Histopathological subtypes and topographical subsites of gastric cancer in sub-Saharan Africa: a scoping review

Background Precision medicine in gastric cancer management involves accurate diagnosis, accurate staging, minimally invasive surgery for early disease, and targeted therapies or immunomodulation for advanced disease. The current approach to the management of gastric cancer relies on tumor-node and metastasis classification, which has been shown to have limitations. Molecular and genetic diagnoses are accurate and available but expensive. The modified Lauren classification has been proposed and is based on the tumor location, tumor histology, and clinical course. This classification is closely related to patient prognosis and could offer an accessible option for achieving individualised care in gastric cancer management. Aim - To map evidence on the patterns of gastric cancer by histopathological subtype and topographical subsite in sub-Saharan Africa (SSA). Methods: Primary studies on gastric cancer, particularly adenocarcinoma, between 2003 and 2024 in SSA were considered for inclusion in the study. A comprehensive search was performed via thePUBMED, Google Scholar, and Web of Science databases, which were subjected to a predeterminedprocess. Eligibilitywas assessed before inclusion, and inaccessible abstracts, full texts, studies in languages other than English, and studies in other countries not in Sub-Saharan Africa were excluded. Descriptive analysis was employed for data synthesis. Results After screening 214 studies from the databases yielded, 20 studies from nine SSA countries were included in the analysis. Most of the studies were retrospective. The intestinal histological subtype and the noncardiatopographical subsite were the most predominant. Two studies evaluated the associations of H.pylori with varioushistological subtypes. Three studies evaluated early-onset gastric cancer with a predominance of the intestinal histological subtype. Conclusion This review offers a comprehensive mapping of the literature on subsites and subtypes, with the intestinal subtype and noncardia subsite of gastric cancer being predominant in SSA. Research gaps are identified for future research in the region and include topographical subsites affected by the histological subtypes of gastric cancer and early-onset gastric cancer.