Development of an African Esophageal Cancer Consortium
Background:
Esophageal cancer is the sixth leading cause of cancer death worldwide. It kills 400,000 people every year, most of whom live in two distinct geographic bands across central Asia and along the eastern Africa corridor that extends from Ethiopia to South Africa. In these high-risk areas, nearly all cases are esophageal squamous cell carcinoma (ESCC). Our group and others have performed many etiologic, genetic, and early detection and treatment studies of ESCC in central Asia, but this disease remains essentially unstudied in eastern Africa. Over the past few years, several groups have begun quality studies of ESCC in Africa, including case-control studies in Dar es Salaam, Tanzania (University of California, San Francisco, and Muhimbili University of Health and Allied Sciences); Eldoret, Kenya (International Agency for Research on Cancer and Moi University); Moshi, Tanzania (International Agency for Research on Cancer and Kilimanjaro Clinical Research Institute); Bomet, Kenya (National Cancer Institute and Tenwek Hospital); and Lilongwe, Malawi (National Cancer Institute and the UNC-Malawi Project). In November 2015, these groups met and decided to create the African Esophageal Cancer Consortium. The goals of the consortium are to raise awareness of the importance of ESCC in Africa, to coordinate etiologic and molecular studies of ESCC in high-risk populations, and to facilitate provision of therapeutic training and equipment aimed to improve survival and quality of life.
The first coordinated activity was to standardize questionnaires so that data can later be compared and combined. The consortium has embraced mobile health technologies through development of an mHealth app for real-time data capture on a phone or tablet and to collect harmonized data from the outset, increase efficiency, eliminate transcription mistakes, and allow real-time quality control and supervision of field activities from any location.
The consortium held its second annual meeting in September 2016. At this meeting, the five member sites affirmed their commitment to the consortium and the first study coordinator was named.
Case-control studies in Moshi, Bomet, and Lilongwe are using the mobile app. A case-control study in Dar es Salaam is complete, with results pending. Coordinated genome-wide association and genomic studies are planned, with collection of biospecimens from multiple sites. The consortium is actively working with partners in China to provide affordable stents in Africa for palliative ESCC treatment as well as to secure training to safely and effectively place stents. Annual meetings will continue to follow-up on progress and develop new initiatives.