Authors and their affiliations

Gebrekirstos Hagos¹, Nazik Hammad², Susannah Stanway³, Verna DNK Vanderpuye⁴, Abdikani Yusuf¹, Tekleberhan Hailemariam⁵, Osman Ahmed⁶, Husein Jamac¹, Ubah Ahmed¹

¹Needle Hospital, Hargeisa, Somaliland

² Saint Michael’s Hospital, University of Toronto, Toronto, Canada

³Royal Marsden Hospital, Sutton Surrey, United Kingdom

⁴National Center for Radiotherapy Oncology and Nuclear Medicine. Korle Bu Teaching Hospital, Accra, Ghana

⁵Dire Dawa University, Dire Dawa, Ethiopia

⁶University of Hargeisa, Hargeisa, Somaliland

Corresponding author: Gebrekirstos Hagos, email: gebrekirstoshagos@gmail.com

Abstract

Purpose: Globally, the incidence of and mortality from cancer are rapidly increasing and present a barrier to increasing life expectancy. Based on regional and global trends, cancer incidence in Somaliland is expected to increase. Until recently, there was no dedicated cancer clinic in Somaliland. In July 2022, a medical oncology service was started in Needle Hospital, Hargeisa, Somaliland. This study reports on patterns of cancer with respect to patients’ region, age, gender, comorbidities, site and subsites of cancer, histology, and stages.

Patients and method: A retrospective study was conducted to determine the patterns of cancer among patients evaluated in the Needle Hospital cancer clinic from July 2022 to June 2023. Data was extracted from the cancer patient registration file and charts. Descriptive statistics were applied using Statistical Package for the Social Sciences (SPSS) version 23.

Results: A total of 232 cancer patients were evaluated during the study period. The median age was 60.0 years. More than half (56.5%) of the patients were female, with a female-to-male ratio of 1.3:1. Most of the patients (66.8%) came from Morodijeh, followed by Togdher (15.1%) and Awdal (5.2%) regions. The most common anatomic subsites of the cancers were breast, esophageal, and prostate cancers, accounting for 15.9%, 8.2%, and 7.3%, respectively. Based on histology, adenocarcinoma, squamous cell carcinoma (SCC), and ductal carcinoma accounted for 26.7%, 25%, and 15.5%, respectively. Most patients presented at an advanced stage; stage IV cancer accounted for 44.4%, and stage III cancers accounted for 29.30% of the total patients.

Conclusion: Based on this study, cancer is one of the emerging health problems in Somaliland. Most patients presented at an advanced stage. Breast, esophageal, and prostate cancers were the most commonly diagnosed cancers. Esophageal cancer being a common finding is disparate, so a study investigating the etiology and biology of esophageal cancer in Somaliland is recommended. We also recommend establishing the National Cancer Control Plan (NCCP), a national cancer registry, and developing research capacity. Finally, to improve cancer outcomes, capacity building in diagnostic and treatment facilities and regional and international collaboration should also be prioritized.