MALIGNANCY TRENDS AND HISTOPATHOLOGICAL PATTERNS IN SOUTHEASTERN NIGERIA: A 7-YEAR REVIEW OF 1,680 SURGICAL SPECIMENS
Formerly Published in Vol 14 No. 4 Jan. – Jun., 2026
Keywords:
Histopathology, surgical pathology, malignancy rates, cancer detection, organ specific patterns, Nigeria, Southeast Nigeria, Abia StateAbstract
Background: Histopathological examination remains the gold standard for definitive diagnosis of tissue lesions and plays a crucial role in cancer detection and management. Understanding patterns of surgical pathology submissions and malignancy rates is essential for resource allocation, quality assurance, and epidemiological surveillance in resource-limited settings.
Objective: This study aimed to analyze the spectrum, distribution, and malignancy patterns of surgical pathology specimens submitted to Federal Medical Centre, Umuahia over a seven-year period (2016-2022), evaluate organ-specific malignancy rates, and determine demographic associations with histopathological diagnoses.
Methods: A retrospective descriptive study was conducted analyzing 1,680 histopathology reports from January 2016 to December 2022. Data extracted included patient demographics (age, sex), specimen type, organ system, and histopathological diagnosis. Specimens were categorized by organ system and diagnoses classified as benign, premalignant/atypical, malignant, inflammatory/infectious, or inadequate. Statistical analysis included descriptive statistics, chi-square tests, independent t-tests, one-way ANOVA, and Pearson correlation for temporal trends. Malignancy rates were calculated using adequate specimens only (excluding the 8 inadequate specimens from the denominator); unclassified/other specimens were retained in the denominator as they represented diagnostically evaluable tissue.
Results: The study analyzed 1,680 surgical pathology specimens with a mean patient age of 39.78 ± 20.47 years (range: 1-98 years). Females constituted 67.9% with a female-to-male ratio Pioneer Medical Journal Vol 14. No 2. Jan – Jun. 2026 1 Jegede et al., Malignancy trends of 2.12:1. The most common organ systems were breast (20.4%), uterus (10.6%), and prostate (9.6%). The overall malignancy rate was 24.8% (415/1,672 adequate specimens). Organ specific malignancy rates varied significantly: cervix (63.6%), prostate (39.8%), breast (36.7%), gastrointestinal tract (30.7%), and uterus (5.6%). Mean age for malignant diagnoses (53.98 ± 17.62 years) was significantly higher than for benign diagnoses (33.12 ± 19.51 years, p<0.0001). Sex was not a significant predictor of malignancy (p>0.05). A declining trend in malignancy rates was observed from 31.4% in 2016 to 12.2% in 2022 (r=-0.622, p=0.136).
Conclusion: This seven-year retrospective study demonstrates a substantial malignancy detection rate of 24.8% in surgical pathology specimens with marked organ-specific variation. The exceptionally high cervical cancer rate (63.6%) underscores the urgent need for enhanced cervical screening programs, particularly through integration of VIA/VILI within the Federal Medical Centre Umuahia General Outpatient Department. The 20-year age gap between benign and malignant diagnoses supports the implementation of age-stratified screening protocols in resource-limited settings. The study provides crucial baseline data for quality assurance and cancer surveillance in southeastern Nigeria.
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