Cancer Incidence

Cook and Burkitt17 have pointed out that there are many difficulties to contend with when studying the incidence of cancer in Africa. They noted that "available medical facilities and demographic data are of a much lower standard than those usually accepted as minimal for adequate cancer registration in the developed world." For many countries in Africa, no data are available on cancer incidence.14 There have been isolated attempts to document cancer in sub-Saharan Africa; however, only a few regions have been able to estimate cancer incidence rates from population-based registries.18

Prostate cancer incidence rates in black Africans are summarized in Table 3-28-11,13,14,19-28 by country or region. The incidence rates cover the time period from 1958 to 1995. Incidence rates from all 16 reports are age adjusted and are standardized to either the African Standard Population20,24 or the World Standard Population.25,27,28 The age-standardized incidence rate of prostate cancer in Africa ranges from a low of 3.1 per 100,000 in Swaziland blacks to a high of 29.2 per 100,000 in Zimbabwe blacks. Without considering the low crude incidence rate of 1.2 per 100,000 from Gambia, the former findings suggest that there are notable geographic differences in prostate cancer incidence in Africa. In addition, estimates of age-standardized incidence rates (new cases per 100,000 population in 1985) of prostate cancer also suggest that regional differences exist in prostate cancer incidence. The age-standardized incidence rates for prostate cancer are 22 per 100,000 for Eastern Africa, 24.1 for Middle Africa, 6.5 for Northern Africa, 20.7 for Southern Africa, and 11.5 for Western Africa.

For completeness of our review of the literature, it should be noted that two reports from West Africa were excluded from the tabular analysis of published prostate cancer incidence rates (see Table 3-2). One study was from Cameroon29 and the other from Nigeria.30 The lack of a standard format for presenting prostate cancer age-standardized incidence rates in these two studies was problematic in comparing their incidence data with those from other African countries. The Cameroon study,29 a hospital case-series study of prostate cancer, reported a

TABLE 3-1. Relative Frequency of Prostate Cancer among African Men, by Country



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