# Patterns of cancer in Needle Hospital, Hargeisa, Somaliland from July 2022 to June 2023

## TL;DR

This study reports on cancer patterns in Somaliland, showing that breast, esophageal, and prostate cancers are most common, with many patients presenting at advanced stages.

## Contribution

The study provides the first detailed cancer pattern analysis from Somaliland following the establishment of a dedicated oncology service.

## Key findings

- Breast, esophageal, and prostate cancers were the most commonly diagnosed cancers.
- Most patients presented at advanced stages (stage III or IV).
- Adenocarcinoma and squamous cell carcinoma were the most common histological types.

## Abstract

Globally, the incidence of and mortality from cancer is rapidly increasing and presents 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.

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 were extracted from the cancer patient registration file and charts. Descriptive statistics were applied using the Statistical Package for the Social Sciences version 23.

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 and squamous cell carcinoma accounted for 42.2% and 25%, 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.

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 aetiology and biology of esophageal cancer in Somaliland is recommended. We also recommend establishing the National Cancer Control Plan, 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 prioritised.