Browsing by Author "Wismayer, Richard"

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    Assessment of Survival Outcomes of Histopatho-Logical Subtypes of Colorectal Adenocarcinoma in Ugandan Patients
    (New Horizons in Medicine and Medical Research, 2022) Wismayer, Richard; Kiwanuka, Julius; Wabinga, Henry; Odida, Michael
    In the West, high grade mucinous adenocarcinomas are more common in younger patients and are associated with a poor prognosis. The survival outcomes of the various histopathologic subtypes of colorectal adenocarcinoma (CRC) and lymphovascular invasion (LVI) are unknown in Uganda. We looked at the survival rates of various histopathologic subtypes of CRC and LVI in Ugandan patients.
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    Dietary Risk Factors for Colorectal Cancer in an Indigenous East African Population
    (Perspective of Recent Advances in Medical Research, 2022) Wismayer, Richard; Kiwanuka, Julius; Wabinga, Henry; Odida, Michael
    Low-income countries in East Africa have a lower incidence of colorectal cancer (CRC) than high-income countries; however, the incidence has steadily increased in the last few decades. In East Africa, the extent to which genetic and environmental factors, particularly dietary factors, contribute to the aetiology of CRC is unclear. Therefore, the objective of our study was to determine the relationship between dietary factors and CRC in an indigenous population in East Africa. We conducted a case-control study and recruited 128 cases and 256 controls, block matched for age (±5 years) and sex. Data regarding diet were obtained from all the participants using an interview-based questionnaire. The potential dietary risk factors and protective factors evaluated included the type, frequency of meat consumed and the type and frequency of fibre foods consumed. The frequency was either 4x and above/week or 2-3x/week or 1x/week or never. Ordinal and conditional logistic regression analyses were used to determine the odds ratios associated with the different risk and protective factors. The mean age (SD) was 53.5(16.2) years and the male:female ratio was 1:1 for all the participants. The most significant risk factors included consumption of boiled beef 2-3x/week (aOR:1.63; p<0.001) and consumption of fried chicken 2-3x/week (aOR: 2.60; p=0.027). Consumption of high fibre foods, including:- cassava for ≥4x/week (aOR: 0.40; p=0.016), millet for 1x/week (aOR: 0.49; p=0.034) and for ≥4x/week (aOR:0.32; p=0.001), spinach for ≥4x/week (aOR:0.30; p=0.003), and potatoes 2-3x/week (aOR: 0.44; p=0.041), were protective against CRC.
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    Prognostic Factors for Survival of Colorectal Adenocarcinoma Patients in Uganda
    (Cancer Management and Research, 2022) Wismayer, Richard; Kiwanuka, Julius; Wabinga, Henry; Odida, Michael
    In Uganda, similar to other countries in East Africa, the incidence of colorectal cancer (CRC) has been steadily increasing. This increase in incidence is accompanied by a poor prognosis. There is limited knowledge on factors responsible for the poor outcome of patients with CRC in Uganda. Cancer survival analysis is one way of determining some of these prognostic factors. The aim of this study was to determine prognostic factors associated with CRC survival in Ugandan patients.
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    Surgery for Colorectal Cancer Improves Survival in Uganda: A Cohort Study
    (Current Practice in Medical Science, 2022) Wismayer, Richard; Kiwanuka, Julius; Wabinga, Henry; Odida, Michael
    Colorectal carcinoma (CRC) incidence and mortality rates are rising in Uganda and other developing low-income nations in Sub-Saharan Africa, while CRC rates are dropping in high-income industrialized countries. In Uganda, many people with CRC do not have access to curative surgery or oncological care. To analyze the impact of surgery and oncology care on CRC in the resource-limited environment of a low-income developing nation, we compared the survival results of patients who underwent curative surgery and, if necessary, adjuvant chemotherapy to those who did not. The study included people who were diagnosed with CRC between January 1, 2008, and December 31, 2018. The Kampala Cancer Registry and medical records from Ugandan hospitals were linked for these patients. The researchers wanted to know if the individuals had had curative surgery and adjuvant treatment. Our outcome variable was survival at 3 years. The log-rank test was used to calculate and compare survival. A total of 247 patients were involved in the study. There were 177 (71.66 %) patients who received curative surgery and 70 (28.34 %) who did not. Curative rectal cancer surgery had a better survival than no curative surgery (p=0.003). Curative colon cancer surgery tended to have a better survival than no surgery (p=0.137). Curative surgery and adjuvant chemotherapy showed better survival than no surgery with no adjuvant chemotherapy (p=0.007). Curative surgery, if necessary, paired with adjuvant chemotherapy, improves survival in a resource-constrained situation. As a result of the increasing burden of CRC, the findings of our study serve to support the extension of CRC care by upgrading surgery and oncology infrastructure in resource-limited areas.
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    Surgical Resection for Colorectal Cancer Improves Survival in Uganda
    (Journal of Advances in Medicine and Medical Research, 2022) Wismayer, Richard; Kiwanuka, Julius; Wabinga, Henry; Odida, Michael
    In Uganda and other developing low-income countries in Sub-Saharan Africa, colorectal carcinoma (CRC) incidence and mortality rates are increasing whereas in high income developed countries, CRC rates are declining. Many patients do not have access to curative surgery and oncological treatment for CRC in Uganda. In this study, we compared the survival outcomes of patients who underwent curative surgery, and, if necessary, adjuvant chemotherapy to those who did not to assess the impact of surgery and oncology care on CRC in the resource-limited setting of a low-income developing country. Participants with a diagnosis of CRC between 1 January 2008 and 31 December 2018 were included. These patients had linked data in the Kampala Cancer Registry and medical records from hospitals in Uganda. Data on whether the patients had or did not have curative surgery and adjuvant chemotherapy were obtained. Our outcome variable was survival at 3 years. We computed and compared survival using the log-rank test. Two hundred and forty seven patients were included in the study cohort. These were 177 (71.66%) patients that had curative surgery, while 70 (28.34%) had no curative surgery. Curative rectal cancer surgery had a better survival than no curative surgery (p=0.003). Curative colon cancer surgery tended to have a better survival than no surgery (p=0.137). Curative surgery and adjuvant chemotherapy showed better survival than no surgery with no adjuvant chemotherapy (p=0.007). In a resource-limited environment, curative surgery and if necessary, combined with adjuvant chemotherapy improves survival. The findings in our study therefore serve to encourage the expansion of CRC care by improving the surgery and oncology infrastructure in resource-limited environments due to the increasing burden of CRC.