The social and clinical profile of patients with ocular surface squamous cell carcinoma in Tanzania

Abstract

BACKGROUND: Ocular surface squamous cell carcinoma (SCC) is the most common ocular malignancy and occurs disproportionately in Sub-Saharan Africa, where high ultraviolet exposure and HIV prevalence coexist. Data describing the social and clinical profile of ocular surface SCC in Tanzania remain limited. METHODS: We conducted a retrospective cross-sectional study of adults with histologically confirmed ocular surface SCC treated at Ocean Road Cancer Institute and Muhimbili National Hospital between January 2016 and December 2019. Demographic, clinical, radiological, and staging data were extracted from medical records and summarized descriptively. RESULTS: Ninety-nine patients were included, with a median age of 43 years; 61.6% were female, and 80.8% were subsistence farmers. HIV prevalence was 70.7%, and among HIV-positive patients, 67.1% were receiving antiretroviral therapy at diagnosis among HIV positive patients. Documentation of CD4 count and viral load was limited. Most patients presented with locally advanced disease (T3 or T4), with 61.6% staged as T4 and 16.2% as T3, while distant metastasis was not observed. Computed tomography (CT) imaging, available in a subset of patients, showed low frequencies of intracranial and contralateral orbital extension. CONCLUSION: Ocular surface SCC in Tanzania predominantly affects young, HIV-positive individuals and commonly presents at an advanced local stage, with documentation gaps in immunological and staging documentation. Improved integration of HIV and cancer care, enhanced diagnostic capacity, and targeted prevention strategies are essential to promote earlier diagnosis and optimize outcomes in high-burden settings.