One Health and Cancer: a comparative study

of human and canine cancers in Nairobi

Kelvin Momanyi1, Anne Korir2, Erastus Mutiga1

1Faculty of Veterinary Medicine, University of Nairobi, Kenya 2Nairobi Cancer Registry, Kenya Medical Research Institute, Kenya

Email:{momanyink@gmail.com}

Twitter:{@momanyink}

18th November, 2015

2nd OHCEA One Health International Conference

Speke Resort Munyonyo, Kampala-Uganda

OverviewONE HEALTH = Our Necessity Entails Humans Ecosystems and Animals Living Together Harmoniously (1)

Relationship between OneHealth & cancer?• Collaborative research plays a key

role in deciphering and solvingcancer challenges [2], evidence?

What is One Health?• Integrative effort added

value + cost savings

• Scope: Zoonoses are justthe tip of the iceberg!

Waters & Wildasin, 2006 Weintraub, 2015

http://iom.nationalacademies.org/Activities/Disease/NCPF/2015-JUN-08.aspx

Overview: Cancer registries in Africa & Kenya

Cancer registries in Kenya:

• 2 population-based

• 3 early development stage

• 3 hospital based registries

25 cancer registries in Africa

• Only 7! Cancer in FiveContinents, Volume 1-10

Impact of cancer to Kenya:

• Number three killer, with a 7%annual total national mortality [3]

Objectives

1• To determine the most common cancers

affecting humans and dogs in Nairobi area

2• To establish the trend of cancers in human

and canine patients during the study period

3• To determine the dog cancer distribution by

breed, age, and gender within Nairobi area

Approach and Methods

Retrospective study of cancers in humans and dogs in Nairobi (2002-2012)

Study area

Dog data collection:5 veterinary clinics + 2 veterinarylaboratories

Human data collection

Approach and Methods

Data preparation and analysisTopographical and Morphological keys of ICD-O-3 [4]

Ethical considerationsUniversity of Nairobi

Kenya Medical Research Institute

Individual facility consent

Patient record confidentiality

Results: Cases and trend of cancer

Actual increase in cancer cases?

Human cases: 15558 (M-42.2%;F-57.8%)

Dog cases: 367 (M-54.0%;F-46.0%)

Increase in population at risk?

Increase in facilities/awareness?

Results: most common topographical diagnoses

Results: most common morphological diagnoses

In both humans and dogs -> high number of (code 8000), & Unknown staging (88.7%) in humans and with no staging in dogs

Associated with diagnostic approach• Post mortem (41.7%)• Clinical only (25.3%)• Laboratory methods (32.9%)

Results: breed and cancer

13 breeds out of 23

Common utility breed

Effect of breed and cancer more related to the number of cases reported than the dog breed and therefore the effect of breed on the cancer cases in this study was generally not clear.

Results: age and cancerTable 2: Age and cancer distribution in humans and dogsHumanyears Dog years*

HUMAN (n=15542) DOG (n=168) Event**Male Female Total Male Female Total

0-5 0-3 months 129 115 244 0 0 0

5-10 3-6 months 135 73 208 0 0 0

10-15 6-9 months

139

99 238 0 0 0

Puberty range in most women and bitches

15-2010-12 months

166135 301 0 0 0

20-25 1-2 204 238 442 2 5 725-30 2-3 241 422 663 1 1 230-35 3-4 347 685 1032 3 1 435-40 4-5 410 924 1334 6 4 10

40-45 5-6 560 1124 1684 5 5 10

The start of increased cancer of all types in both species

45-50 6-7 587 1082 1669 4 1 550-55 7-8 613 981 1594 8 4 1255-60 8-9 546 851 1397 8 5 1360-65 9-10 662 742 1404 4 8 1265-70 10-11 571 542 1113 16 12 2870-75 11-12 548 449 997 15 5 20

75+ 12+ 702 523 1225 21 24 45

A reasonable equivalent of an upper age extreme for both species

*Age conversion using the online access tool from Pedigree [5,6]

** Events common to both species as described by Lebeau [7]

The number of cancer cases in both

humans and dogs generally increased with advancing age

Humans: Earlier age onset of breast and cervical cancers infemales and later age onset of prostate cancers in males

Dogs: Partly could be explained by the progressiveincrease in skin cancers in both male and female dogs

Conclusion

Globally, the burden of cancer is continually increasing[13] and Africa is now awake toaddress cancer, evident with the recent increasing publicity and sensitization campaignssuch as the 9th Stop Cervical, Breast & Prostate Cancer in Africa conference[14]

Why the dog is a preferable model & sentinel for human cancer? 1. Naturally develops spontaneous

cancers [8]2. Spectrum of cancers diverse as in

humans [9]3. Approx. all 19000 genes in dog

match to a similar gene [10]4. Tumor initiation & progression

influenced by similar factors [11]5. Share many features i.e. histologic

appearance, therapeutic response, distribution & tumour biology [12]

The commonality of some of the cancers in both humansand dogs fortifies that it may be possible to use dogs asanimal models and sentinels in the study of humancancers in Kenya Africa. Why could this be possible?

Call to action

• Joint human-animal cancer registries & integrated, comparativecancer surveillance systems Possibly lead to accelerated detection of risks of cancer and promote

cost-effectiveness

• Integration of small animals (dogs & cats) into the NationalCensus (will also support other intervention strategies thatrequire a known small animal population)

• Invest in One Health ‘knowledge’ and One Health clubs

We can win the battle against cancer through development of collaborative comparative oncology

research in Africa through:• Intra-Africa collaborations • North-South collaborations

Acknowledgments

Faculty of Veterinary Medicine, University of Nairobi

Andys Veterinary Clinic, at Loresho &along Ngong road

Central Veterinary Laboratory, Kabete

Department of Veterinary Microbiology, Parasitology and

Pathology, University of Nairobi

Sercombe Veterinary Clinic

Small Animal Clinic, Faculty of Veterinary Medicine,

University of Nairobi

Contributors

Nairobi Cancer Registry, Kenya Medical Research

Institute

Study team

References (in order of citation)

1. Brian Evans (2010): Global One Health Conference, Melbourne, Australia, January 2010 as quoted in theCanadian Food Inspection Agency presentation available at: http://slideplayer.com/slide/6301017/

2. Zinsstag, J., et al., One Health: The Theory and Practice of Integrated Health Approaches. 2015: CABInternational.

3. GoK, National Cancer Control Strategy 2011-2016, M.o.P.H.a.S.a.M.o.M. Services, Editor. 2011: Kenya. p.38.

4. IARC, International Classification of Diseases for Oncology. Vol. Third Edition. 2013, Online: World HealthOrganization.

5. Pedigree. Dog Age Calculator. 2015 [cited 2015 4/11/2015]; Available from:http://www.pedigree.com/all-things-dog/dog-age-calculator/.

6. Patronek GJ, Waters DJ, Glickman LT. (1997): Comparative longevity of pet dogs and humans: implicationsfor gerontology research. J Gerontol A Biol Sci Med Sci (1997) 52A (3): B171-B178

7. Pedigree. Dog Age Calculator. 2015 [cited 2015 4/11/2015]; Availablefrom:http://www.pedigree.com/all-things-dog/dog-age-calculator/

8. Lebeau, A., Bull. Acad. Vet. France (Paris) 1953. 26: p. 229-232.9. Brønden, L.B., A. Flagstad, and A.T. Kristensen, Veterinary cancer registries in companion animal cancer: a

review Veterinary and Comparative Oncology, 2007. 5(3): p. 133-144.10. Ostrander, E.A., U. Giger, and K. Lindblad-Toh, The dog and its genome. 2006, Cold Spring Harbor, N.Y.:

Cold Spring Harbor Laboratory Press.11. Withrow, S.J. and D.M. Vail, Withrow & MacEwen’s small animal clinical oncology. 2007, St. Louis, Mo:

Saunders Elsevier.12. Paoloni, M. and C. Khanna, Comparative Oncology Today. Vet Clin North Am Small Anim Pract, 2007.

37(6): p. 1023-v.13. Popat, K., K. McQueen, and T.W. Feeley, The global burden of cancer. Best Pract Res Clin Anaesthesiol,

2013. 27(4): p. 399-408.14. SCCA, 9th Stop Cervical, Breast & Prostate Cancer in Africa, in Investing to save lives: The role of public &

private sector partnerships. 2015: Nairobi, Kenya.