Trends in the incidence of cancer in the population of Kyadondo County, Uganda – which comprises the city of Kampala and a peri-urban hinterland – are presented for a period of 25 years (1991-2015) based on data collected by the Kampala Cancer Registry. Incidence rates have risen overall – age adjusted rates are some 25% higher in 2011-2015 compared with 1991-1995. The biggest absolute increases have been in cancers of the prostate, breast, and cervix, with rates some 100% (prostate), 70% (breast) and 45% (cervix) higher in 2010-2015 than in 1991-1995. There were also increases in the incidence of cancers of the oesophagus and colon-rectum (statistically significant in men), while the incidence of liver cancer – the fifth most common in this population – increased until 2007, and subsequently declined. By far the most commonly registered cancer over the 25-year period was Kaposi sarcoma, but the incidence has declined, consistent with the decreasing population-prevalence of HIV. Non-Hodgkin lymphomas, also AIDS-related, increased in incidence until 2006/7 and then declined – possibly as a result of availability of anti-retroviral therapy. The trends reflect the changing lifestyles of this urban African population, as well as the consequences of the epidemic of HIV/AIDS and the availability of treatment with ARVs. At the same time, it highlights the fact that the decreases in cancer of the cervix observed in high and upper-middle income countries are not a consequence of changes in lifestyle, but demand active intervention through screening (and, in the longer term, vaccination).
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