Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali
2021
CHU (University Hospital Center) Point G: The
department of surgery B is a surgical department of CHU Point G. The department
is par excellence a reference department for cases of visceral surgery, cancer
surgery, cardiovascular surgery, plastic and endocrinology surgery. As a
reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery
department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January
2008 to June 2018 (126 months). Results: We have identified 380 cases of
digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive
cancers. The mean age of the patients was 57.21 ± 13 years. Male sex
represented 55% (n = 106). Eating habits were dominated by the consumption of
to with potash (cereal paste) with 64.76% (n = 185). The main methods of
preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic
smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n
= 5). The low socio-economic class represented 126 cases or 65.38%. Housewives
and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20%
(n = 39) had a history of epigastric pain. Epigastralgia was the most common
functional sign with 84.5% of cases (n = 169). An epigastric mass was found in
72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative
surgery concerned the majority of our patients with 64.8% of patients (n = 79).
The postoperative consequences were simple in 28.57% of cases (n = 28), the
postoperative morbidity and mortality were respectively 33.61% (n = 41), and
23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years
and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years
after curative surgery. Conclusion: The risk factors for stomach cancer
are many and varied. Some are particularly present in Africa. Delay in
diagnosis due to a belief in traditional healers is common in our community.
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