COLLABORATIONS in 2018
The official partnership between AFCRN and IARC continues. AFCRN provides the facilities and features of a “Regional Hub” for sub-Saharan Africa, as part of the Global initiative for Cancer Registration (GICR). The capacity of AFCRN to undertake this work is supported through funds received via a contract (APW - Agreement for Performance of Work). This included funds provided by The GAVI Alliance (the “Global Alliance for Vaccines and Immunisation”) and a contribution from CDC to IARC.
American Cancer Society (ACS). It was suggested that the new series of Cancer in sub Saharan Africa should be prepared in 2018. Paper of the first results from Gulu cancer registry and the Cotonou cancer registry have been submitted to peer reviewed journals. A study of trends in incidence of breast cancer in SSA will also be published during 2018. Also, the additional support from ACS allows an AFCRN TNM staging and coding course in November to include more students.
AFCRN Database. As membership criteria, a new data submission, comprising a listing of case records (anonymous) from each AFCRN member, was requested in June. The database is hosted by IARC under a Research Agreement. Contributing to the database is a criteria for membership of AFCRN and most members did so. A few experiencing technical difficulties are working on the request. Access for research studies (including by IARC researchers) is via request to the AFCRN Research Committee.
Data from this year’s submission will be used for ‘Cancer in sub Saharan Africa III’.
Treatment and Follow-up Study. A research study Comparing therapy and outcome in cancer patients of low and middle resource settings using population-based registries , led by Dr Eva Kantelhardt, is in its final stage. The study focuses on the most frequent cancers in females and males in sub Saharan Africa, for which early diagnosis, and effective treatment, are expected to result in favourable outcomes: Breast (female), cervix, prostate and colorectal cancers, and non-Hodgkin lymphomas).
Data collected from the 11 centres (Eldoret, Nairobi, Cotonou, Brazzaville, Abidjan, Bamako, Maputo, Namibia, Kampala, Bulawayo and Addis Ababa) has been analysed and used for publications. Each publication focuses on one site are being prepared by the German medical students as well as the Oxford DPhil candidate (Dr Yvonne Joko).
Make Cancer a Reportable Disease In collaboration with IARC and WHO AFRO, AFCRN took initiative and searched the existing legislation and regulations from African countries, as well as from other parts of the world to try to draft a model regulation that could be recommended to member states by WHO.
So far, the only regulation available within the African continent was the one from RSA. Since the UICC WCC (Nov 2016), Dr Parkin had been in contact with Mr Jonathan Liberman from the Cancer Council and the McCabe Centre for Law and Cancer, Australia to pursue their professional voluntary help.
The proposal has also been put to the Bloomberg Foundation and early discussions have been held.
RESEARCHES in 2018
Joint research projects within the context of AFCRN (ie, involving members in more than one country) have to be submitted to, and approved by the AFCRN Research Committee. Criteria for collaborative studies have been developed (click Here to view)
1. SurvCan 3. This third study of cancer survival in low and middle income countries was launched in 2016. 11 member registries took part in this study: Abidjan, Addis Ababa, Eldoret, Nairobi, Blantyre, Mauritius, Bamako, Kampala, Harare, Eastern Cape and Seychelles. Data collection was completed in all participating centres.
The follow up results from the Treatment and Follow-up Study, led by Dr Eva Kantelhardt, will also be used in SurvCan 3.
2. Field trials of the “Essential TNM” in Harare (Zimbabwe), Abidjan (Cote d’Ivoire) and Blantyre (Malawi) cancer registries were completed in 2016 and the results have been analysed and presented in both the IACR conference and UICC WCC in 2016. It was observed that cancer registrars with relevant oncology background knowledge did significantly better than those without. Therefore, it is considered that a new training component is needed for registrars in order to be able to stage cases using this system.
IARC conducted a “Masterclass” in December 2017, for selected registry staff to act as Trainers in future GICR courses on coding and staging. Four AFCRN-member registry staff took part. AFCRN received supports from the pharmaceutical company ROCHE to support a) the development of such a new training course, including appropriate training materials (complete); b) a tailored training courses. An additional fund from American Cancer Society allows this much needed training to include more students from our member registries.
The first course, in collaboration with the GICR team at IARC, will take place in November 2018 (Addis Ababa)
3. The monograph book of Cancer of Childhood in Sub Saharan Africa is now published. 16 registries with >100 cases registered in a recent time period of 10 years or similar joined the study. This project has been funded by the South African Medical Research Council. PI is Dr Cristina Stefan. Publication available here:
4. A publication Survival from Childhood Cancers in Eastern Africa: A Population-based registry study is complete and published. The data was from the Childhood Cancer Survival Study funded by the South African Medical Research Council. PI is Dr Cristina Stefan. Participating centres: Kampala, Nairobi and Harare.
5. The Bloomberg Philanthropies - Data for Health Initiative has partnered with AFCRN to provide technical guidance to country partners and to the implementation team at Vital Strategies, and necessary trainings. The pilot country in SSA is Tanzania. The project “Tanzania National Cancer Registration Program” started in October 2017, for 18 months. The goal is to develop a national cancer registration programme for Tanzania. with the support from Bloomberg Philanthropies/ Vital Strategies, AFCRN and its consultants have conducted 3 consultancy visits, 2 training courses, 2 CanReg onsite support and provided financial support to four provincial cancer referral centres. A procedure manual and a reporting template specific for Tanzania cancer registries were prepared.
A training course on data analysis and reporting will be organised in Dar es Salaam, following the initial course in Entebbe (11-13 Oct). Also, more CanReg onsite support will be provided to the two cancer centres in Dar es Salaam.
6. The Foundation Sanofi Espoir, responsible for the My Child Matters Program, funded a one-year pilot project to strengthen childhood cancer registration in Africa (ended September 2018). In this pilot phase, registries in 3 Francophone countries (Cote d’Ivoire, Congo and Burkina Faso) took part. The program involves 1) Extension of childhood cancer registration to cover the entire national population (rather than the more limited geographic area covered by the general registry). 2)Staging: to teach cancer registrars to record stage, using the simplified staging scheme “Tier 1”, as it appears for childhood cancers, in the TNM Manual (8th Revision). 3) To conduct a study of survival from 6 major neoplasms of childhood, diagnosed in more recent years. The project has enabled the creation of 3 national paediatric cancer registries: for Côte d'Ivoire (based on the Abidjan cancer registry), the Republic of Congo (extension of the Brazzaville registry) and Burkina Faso (a new register). The survival of childhood cancers recorded in previous years is being studied in Harare (Zimbabwe), Kampala (Uganda) and Abidjan.
Three consultancy visits made to the three Francophone participating centres by Ms Cecile Ingabire in February and March; Two training courses on childhood cancer staging and survival follow up, one in English (Harare), one in French (Abidjan); Data from the three Francophone centres have been analysed and used for preparation for a poster at the SIOP conference in November. Ms Ingabire has received a sponsorship to present the result at the conference.