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article · BMC Gastroenterology

Prevalence of gastric cancer and its associated mortality among patients undergoing upper gastrointestinal endoscopy at a tertiary level hospital in Tanzania

In plain language

A cross-sectional study of 870 adult patients undergoing upper gastrointestinal endoscopy at Muhimbili National Hospital in Tanzania examined the prevalence and short-term outcomes of gastric cancer. The cancer was identified in 8.9 percent of the patients, who had an average age of 59.4 years. Most tumours were adenocarcinomas located in the antrum, presenting primarily with upper abdominal pain and weight loss. Both Helicobacter pylori infection and cigarette smoking were independently associated with the disease. Over a 90-day follow-up period, 45.5 percent of the gastric cancer patients died. Furthermore, 88.3 percent received only palliative care, whereas just 9.1 percent were eligible for curative treatment, reflecting advanced disease stages at diagnosis.

Key takeaways

  • Gastric cancer was diagnosed in 8.9 percent of patients undergoing upper gastrointestinal endoscopy at the hospital.
  • Helicobacter pylori infection and cigarette smoking were identified as independent risk factors for the disease.
  • Over 88 percent of diagnosed patients received palliative care, with only 9.1 percent eligible for curative interventions.
  • The 90-day mortality rate following diagnosis was 45.5 percent.

Why it matters

Data on gastric cancer in African settings remain scarce. These findings show a high burden of advanced disease and substantial short-term mortality among endoscopy patients at a tertiary hospital, highlighting the strong links to Helicobacter pylori and smoking. This evidence helps healthcare providers and public health authorities understand local risk factors and the urgent need for earlier detection strategies.

Commercialisation angle

The abstract outlines epidemiological and clinical observational findings rather than a commercial product or service. However, the strong independent association with Helicobacter pylori highlights potential demand for accessible, early diagnostic tools and screening programmes among healthcare providers. As purely observational clinical research, the abstract does not indicate an immediate application pathway or commercial readiness level.

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Abstract

BACKGROUND: Descriptive data on gastric cancer (GC) from African countries are limited. We describe the prevalence, clinicopathological features, short-term outcomes and factors associated with gastric cancer at Muhimbili National Hospital (MNH), which is a tertiary-level facility in Tanzania. METHODS: This cross-sectional study enrolled consenting patients aged ≥ 18 years who underwent diagnostic upper endoscopy at MNH from September 2023 to February 2024. The participants were followed up for 90 days to determine whether they died or developed gastrointestinal bleeding or gastric outlet obstruction. Sociodemographic and clinicopathological data were collected through a questionnaire and analysed via SPSS software. The prevalence of gastric cancer and short-term outcomes are expressed as proportions. Logistic regression analysis was used to test the significance of the associations between predictor variables and gastric cancer. A p value of < 0.05 was considered significant. RESULTS: A total of 870 patients were included, 459 (52.8%) of whom were male. The mean (± SD) age of the participants was 53.3 (± 17.4) years. GC was observed in 77 (8.9%) patients, with a male to female ratio of 0.83:1 and a mean age of 59.4 (± 10.6) years. The symptoms associated with GC were upper abdominal pain in 71(92.2%), weight loss 39(50.6%), abdominal fullness 24(31.2%), and vomiting 23(29.9%). H. pylori antibody testing was positive in 63 (81.8%) GC patients. The antrum was the most common location for GC in 51 (66.2%) patients, with ulcerative morphology in 47 (61.0%) patients. Histologically, 72 patients (96.1%) had adenocarcinomas. H. pylori infection (aOR 4.711; 2.493-8.902; P < 0.001), and cigarette smoking (aOR 2.477; 1.453-4.221; P = 0.001) were independently associated with GC. The 90-day mortality rate was 45.5% (35/77). Within the 90-day follow-up period, 88.3% (68/77) of the patients received palliative care, and 9.1% (7/77) were eligible for curative treatment. CONCLUSIONS: The prevalence of gastric cancer among patients undergoing upper gastrointestinal endoscopy at Muhimbili National Hospital is high. Most patients have advanced disease at presentation, and the 90-day mortality rate is high. Cigarette smoking and H. pylori infection were independently associated with GC in this population.

Research topics

  • Helicobacter pylori-related gastroenterology studies
  • Gastric Cancer Management and Outcomes
  • Colorectal Cancer Screening and Detection

Read the original research

This page summarises published work. The authoritative version sits with the publisher.

DOI: 10.1186/s12876-025-04331-x

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