Exploring risk factors and progression of childhood cancers in Uganda

Vaccine and Infectious Disease Division

Exploring risk factors and progression of childhood cancers in Uganda

Dr. Innocent Mutyaba

Dr. Innocent Mutyaba

Independent research funding for a trainee can now be counted among the milestones of the Uganda Program on Cancer and Infectious Diseases (UPCID), centered at VIDD.  Dr. Innocent Mutyaba, who completed his one-year fellowship program in Seattle in September and has returned to practice at the Uganda Cancer Institute, was recently awarded a grant from the African Organization on Research and Training in Cancer to fund a retrospective study of the incidence, risk factors and survival of pediatric infection-related cancers.

“I am so excited that our trainees are able to secure independent research funding,” said Dr. Corey Casper, VIDD assistant member and director of UPCID.  “This is one of the key metrics of success for our training program.”

"This grant is a significant step forward for me as a beginning researcher,” Mutyaba added.

UPCID a collaboration between the Hutchinson Center and the Uganda Cancer Institute in Kampala, Uganda’s only cancer treatment facility.  The program aims to gain a better understanding of infection-related cancers, which are especially prevalent in Uganda and other sub-Saharan African countries, as well as improving patient care and training of Ugandan doctors in oncology.  In 2007, the first Ugandan doctor came to the Hutchinson Center for a one-year training fellowship; three other trainees have since completed such fellowships, raising the number of oncologists in Uganda from one to five. 

Mutyaba’s research focuses specifically on childhood cancers, which are much more common and more deadly in Uganda than in the developed world.  The five-year survival rates for many pediatric cancers in the developed world are between 60 and 90%, while in Uganda, the five-year survival for any cancer is 13%.  Mutyaba’s research proposal aims to fill critical knowledge gaps about pediatric cancer, including how common it is, what outside factors influence the risk of cancer, predicting how these diseases will develop, and how to best manage care of childhood cancers.

To address these questions, Mutyaba and colleagues in UPCID will look at past patient records at the UCI for all cancer patients from Kyandondo County under age 20 between 2007 and 2010 , an estimated 330 to 370 cases.  They will look for incident rates of pediatric cancer overall, and by age and gender, using the resources of the Kampala Cancer Registry.  They will look for correlations of pediatric cancer with such risk factors as HIV infection, malnutrition, family history of cancer, and socioeconomic status.  Also based on patient records, they will then look for the median time between cancer diagnosis and presentation for care at the UCI, to gain an idea of how quickly the diseases progressed and at what stage children are able to seek care; they will also examine the one-year survival rates of the cancers identified, the cause of death, and whether any specific risk factors such as HIV infection increase chances of mortality.

Mutyaba hopes that learning more about all aspects of these common but devastating diseases in Uganda will help future researchers and clinicians improve care and treatment for children with cancer, not just in Uganda, but in all African countries. 

"The biggest challenges we face in cancer care in Uganda are advanced stage of disease at initial presentation for care and poor understanding of treatment outcomes,” Mutyaba said.  “Through this study, we hope to characterize who gets cancer, their access to cancer care, and predictors of 1-year survival.  These findings will provide a platform for future studies to examine interventions aimed at reducing the proportion of cases presenting with advanced stage of cancer."

For more information on the Uganda Program on Cancer and Infectious Diseases, click here.