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Experts: Cancer research from West won’t work on Africans


Concerns over cancer research

Scientists fault use of data collected from Americans to make clinical decisions to treat Kenyan patients

Researchers have called on the government to invest more into cancer research amid evidence that the standard care has been too general to work on patients or too westernised.

Dr Francis Makokha, a cancer researcher at the Mount Kenya University, said Kenya needed “precision medicine” where patients are treated based on the disease driver genetic mutations they possess rather than a generalised approach as has been the practice.

The researcher cited a report in the journal Science, which indicated that doctors will no longer refer to research on African Americans in the West to make clinical decisions.

“The study in the Nigerian population demonstrated a different mutational pattern from that observed in African Americans, suggesting differences in heredity and environmental factors that increase the risk of cancer. This was also evidence that cancer risks at genetic level may be region and population or race,” he told HealthyNation.

An oncologist and lecturer at the school of medicine at University of Nairobi, Dr Andrew Odhiambo, called for more research especially in cancers to guide decisions.

The research would go beyond collection of data to include specificity of treatment.

Citing unpublished data at his clinic, Dr Odhiambo said while data from the Americas showed the link between bacterium H Pylori and stomach cancer, he had not established such association in his practice.

Dr Odhiambo said he had collected 440 cases of cancers of the stomach in Kenya since 2017 to late last year and had not seen the link. “Clearly, that shows we need more investigation into this,” he said.

PRECISION MEDICINE

Cancer is a major public health threat in Kenya. According to the cancer registry kept by World Health Organisation (WHO), Kenya reports the highest figures in East Africa, with 47,887 cases and 176 deaths per 100,000 people. Uganda reported 32,617 cases of cancers in 2017, with 151 deaths per 100,000 people. Tanzania reported 42,060 and 132 deaths per 100,000.

While the government has increased it’s funding into the treatment and management of cancer, health experts have expressed concern that is not enough compared to what is needed.

African countries have tried the use of genomics in cancer care.

In 2018, a study compared DNA data from Nigerian breast cancer patients to patients in a US database and found that certain aggressive molecular features were far more prevalent in tumours from Nigerian women than in black or white American women.

The study, published in Nature Communications, reported that those differences in multiple molecular features could in part explain disparities in breast cancer mortality for women from Nigeria, and perhaps other West African nations.

Study author Prof Olufunmilayo Olopade said: "In the era of precision medicine, our data provide insights that could reduce the number of deaths from breast cancer across Sub-Saharan Africa and the developing world."

In a previous interview, Ms Anne Korir, the head of the National Cancer Registry, attributed these high numbers to late diagnosis, inadequate treatment options and resources.

At the moment, money invested in cancer research goes mainly to data collection.

Sam Kariuki, a professor of microbiology at Kenya Medical Research Institute, said these high numbers and the deaths of high profile people had triggered an investment in cancer.

Prof Kariuki cited cancer centres coming up funded by the national government as well as the National Cancer Institute. He said in partnership with the institute, the Health ministry was likely to launch a national surveillance registry which would analyse data collected for more than 10 years to map the cancer hotspots in Kenya.