence and total burden of cancer for 2015,we analysed data from the Malawi National Cancer Registry for the period from 1996 to 2005. We obtained age standardized incidence rates for the most common cancers in Malawi. Linear trend models were used to predict incidence rates and the burden of cancer for Blantyre for 2015. The most common cancers, in terms of age-standardized (world) incidence rates were Kaposi sarcoma (50.5 per 100,000 for males, 26.4 for females), cervical cancer (49.3 per 100,000), oesophageal cancer (22.3 for males, 14.6 for females), non-Hodgkin lymphoma (6.6 for males, 5.3 for females), eye cancer (4.4 for males, 5.4 for females), and breast cancer (11.9). Predictions based on the rather rapidly increasing trends would yield an upper limit of 2512 cases of cancer in Malawi by 2015; an absolute percentage increase of 193.4 % and 242.7 % among males and females, respectively. Based on our analysis we conclude that incidence rates of cancer in Blantyre have been increasing between 1996 and 2005. Apart from the AIDS pandemic in Malawi, population growth and ageing will also contribute to the projected threefold increase in the number of cancer cases.

Keywords: Cancer, incidence, predictions, time trends

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