Epidemiological and clinical aspects of pancreatic cancer in Senegal

The objective was to verify if the introduction of ultrasonography in our practice has entailed modifications of the epidemiology and the clinic of pancreatic cancer in Senegal. We have performed a retrospective study of cancer of the pancreas diagnosed on the basis of clinical signs, ultrasonography, surgical findings and necropsy from March 92 to October 97. The chi-square test according to Mantel-Haenszel has been used to compare qualitative variables. The routine practice of ultrasonography has allowed to establish the diagnosis of 107 cases of pancreatic cancer within 5 years and half. The sex ratio was 1.05 and the average age was 60 years +/- 13 without significant difference according to the sex. The mean period of diagnosis was 5 months. However the classic form associating thinness and cholestatic jaundice or palpable abdominal mass dominated the clinical symptoms (74.5% of cases). A very deep alteration of the general status has been noticed in 25.5% of cases. At surgery, according to the TNM classification, 22% of our patients were at stage II and 78% from stage III to IV. In Senegal, the prevalence of pancreatic cancer is increasing since the introduction of ultrasonography. This technique has shown that the male predominance is less than reported in previous studies. Nevertheless the diagnosis remains late. As far as we cannot identify risk groups, recent appearance of digestive disturbance even atypical after 50 years old, is enough to suspect the diagnosis.