Puzzle over surge in cancers of the digestive system

Oesophagus, stomach, colon and liver cancers said to claim more lives than breast cancer.

A worrying increase of cancers of the digestive system has left experts puzzled with still no clear explanation for the surge.

The oncologists noted that while breast, cervical and prostate cancers have been the most common in the country, gastrointestinal cancers have proved more lethal due to the number of fatalities. As per the 2018 Globocan report, if one is diagnosed with oesophagus cancer, they have a 0.66 per cent chance of surviving.

This is while a breast cancer patient, the leading cancer in the country, has a 23 per cent chance.

4,380 new cases

In the 2018 report, there were 4,380 new cases of oesophagus cancer with 4,351 deaths reported. This is while there were 5,985 cases of breast cancer with 2,553 deaths.

In the list which has 35 cancers, nine are linked to the digestive system, with four in top 10. Oesophagus is the leading that claims more lives, followed by stomach, colon, and liver. Others are lip, oral cavity; rectum, pancreas, gallbladder and salivary glands. “Some 10 years ago, these cancers were not common. We do not know if we were missing them because we were not diagnosing them,” said Dr Andrew Odhiambo, a medical oncologist and lecturer.

He noted that some research papers have alluded the cancers to types of food and the kind of alcohol people take.

“As researchers we need to understand what is the cause, is it the type of alcohol, the food that we eat or tobacco. We already have evidence that hot tea and third generation alcohol are some of the links,” said Odhiambo. 

A common sign of these cancers as Dr Fredrick Chite said, is persistent acid reflux, which medically is simple to treat with anti-acids.

“We encounter patients who have been treated so many times for acid reflux. The main reason that pushes them to get a diagnosis is that they cannot eat solid foods,” said Chite, from Ampath and academic research body that works with Moi Teaching and Referral Hospital. A study which came out early in the year and published in the International Journal of Cancer did single out taking hot tea - above 60 degrees - as a contributing factor to cancer of the oesophagus. This study, if married with findings published in the Cancer Epidomiology Journal in May, would partly explain why such cancers of the digestive system are on the rise in the country.

The study, noted that Kenyans top the list among those individuals who enjoy their beverage - mainly tea - at extreme temperatures as high as 72 degrees.

Such puts them at risk of cancers of the food pipe.

Dr Chite did acknowledge these findings, indicating that the trend has been found to affect people living along the Rift Valley, which stretches to South Africa.

Epidemiological studies

He however insisted that it is still premature to have conclusive reasons for the cancer causes.

“There are some things partly to blame (for the lack of answers) like research. If we get enough funding we can do epidemiological studies and find out what the contributing factors are,” said Dr Chite.

Dr Chite noted that one of the contributing factors to the surge is the culture of checkups.

While other cancers like cervical, breast and prostate can be checked through non-invasive means, it is a rigorous and at times painful process to ascertain cancers of the digestive system. Some procedures like endoscopy are surgical. “Still, we have to encourage people to come and get checked. We have 200 types of cancer and there is no one test that you can do to ascertain that you do not have any of them,” said Dr Chite.