UCI lists top seven causes of cancer in Uganda

Health experts at Uganda Cancer Institute (UCI) have highlighted sexually transmitted infections, unhealthy diets, polluted environment and skin bleaching as some of the top risk factors for cancer in the country.

According to government statistics, UCI registered around 3,500 new cancer cases in 2015 but number of new cases registered annually has now increased to around 7,500.

Dr Nixon Niyonzima, the head of research and training at UCI said “Cervical cancer which is infection-related is the commonest cancer in women and Uganda, and then prostate cancer is the commonest in men.”
Dr Alfred Jatho, the head of community cancer services at UCI said that besides cancer of the cervix, liver cancer is also infection-related. 

“These infections that cause those types of cancers are sexually transmitted. One example is human papillomavirus (HPV) which is sexually transmitted and is responsible for cancer of the cervix, throat, and anus,” he said on Monday.  
Dr Jatho also advised young people to abstain from sex and asked those who cannot abstain to have safe sexual behaviour and use condoms to avoid these infections.

“If you are married, zero-graze around there, you will reduce your risk of acquiring these infections. There is a vaccine for HPV countrywide for young girls of 10 years. There is also a vaccine for hepatitis B [to prevent liver cancer],” he said.

Dr Martin Origa, a specialist in cancer of the female reproductive system at UCI, said the most common symptoms of cancer of the cervix include vaginal bleeding, most especially during sexual intercourse or when a woman is cleaning her private part.

“They may see blood on their finger. But there is also a foul smell that comes out of the (private part) vagina. But there is also painful sexual intercourse,” Dr Origa explained.

But by the time a patient sees these symptoms, the disease has already broken out. “We want all women to come when they have no symptoms. There are no symptoms in its early stages, called pre-cancer,” he said.
According to figures from the UCI, in 2022 alone, about 4300 died at the centre of the disease, making cervical cancer the leading cause of admission and deaths at the facility.

“Majority of the women who come are at the advanced stage of cancer –that is stage 3 and 4,” Dr Origa said. But he advised women to come for regular checkup so the cancer can be diagnosed early and treated successfully. He said women who are HIV-positive are also at higher risk of developing cervical cancer.

Apart from infection-related cancers, Dr Jatho said, the second biggest risk factor for at least ten types of cancers, is alcohol.
“Alcohol increases the risk for many types of cancers. For liver cancer, alcohol increases the risk between 20 and 30 percent. Any level of alcohol consumption increases the risk of cancer so if you can avoid it, it is better and if you cannot, do light drinking,” he said.

“Regular beer has 4.5 to 5 percent [alcohol], that is an equivalent of 1 unit of drinks, so in our context, if you take an average of a half litre of a bottle containing alcohol of 5 percent, that is one unit.
“For Uganda waragi which has 40 percent [alcohol], one unit should be taken by ten people, anything more is excess drinking. And when you are a pregnant woman, it is zero drinking,” he added.  

Information from the Union for International Control also indicates that “even low levels of alcohol consumption have been linked to an increased risk of certain types of cancer, including breast, colorectal, liver, and upper digestive tract cancers.”

But drinking alcohol is not the only culprit, according to cancer specialists. Dr Jatho said tobacco is the third risk factor for cancers in Uganda. “Many years ago, they said tobacco increase only the risk of the cancer of the lung, no. new evidence shows that tobacco can cause any type of cancer. Even for cancer of the cervix, a woman who smokes is at a higher risk,” he said.

Another important risk factor is refusing to eat a balanced diet.

“If you are a Muganda, traditionally, your mindset is that food is matooke (plantains), that is cultural orientation but what your body needs is a lot more. You should even eat millet, potatoes and maize,” Dr Jatho said.
He continued: “If you are coming from western Uganda, taking only milk is not good you need to eat other things –eat the sweet potatoes and millet.”
A US-based researcher Michael Donaldson and colleagues, reviewed the evidence for an anti-cancer diet. The report states “that 30–40 percent of all cancers can be prevented by lifestyle and dietary measures alone.”

“Obesity, nutrient sparse foods such as concentrated sugars and refined flour products that contribute to impaired glucose metabolism (which leads to diabetes), low fiber intake, consumption of red meat, and imbalance of omega 3 and omega 6 fats all contribute to excess cancer risk,” the report reads. 
Dr Jatho said this balanced diet should have a lot of vegetables and fruits.  
“In addition to balancing the diet, make sure you eat adequate fruits and vegetables which make you shine or glow. Your body works like a factory, and it is always producing some harmful products,” he explained.
“Fruits and vegetables help remove harmful products that our body generates. Do not over-eat and eat good quality food, not those with aflatoxin that cause liver cancer. This is a big problem in our country,” he added.
The expert also said that when cooking, one should make sure food is not burned.  “That burned part form a cancer-causing chemical (polycyclic aromatic hydrocarbon). When you roast the meat, remove the burned part. If you have access to organic food, go for it, but if you can’t get it, you can get what is there,” he said.

He also advised people to avoid a sedentary lifestyle, avoid staying in a polluted environment and refuse the temptation of bleaching their skin.
“Have physical activity of at least 30 minutes a day –make sure you are not overweight. Don’t stay in areas with a lot of smoke or near people who are smoking,” he said.

“Some factories produce a lot of fumes, make sure you wear masks and don’t touch chemicals with your bare hands. Do not bleach your skin because it will increase your risk for cancer,” he added.
 According to information from the World Health Organsiation and the “long-term use of skin lightening products (SLP) can lead to the skin cancer.”

Referring to 65-year-old woman from Togo who developed skin cancer after using SLPs, Information from the agency indicates that “Long term, regular use of SLP containing hydroquinone and potent corticosteroids on the whole body and face for 30 years: Led to the development of invasive cutaneous squamous cell carcinoma, a type of skin cancer.”

“The cancer had spread to the lungs (pulmonary metastases), as diagnosed by further medical examinations. The evidence in this case highlights the potential risks associated with prolonged use of SLP and skin cancer,” the information in 2023 analytical factsheet reads.