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Calabar Cancer Registry

TYPE OF REGISTRY AND DATE ESTABLISHED:

The Calabar Cancer Registry is a population-based Registry. It started as a hospital-based Registry in 1979 under Professor Ed’.B. Attah but became population-based in 2004 after a visit by the representative of the International Agency for Research on Cancer (IARC), Lyon, France.

 

ORGANIZATIONAL STRUCTURE:

The Calabar Cancer Registry is headed by Professor Ima-Obong A. Ekanem, a Consultant Pathologist as the Director. She is assisted in the day-to-day running of the Registry by Mr. BB Etim-Okon, a Principal Administrative Officer as the Acting Registrar. Mr. Joel Bassey, a Senior Clerical Officer, serves as the data collector and Data-Entry Clerk. Mrs. Ejen M. Anah functions as the Medical Social Worker in charge of patients’ counseling while Mrs. Favour Abela Ofor and Mrs. Ekanem Bassey serve as Anatomist and Administrative Officer respectively.

There is also an Oncology Nurse who counsels patients on the detection of early warning signals of cancer and also assists during the collection of cervical smear and breast fine needle aspiration biopsy in the Cytology clinic.

Director’s Contact details:
Prof. Ima-Obong A. Ekanem
Department of Pathology
University of Calabar Teaching Hospital
P.M.B. 1278
Calabar – Cross River State
Nigeria
Email:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Telephone: +2348037183961


AFCRN visit in Nov 2012. CCR staff from left to right: Mrs Ejen Anah, Favour Ofor, Mr Joel Bassey and Prof Ima Obong Ekanem, Director, CCR)

 

LOCATION:

Calabar Cancer Registry designated N14 (IACR) is located in the Department of Pathology, University of Calabar Teaching Hospital (UCTH), Calabar, Cross River State, Nigeria.

 

SOCIO-CULTURAL AND POLITICAL LANDSCAPE:

Cross River State was created on September 23, 1987, when the Armed Forces Ruling Council, headed by General Ibrahim Babangida, restructured the nineteen-states in the country, into twenty-one (21) states with Abuja remaining as Federal Capital Territory and the seat of Government.

With the excision of Akwa Ibom State from Cross River, part of the Old Calabar and Ogoja Provinces now constitute the present Cross River State.


Map of Cross River State

The State is situated within the tropics sharing common boundaries with the Cameroun Republic in the East, Benue State in the North, Enugu and Abia States in the West and Akwa Ibom State in the South. It lies between latitudes 50 32’ and 400 27’ North and latitudes 70 50’ and 90 28’ East. Obudu plateau, with an altitude of 1575.76 meters above sea level, enjoys a temperate climate like other temperate regions of the world.

LAND AREA: 23,074,425: square kilometers
CAPITAL: Calabar
POPULATION: 2,892,988(National Population Census, 2006)
ATLANTIC COASTLINE: 129km
COASTLINE AREA: 10,000 square kilometres
NO. OF LGAs: EIGHTEEN (18)

Majority of the inhabitants are the rural dwellers who engage in fishing and farming, while the urban dwellers are teachers, civil and public servants. Social activities in Calabar, for example, are to some extent, comparable to that of other towns in Nigeria. These include drinking of alcoholic beverages including palm wine and local gin (“Kai-Kai”) as well as relishing in local delicacies such as dog meat, goat head (“isi-ewu”), fresh fish pepper soup, etc. Garri (and other cassava products) remain the staple food in the state while yam, plantain, coco-yam are also cultivated and eaten by the people. Rich vegetable soup such as Edikan Ikong, Afang as well as Ekpang Nkukwo are consumed by the locals as well as visitors.

 

DEMOGRAPHIC PECULIARITIES AND POPULATION:

Cross River State with a population of 2,892,988, Male: 1,471,967 and Female: 1,421,021 (2006 National Population Census) is composed of three major ethnic groups. These are the Efik, the Ejagham and the Bekwarra. The Efik language is very widely spoken in Cross River State. The Efik-speaking people live mainly in the Calabar Municipality and Calabar South LGAs as well as in Bakassi, Akpabuyo, Odukpani and in parts of Akamkpa LGAs. There is also a Qua Community in Calabar, which speaks Ejagham.

However, there are other ethnic nationalities such as the Ibibio, the Ibo, the Yoruba the Hausa, etc, who are strictly, settlers.

 

METHODS OF REGISTRATION: DATA MANAGEMENT:

The Calabar Cancer Registry does active cancer registration. Our cancer registration practices involve visits to all the health institutions within our area of coverage.

Initially, the registration area covered the six LGAs: Akamkpa, Akpabuyo, Biase, Calabar Municipality, Calabar South and Odukpani. However, the following three (3) LGAs, Akpabuyo, Calabar Municipality and Calabar South constitute our catchment of activity with a population size of Six hundred and forty-two thousand, four hundred and seventeen (642, 417). Regular visits are made to the hospital wards, Health Records Department and laboratory department’s mainly-Histopathology and Haematology at the UCTH, Calabar.

The key methods of diagnosis used are:

i.     Histology
ii.    Clinical
iii.    Cytology
iv.   Autopsy
v.   Death Certificate

To ensure quality control, as far as possible, histological confirmation is obtained in cases registered.  All entries are cross-checked validated and updated regularly by the Director.

 

SUMMARY OF REGISTRY DATA (JAN 1- DEC 31), 2014

Total number of cases 128; male 58, female 70 ( F>M, Ratio=1.2:1)

Commonest cancer sites in all age groups and both sexes: Breast (21.9%), Prostate (17.19%), Uterine cervix (9.38%), Lymphoid (9.38%), Colon (3.9%), Ovary (6.25%), Others and Undefined (32%).

Commonest in

Male: Prostate 22 cases.

Female: Breast 28 and Uterine cervix 12 cases respectively

Childhood cancer: 5 cases,  Ear/Nose 2 cases and Eye 3 cases

Key methods of Diagnosis: Histology( 45.3%), Cytology( 22%), Clinical( 32%), Autopsy( 0.7%), Death Certificate only( 0%).

 

ACHIEVEMENTS:

  • Relocation to the Permanent Site of UCTH in February 2012.
  • Visit by Ben J. S. al-Haddad of the University of Minnesota School of Public Health 14-16 February, 2012 for collaborative work in the Cancer Registry.
  • Improved staff strength (3) new members including a Medical Social Worker posted to the unit.
  • Improved power supply since relocation.
  • Annual World Cancer Day February 4th and World No Tobacco Day May 31st campaigns since 2012.

 

PUBLICATIONS FROM THE REGISTRY:

  1. Elima E Jeddy – Agba, Maria-Paula Curado, Emmamuel Oga, Modupeola O.Samaila, Emmamuel R, Ezeome, Christopher Obiorah, Adebayo Ojo, Ima-Obong A. Ekanem,g, Cornelius Ukah,  Ahmed Mayuni,  Enoch A. Afolayanj,  Popoola Abiodunk, Babatunde J. Olasodel, Abidemi Omonisil, Theresa Otum,Patience Osinubin, Patrick Dakuma, William Blattnero, Clement A. Adebamowoa, oThe role of hospital-based cancer registries in low and middle income countries—The Nigerian Case Study Cancer Epidemiology :Available online 15 June 2012
  2. Godwin A Ebughe1*, Ima-Obong Ekanem1, Ayodele J Omotoso1, Marcus Inyama2, Thomas U Agan3, B U Ago3,A Ibanga4, Dennis Nkanga4, U Etiuma5, Grace Inah6 Malignancies in AIDS patients: the experience of a tertiary hospital in a high prevalence zone Infectious Agents and Cancer 2012 7(Suppl 1):P17.
  3. Marcus A Inyama1*, IA Ibanga1, Godwin Ebughe2, I Bassey2, Ima-Obong Ekanem2, ME Asuquo3 AIDS-related lymphoma at the University of Calabar Teaching Hospital (Nigeria): a seven year review Infectious Agents and Cancer 2012 7(Suppl 1):P1

 

CHALLENGES:

  • Lack of field vehicle for active cancer data collection outside Calabar.
  • Need for appropriate budgetary allocation to the Registry for enhanced activities.
  •  

    ACKNOWLEDGMENT:

    We sincerely thank the Management of the University of Calabar Teaching Hospital (UCTH) for her various forms of support in the running of the Registry and in particular, the Chief Medical Director, Dr. Thomas Agan who has always been there for us.

    We also specially thank the Institute of Human Virology Nigeria (IHVN), the Federal Ministry of Health and the International Agency for Research on Cancer (IARC) for their assistance to the Registry at different times.

     

    BY: PROF. IMA-OBONG EKANEM
    DIRECTOR, CALABAR CANCER REGISTRY

    October 2015

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