Cancer patterns suggest southern Ethiopia’s AIDS epidemic began after mid-1980s

Researchers can track AIDS epidemics by looking at the levels of cancers associated with the disease, such as cancers of the immune system and skin. A 2019 study of southern Ethiopian medical records showed that from 1963 to 1986, cancer cases did not rise much, and so the region’s AIDS epidemic likely only began after this period. 

In many other countries, the number of Non-Hodgkin’s lymphoma (NHL), which is the cancer of the immune system, and Kaposi sarcoma, which is the cancer of the skin or lining of mucous membranes, increased alongside the incidence of AIDS. Patients suffering with AIDS are more likely to develop these cancers and are more severely affected, so researchers can use cancer medical records as a way to track the start and progression of the AIDS epidemic.

This study specifically looked at the rate of NHL and Kaposi sarcoma in the Gamo Gofa and Sidamo Regions of southern Ethiopia between 1963 and 1986.

The author analysed the medical records of cancer patients from 3 different Ethiopian hospitals. Using statistics and comparisons to cancers with similar symptoms, they were able to calculate the frequency of these cancers, meaning the number of people affected.

The author noticed that the incidence of NHL and Kaposi sarcoma did not drastically change during this period. In 1978, the number of people who had Kaposi sarcoma was high, but likely not related to AIDS because the patients did not seem to be as severely affected as AIDS patients usually are.

The author cautions that these findings are only based on recorded data from 1963 to 1986, and so there is a chance that not all cases were recorded. 

But the author suggests that southern Ethiopia’s AIDS epidemic may only have started after this period, in the mid-1980s, because of the stable cancer levels observed in previous decades. This insight may help researchers understand the history of AIDS and patterns of cancer in the past.

The author of this paper was from Ethiopia. 

Abstract

The pattern of Non-Hodgkin's lymphoma and aggressive Kaposi's sarcoma is known to have changed in some countries as the prevalence of the acquired immunodeficiency syndrome increases. A retrospective analysis of histologically verified cancers in southern Ethiopia during the period 1963-86 did not demonstrate any change in the pattern of aggressive Kaposi's sarcoma nor of Non-Hodgkin lymphomas, suggesting that the HIV epidemic did not start before the mid-1980s.

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