Cancer Epidemiology
Medical Research Council
MRC/UVRI and LSHTM Research Unit Uganda
We will build on our work showing that the malignant and non-malignant consequences of oncogenic infections (including HIV) are a major cause of morbidity and mortality in Uganda and that lifestyle risk-factors such as tobacco are currently relatively less important in this setting. We will i) examine the transmission dynamics of oncogenic infections, ii) initiate preventive interventions and, iii) conduct aetiological research on specific cancers. For example, the determinants and immune correlates of suppression and transmission of Kaposi’s sarcoma associated herpesvirus (which exists at higher prevalence in our rural cohort than has been reported anywhere else in the world) will be studied. Working within our population platforms, we will: i) examine the impact of a national HPV vaccination scheme on circulating subtypes of HPV; ii) assess the feasibility of H. pylori eradication in a population in which infection is ubiquitous; iii), conduct a feasibility study of Hepatitis C Virus cure and iv) develop further work on understanding liver disease and progression of chronic infection with Hepatitis B virus. We will also seek external funding to conduct a randomised-controlled trial of low-technology methods (a package of post-harvest measures) in combination with a bio-control approach to reduce aflatoxin levels, which we have previously shown to be an important exposure. Comparative research on the epidemiology and aetiology of haematological malignancies in Uganda and in the UK will be further developed, in conjunction with studies of the HIV-related cancers Kaposi’s sarcoma and conjunctival carcinoma.
2.1 Biological and endogenous factors / Unit