Trends in cancer incidence in Kyadondo County, Uganda, 1960-1997

Incidence rates of different cancers have been calculated for the populatio n of Kyadondo County (Kampala, Uganda) for four time periods (1960-1966; 19 67-1971; 1991-1994; 1995-1997), spanning 38 years in total. The period coin cides with marked social and lifestyle changes and with the emergence of th e AIDS epidemic. Most cancers have increased in incidence over time, the on ly exceptions being cancers of the bladder and penis. Apart from these, the most common cancers in the early years were cervix, oesophagus and liver; all three have remained common, with the first two showing quite marked inc reases in incidence, as have cancers of the breast and prostate. These chan ges have been overshadowed by the dramatic effects of the AIDS epidemic, wi th Kaposi's sarcoma emerging as the most common cancer in both sexes in the 1990s, and a large increase in incidence of squamous cell cancers of the c onjunctiva. In the most recent period, there also seems to have been an inc rease in the incidence of non-Hodgkin lymphomas. So far, lung cancer remain s rare. Cancer control in Uganda, as elsewhere in sub-Saharan Africa, faces a threefold challenge. With little improvement in the incidence of cancers associated with infection and poverty (liver, cervix, oesophagus), it must face the burden of AIDS-associated cancers, while coping with the emergenc e of cancers associated with Westernization of lifestyles (large bowel, bre ast and prostate). (C) 2000 Cancer Research Campaign.