NATIONAL POPULATION BASED- CANCER REGISTRY-

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NATIONAL POPULATION BASED- CANCER REGISTRY-

• Dr. G.Z. Mutuma
• Principal Research Officer,
• Head, Non-Communicable Diseases Research
  Programme,
• Kenya Medical Research Institute,
• Nairobi, Kenya.

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Pathology Oncology Research Unit (PORU)

• Non-Communicable Diseases Research Programme.
  (NCD)
• 1. Registries
• Cancer registry - Since 2001
• Other NCD registries -Not yet
• 2. NCD Research- Cancer research
• Cervix, Burkitts Lymphoma, Oesophagus, Liver,
  NSC, Breast.
• 3. DIAGNOSTIC-Histology, cytology and
  Immunohistochemistry.

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Pathology Oncology Research Unit (PORU)

• COLLABORATORS.
• 1. MOH
• 2. WHO
• 3. NCI- US
• 4. UICC
• 5. IARC and IACR
• 6. INCTR
• 7. OTHER ORGANIZATIONS-

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Nairobi Cancer Registry POPULATION.

• Population based Cancer registry An important
  tool for cancer Research, control, prevention and
  treatment
• Nairobi Cancer Registry covers a population of 4
  Million.
• Nairobi city and its Adjacent divisions.

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NAIROBI CANCER REGISTRY- MAP.
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Nairobi Cancer Registry - Background

• Nairobi Cancer Registry is a population-based
  registry that was established in the year 2001 at
  the Kenya Medical Research Institute (KEMRI),
  Nairobi.
• The initial three years was funded by National
  Cancer Institute (NCI) of USA

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Population-based cancer registry

• A population-based registry records all new cases
  in a defined population with emphasis on
  epidemiological research, and evaluation of
  health services for prevention, diagnosis and
  treatment of the disease.
• In Kenya
• Nairobi Cancer Registry KEMRI
• Eldoret Cancer Registry - MTRH

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The goals of population-based registries.

• Research
• Cancer prevention
• Early detection
• Determination of cancer rates and trends
• Patterns of care and outcomes
• Evaluation of control efforts

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Nairobi Cancer Registry. Roles.

• Provide data on
• Statistics
• Incidence rates
• Age Standardized Rates
• Mortality rates
• Treatment strategies
• Public health initiatives

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Quality control

• To assure that every cancer patient has been
  reported
• To avoid over-counting and under-counting cases
• To monitor multiple primaries
• To document completeness of the registry

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What to collect

• Eligible cases
• Newly diagnosed returns
• Tissue and clinical diagnoses
• Treated and untreated
• Current status

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Sources of Data.

• Hospitals hospital-based cancer registries
• Cancer centers / Hospices
• Pathology labs. Imaging centers
• Physician offices - Private clinics (chemotherapy
  and radiotherapy
• Death certificates
• Public health sources screening programmes

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Hospital sources

• In-patient records
• Out-patient records
• Histopathology labs
• Radiology units
• Hematology labs
• Private physicians attached to the hospital
• Surgery
• Autopsy reports

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Pathology department

• Tissue histology
• Biopsies, excisions
• Cells cytology
• Pap smears, ascites, pleural fluid, sputum
• Bone marrow hematology
• Autopsy

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Medical records department

• Admission form/Patient registration form
• Discharge summaries
• Disease index cards ICD books
• Reports
• Pathology
• Imaging
• Operations
• Consultation
• Treatments Chemotherapy, Radiotherapy
• patient appointment schedules

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NCR relation with IACR IARC

• IARC supported the registry trough training of
  registrars both locally and abroad. (4 cancer
  registrars have been trained in Lyon and
  South-Africa)
• One fellowship offered to the supervisor through
  IACR to train in Thames Cancer Registry , UK
• Registrars have benefited through Annual
  conferences by presenting abstracts on various
  topics.

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Most Common Cancers as Registered by Nairobi
Cancer Registry - KEMRI
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• In the Nairobi population the 16 most common
  cancer sites among males are prostate,
  oesophagus, stomach, liver, larynx, pancreas,
  trachea, bronchus and lung, rectum, mouth, colon,
  Non-Hodgkin lymphoma, Multiple Myeloma, Brain,
  nervous, nasopharynx, bladder and bone. They
  account for 69.1 of incident male cancer cases.

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  In the Nairobi population the 20 most common
cancer sites among females are Breast, Cervix,
Uteri, Stomach, Oesophagus, Colon, Ovary, Liver,
Corpus Uteri, Bone, Trachea, Bronchus, Lung,
Pancreas, Uterus unspecified, Multiple Myeloma,
Rectum, Non-Hodgkin lymphoma, Mouth, Nasopharynx,
Larynx, Brain, Nervous system and Bladder. They
account for 78.1 of incident females cancer
cases.
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POINTS TO NOTE

• 1. Lung cancer becoming more common.
• 2. Stomach cancer the 3rd common in adults

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LUNG CANCER ? MORE COMMON Nairobi Cancer Registry
KEMRI-
Lung Cancer is not among the top ten cancers in
Kenya
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Lung cancer in Europe
Lung cancer is the most common cancer in Europe
and other developed countries and Oesophagus is
the least common yet the most frequent cancer in
Kenya
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Childhood cancers as reported to Nairobi Cancer
Registry
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Future Plans

• Establishment of a National Cancer Registry
• The government is interested in the National
  statistics to show burden of cancer in the whole
  country
• With some support Nairobi Cancer Registry is well
  place to set up a National Cancer Registry. i.e.
  we have trained personnel, equipment and
  established good relation with hospitals.
• Initial coordination funding from WHO 2007

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ON-GOING REGIONAL REGISTRIES

• 1. RIFT VALLEY- ALREADY GOING ON (MRTH)
• 2. WESTERN KENYA- KISUMU- Kisumu cancer registry
  has so far been set up and there is ongoing case
  abstraction and registration
• 3. CENTRAL REGION NYERI COUNTY
• 4. COASTAL REGION- MOMBASA

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Future Plans

• 1. COASTAL REGION-
• MOMBASA COUNTY
• 2. EASTERN
• EMBU COUNTY
• MACHAKOS COUNTY
• 3. RIFT VALLEY
• NAKURU COUNTY
• BOMET COUNTY

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Eradication of NCDs
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Healthy living Healthy eating
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Cancer Registrars Training August 2011, KEMRI
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Thank you for your attention!