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Re-evaluating early-onset OSCC in Africa: findings of minimal cumulative incidence
  1. Mohamed Noureldin1,
  2. Joel H Rubenstein1,2,3,
  3. Brooke Kenney4,
  4. Akbar K Waljee2,4,5
  1. 1 Division of Gastroenterology, University of Michigan, Ann Arbor, MI, USA
  2. 2 Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA
  3. 3 Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
  4. 4 Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
  5. 5 Center for Global Health Equity, University of Michigan, Ann Arbor, MI, USA
  1. Correspondence to Dr Akbar K Waljee, University of Michigan, Ann Arbor, Michigan, USA; awaljee{at}med.umich.edu

https://doi.org/10.1136/gutjnl-2023-331687

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    We read Arnold et al’s article1 with interest and wanted to extend this work to Africa. A high incidence of oesophageal squamous cell carcinoma (OSCC) has been reported in African countries from Kenya to South Africa2 where early-onset (age <45 years) OSCC accounts for 30% of cases in the region. As such, we examined the cumulative lifetime and age-specific incidences of OSCC in Africa. We identified patients with OSCC in three major African cancer registries, using the 2013–2017 Cancer Incidence in Five Continents Volume XII (CI5-XII) database and calculated the age-specific, cumulative lifetime and cumulative early-onset incidence of early-onset OSCC, all of which will allow us to account for the underlying age structure of the population.

    We identified 1022 patients diagnosed with OSCC between 2013 and 2017, of which 47.2% (n=482) were females and 12.3% (n=126) were <45 years old consistent with early-onset OSCC (figure 1). Region-level proportions of early-onset OSCC cases varied from 7.6% (26/340) in Eastern Cape, South Africa, to 15.6% (60/384) in Nairobi, Kenya. The cumulative lifetime incidence and cumulative incidence3 of early-onset OSCC were 1508 and 33 cases per 100 000 person-year, respectively, and early-onset OSCC only accounted for 2.2% of cumulative lifetime incidence …

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    Footnotes

    • Twitter @AkbarWaljee

    • Correction notice This article has been corrected since it published Online First. The initials have been added to the last author's name.

    • Contributors The original concept was developed by MN, JHR and AW. MN and BK performed the data analysis and drafted the initial version of the manuscript. All authors took part in the creation of later drafts and revisions of the manuscript.

    • Funding MN is supported by NIDDK T32 DK062708. Research reported in this publication was supported by the Office of the Director, the National Institutes of Health, the National Institute of Biomedical Imaging and Bioengineering, the National Cancer Institute, the National Institute of Mental Health and the Fogarty International Center of the National Institutes of Health under award numbers U54TW012089 (Abubakar A and Waljee AK) and U01CA287852 (Saleh M, Waljee AK, Balis U, Rao A, Sayed S).

    • Competing interests AW is a member of the Gut Editorial Board. All other authors report no disclosures.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.