The registry was founded in 1994. It worked for about 8 years, under the direction of the late Professor Antoine Echimane, but ceased operations in 2002. After a period of political instability in the country, recording restarted in 2011, focusing on retrospective record (since 2007) at first, but with the goal of complete data collection for 2012 in this year.
Registre de cancer d' Abidjan
Centre Hospitalier Universitaire de Treichville
01 B.P. V.3
Medical Director: Prof. Innocent Adoubi (Head of Cancer)
Deputy: Dr. Amalado Ayemouu (oncologist Radiation Therapist)
Director: Guy N'da
Location and logistics Cancer Registry
The registry office is based in the Department of Oncology, including a desk for the director, a computer room and a meeting room (room A Echimane). There are 3 computers available, but only one (the one used for data entry) dedicated to the registry, an inverter, but no photocopier. The registry is the owner of a VW van (offered by an NGO), but it is out of service now and in need of repair. Currently, transportation is by public transport, or in personal vehicles.
The staff of the Cancer Registry:
The Medical Director is Dr. Adoubi Innocent, Head of Oncology. The register manager / coordinator is Dr. Guy N'da working in the same department, and with a Masters in Public Health (MSP University of Cocody), he spends 80% of his time to work the register.
In addition, there is a full-time computer (Julius Bakare), two investigators (Nathalie Guia, Kinda Korotoum), and an archivist / Secretary (Sally Kouamé), working mainly for the oncology department.
Source of Funding
The staff are generally paid from the budget of the Department of Oncology. There is no budget for the purchase of supplies and equipment or for maintenance and replacement of equipment. A grant was received from Hoffman La Roche which has some modernization and purchase of office equipment. Transportation costs, particularly travel expenses are covered by the budget of the Service.
Population coverage of the registry
The registry is intended to cover the city of Abidjan. The city consists of 10 areas, but registration also includes several neighborhoods of the city of Abidjan (shown below, Fig 1)
Abidjan: Abobogare; Adjame; Attiecoube; Cocody; Koumassi; Marcory; Plateau; Port-Bouet; Treichville; Yopougon
Outer Abidjan: Alepe; Anyama; Bingerville; Bonoua; Dabou; Grand-Bassam
The most recent census in 1998. However, there are more recent estimates of the population, based on a growth rate estimated at 2.8% per year.
The registry obtains estimates of population by age and sex for the period 2009-2011 from DIPE (Department of Information, Planning and Evaluation) of the Ministry of Health. Districts do not exactly correspond to the municipalities of Abidjan. If we include Yogoupon East (but not "Yopougon-Songon") and that takes 80% of the population of Cocody-Bingerville, we obtain an estimate of 3,772,230 inhabitants in 2010.
Sources of information for the base register
The main sources of information are the three major teaching hospital serving the city (Treichville, Cocody and Yopougon), each offering a full range of diagnostic and therapeutic services. Other public hospitals are relatively small, and there is also a Military Hospital and a number of small private clinics to serve patients better off, some of which were important sources of case (PISAM, for example).
The only service of Oncology is the Treichville, there is no radiotherapy currently active. Patients requiring radiotherapy are sent to Ghana, Morocco, Tunisia and France (at their own expense). The Department of Pediatrics of the University Hospital of Cocody an activity oncolpédiatrie important service and Hematology Clinic (CHU Cocody) also sees a large number of lymphoma and hematologic malignancies.
None of the hospitals has a centralized records. Medical records are kept in each service. In general, each service maintains a Register of Inputs and Outputs, and this register includes for each admission, hospital number, name, age, sex and diagnosis (as well as the state output), but not the home. Few services (eg ENT Treichville) keep a register of patients with cancer (because of their personal interest).
At present, there is no separate Hospice (offering home care), but it is a project in progress (target 2013) with a working group, in collaboration with the Association of Palliative CareLaboratoires
There are three - Treichville CHU CHU of Cocody, and clinical Wilic (private).
All three have only a technical basis: for example, specialized diagnostic procedures (immuno histochemical) require sending samples (or blocks) to collaborating center in Europe or the United States.
In both laboratories visited (Treichville Wilic), there was no real registrar of cases. However, both maintain a file of reports. About 15-30% of diagnoses relate to cancer patients.
At the clinic Wilic, reports are carefully printed and filed. Although the patient's address is not included in the report, it is known, as it is recorded by the receptionist when samples are submitted. These addresses can be easily recovered.
A Treichville reports are simply stored in cardboard folders (many reports tend to "disappear"). As usual, the home is almost never recorded on the application form (the number of hospital records either). The demographic and clinical data should be plotted in each case seeking the service (where the patient was referred).
Case finding should be fully active, with visits to each service and private clinics. A "focal point" has been identified in key services and clinics.
The data collection form (Attachments) was developed, based on that which was used from 1994 to 2002.
Local coding has been developed for many variables, and rarely corresponds to the codes used previously (in 1994-2002). Staff received no training or experience in the coding of cancer, so that the tumor site is encoded using two two-digit ICD-10, and a local coding system was created for the tumor morphology.
The database of the initial registration period (1994-2002) in CANREG-4 was recovered by IARC and installed in the registry. It includes about 5,000 cases, the majority (3681) lived in the neighborhoods of Abidjan 10.
Currently, the registry is a database created in ACCESS, supplemented by an input screen in EPI-INFO. Data for three years (2007-2009) were available. Unfortunately, the definitions of the variables on the leaf collection and coding are different from those of the original database, and for some items (site, histology) local encoding schemes are used. There is no due process for the duplicate detection or update existing records. The Quality Control procedures are lacking.
Data analysis / results
Some analysis results for the period 2007-2011 were made on the basis of all cases from the files created by ACCESS EPI-INFO. These results were used for presentations and local publications (see graphs below).