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Sun,25Jun2017

Maputo Cancer Registry

The Maputo City Cancer Registry (Registo de Cancro da Cidade de Maputo) was launched in July 2014 and aims to collect all cancer cases occurring in residents from  Maputo City. The Director of the Registry is Dr Cesaltina Ferreira Lorenzoni, pathologist at the Department of Pathology in Maputo Central Hospital and Director of the National Cancer Control Plan.

The registry is located in the Department of Pathology, within the Maputo Central Hospital.

Currently there are five registrars (Carlos Mahumane, Sérgio Manhique, Maria Emércia Marumba, Albertina Mapose, and Xavier Sitoe) assigned to the registry, and paid for by Hospital Central de Maputo.

A motorcycle has been provided (and lessons for one of the registrars funded) to facilitate visits to sources outside Maputo Central Hospital

The Registry covers the whole province of Maputo City (a total area of 300 Km2), capital and largest city of Mozambique. According to the Annual Estimates for the province of Maputo City made by Statistics Mozambique, in 2014 the population was 1,225,868 inhabitants (590,224 men and 635,644 women) – Figure 1. The city is administratively divided into Districts and these into smaller city quarters called Bairros.

 

Sources of information for the registry

Pathology

Department of Pathology (HCM). Place of residence is now on the pathology request form, and in 2014/2015, it was missing in only 52/2825 cases (as noted in earlier reports, place of residence was NOT available in the pathology registry previously), but hospital record number is still missing in ~30% of requests (especially for non-HCM cases).

PatLab is a private laboratory. Copies of forms mentioning cancer are obtained and used to register cases – many come from Private Hospital.

Hospitals

For HCM, case finding is restricted to:

  • Oncology (it has a manual register at present, but plans to implement a computerized system very soon).
  • Onco-paediatics
  • Adult haematology (does bone marrow biopsies)
  • Clínica Especial (private patients)
  • The pain unit
  • Dermatology (for KS cases without biopsy)

To identify deaths in HCM, the hospital morgue is visited daily. Every 2 months, a listing of deaths with cancer as basic or immediate cause is obtained from the Intra-Hospital Death Registration System.

The database of Maputo Central Hospital is not currently being used. There are plans to upgrade the hospital information system.

Hospital Jose Macamo. Only the dermatology service is visited (to find cases of KS without biopsy).

There are plans to visit Primary Health Care Centre Alta Mae, which treats KS cases.

Death register

In order to trace deaths at home, there are plans to include death data from the Civil Register Office. Data collection has begun from the largest of these (Primeira Conservatória) serving the majority of the city of Maputo. The death certificates are archived in paper form.

 

Methods of registration

Registration is both passive and active.  Since 2015, the activities of the hospital-based and population-based registries have been merged, and the allocation of staff time re-organized to reflect the combined function as hospital based and population based registry.

The databases of the two registries have been merged into a single CanReg system.

Coding of topography and morphology is done by the registrars and everything is checked by a pathologists afterwards. Information is then introduced in a CanReg-5 system. The data collection forms are stored in alphabetical order of patients’ name.

Death certificates mentioning cancer identified at the Mortuary are also registered in the same way.

 

Data management

 

Contact details

Cesaltina Ferreira Lorenzoni, MD, MSc
Especialista em Anatomia Patológica
Mestre em Saúde Pública
Tel: (+258) 82 2809686

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Namibian Cancer Registry

History of NCR

The Namibia National Cancer Registry (NNCR) was started in 1995, when Rössing Uranium mine, in co-operation with the Namibian Ministry of Health (Oncology clinic) and the Cancer Association of Namibia, collected all cancer cases reported to the Windhoek state pathology laboratory and the single existing private pathology laboratory from 1979 to 1994. From 1995 onwards, the Namibia National Cancer Registry commenced active registration of both pathology-based and clinical cases for four sentinel regions (Erongo, Oranjemund, Oshakati and Khomas). Cases that are diagnosed in South Africa are re-routed to the Namibian registry via a network of registries, which are technically supported by the International Agency for Research on Cancer (IARC). The Namibia National Cancer Registry aims to provide a database of information that will ultimately lead to improved cancer prevention and control among the Namibian population.

The Namibia National Cancer Registry is a population-based registry.

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Registre des Cancers du Niger

Registry

The Cancer Registry of Niger was founded in 1992, in the Faculte des Sciences de la Sante of the University of Niamey. It is located in the Department of Pathology at the University Hospital. This department is a referral centre for pathology services for the whole country. Nevertheless, the registry was designed to be population based with complete recording of all cancer cases diagnosed among the population of the capital city, Niamey. Niger comprises eight administrative subdivisions, three in the capital city. In 1995 the population of Niamey was estimated to be 521,000.

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Abuja Cancer Registry

REGISTRY

The Abuja Cancer Registry started operation as a Hospital-based registry in September, 2006 and is situated in the National Hospital, Abuja- FCT, Nigeria. The focus was to weigh the burden of cancer on the hospital

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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.

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Ibadan Cancer Registry

The Ibadan cancer registry [IBCR], University College Hospital, was started in 1960 by the late Professor G M Edington with the aim of providing cancer incidence rates for different cancer types in Ibadan and its environs. It was hoped that the data collected would give an insight into cancer in the region and highlight possible geographic variations.  The registry was ab initio set up as a population-based one, covering Ibadan and its environs.  It is located in the Pathology Department of the University College Hospital, Ibadan, Nigeria.

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Nigerian National System of Cancer Registries

THE NIGERIAN NATIONAL SYSTEM OF CANCER REGISTRIES (NSCR)

The Nigerian National System of Cancer Registries (NSCR) was established in 2009 as collaboration between the Institute of Human Virology Nigeria, University of Maryland, Baltimore, the Federal Ministry of Health and Health institutions in Nigeria.

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Registre des cancers de la Réunion

The Registry

The registry was founded in 1989. It is managed by the public health department of the Reunion University Hospital since 2010. It is financed by the regional health agency (ARS Réunion – Mayotte).

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Seychelles National Cancer Registry

THE REGISTRY

THE SEYCHELLES HOSPITAL, PO box 52, Victoria, Mahe Island
Responsible: Anne Finesse
E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Phone:  +248 4388416

The Seychelles National Cancer Registry (SNCR) was established in 2008 under the Cancer and Mental Health Programme of the Ministry of Health within the Public Health department,to address the burden of cancer in the country. Registration is not mandatory by law. An advisory committee consisting of different medical and public health experts was formed upon establishment of the registry, but has not assembled for over a year.

 

LOCATION

The Seychelles National Cancer Registry is located within the hospital diagnostic centre in a new building donated by Sheikh Khalifa Bin Zayed Al Nahyan of the United Arab Emirates in 2011. In the same complex with the hospital are the Ministry of Health and the WHO Office. The registry consists of one office, which is equipped by one computer (donated by International Atomic Energy Agency) with installed CanReg4 software and two printers.

 

STAFF

The registry registrar is the only full-time staff member. Ms Finesse is a Senior health information assistant, who received training in cancer registration at the cancer registration course of the International Agency for Research on Cancer Summer School in 2008, and at a visiting fellowship at the Vaud Cancer Registry. Five medical specialists (for general surgery, gyneacology, ear, nose, throat, urology and oral cavity cancers) from the Seychelles Hospital act as registry consultants by providing assistance in coding stage of disease on monthly or two-weeks basis. Also attached the registry (one part time) lab technologist responsible for notifying all new cancer cases recorded at the laboratory.

 

POPULATION

Republic of Seychelles consists of 116 islands, of which Mahe, Praslin, La Digue and Silhouette are permanently populated. Close to 90% of the population lives on Mahe island. Administratively, the Seychelles are divided in 26 districts. The population of Seychelles was 89,949 according to the 2013 estimate by the National Statistics Bureau. Population estimates are considered to be more reliable than the census data as they take migrations into account. The census overestimates the total population number, due to registration of temporary residents. The population is younger than in European countries, but older than African mainland, and has been increasing by 1% annually between 1994 to 2012. (National Statistics Bureau. Statistical Bulletin 2010). The main ethnic group is Creole (85-90% population) and the main religion is Roman Catholic.

 

SOURCE OF INFORMATION

Hospitals

There are five hospitals in the registration area, on Mahe, Praslin, La Digue, and Silhouette islands. However, apart from the Seychelles hospital in Victoria, the others serve mostly as emergency hospitals, and provide only basic diagnostics. There is also one hospice on Mahe island.

The Seychelles Hospital has 404 beds capacity and consists of female health, male health, surgery, internal medicine, pediatric, radiology, pathology and cytology, and psychiatric wards.

Cancer diagnosis
The pathology laboratory at the Seychelles Hospital is the only pathology laboratory in the country. It employs two pathologists, and three technicians. These two technicians also work as cytoscreeners for Pap-smear readings with two cytotechnologists. The pathology department keeps a database from the year 2005. However, the laboratory software is mainly used for registering and printing out the pathological findings, while the data reported to the cancer registry are saved in Excel files. There are over 1000 yearly biopsies and about 1000 Pap-smears. Haematology laboratory employs five laboratory technicians. Bone marrow examinations and immunodiagnostics are available.

The diagnostic unit disposes of X-ray, 1 digital mammography machine, CT and MRI scans, colonoscopy, and gastroscopy.

 

Cancer Register Books

All health centres, as well as all hospital wards notify the patients in ''Cancer register'' books – listings of patient data (name and surname, age, sex, address, file number, telephone number, diagnosis, basis of diagnosis, date, clinician/physician, date of next exam) that are filled in upon every visit or prescription of palliative treatment. The cancer registrar collects them every three months from the health centres in primary care and hospital wards, and brings them back as soon as the data are entered. On Praslin and La Digue islands, there are nurses appointed for registrations in the cancer register books.

 

METHODS OF REGISTRATION

Cancer Notification Forms

The case finding system is a combination of active and passive based on cancer notification forms (Appendix 1). Upon confirmation of diagnosis, the name and surname, date of birth, basis of diagnosis, date of diagnosis, primary site and morphology (both text and ICD-O-3 codes) are filled in at the pathology laboratory,where there are one lab technologist responsible for notifying all cases recorded. Therefore, every notification is checked at the registry, and corrected if neccessary. In case of corrections, the pathology laboratory is notified, so that their database can also be updated. After the patient has received treatment, the registrar collects his medical record from the ward. The availability and location of the medical records can be checked in the hospital documentation centre. The database at the documentation centre does not contain medical data, but personal identification data and the medical record number.  Based on the data from the medical record, the registrar completes the rest of the cancer notification form. The personal ID number is always available, as based on it the right to free medical treatment is exercised. Non-Seychellois population temporarily living at the Seychelles can also be assigned the national ID number, which can be differentiated from those of Seychellois population. Stage is coded as extent of disease, summary stage according to the SEER summary staging manual and TNM stage. However, the medical record often does not contain stage of disease, which is a problem for registration. If a person is diagnosed and/or treated overseas, the hospital receives medical records from the hospital abroad and the notification is completed at the registry based on this record. Yearly number of notifications received is about 150.

 

Data Management

The computer system used is CanReg4, which was planned at the start of the registry, and then customized at the International Agency for Research on Cancer. In the database there are 1074 (2005-2012) cancer cases, as some data was also entered retrospectively. So far there has been no need to add new variables to the existing dataset, however, there is a need to add additional data sources, which is not possible in the current system.

The cancer notification data are usually entered in batches of about 20 from the same ward at a time, to be able to check with the respective consultant. When the cancer register books are collected, every patient entered is cross-checked with the registry database. If the person is in the registry database, the data are cross-checked and updated with the date of last contact. If more specific topography or morphology information is available, this is also updated. If the person is not in the registry database, he is tracked through the hospital documentation centre, and when the medical record is identified, the cancer notification form is filled in and entered into the database. The information on date and cause of death is completed from the mortality data.

Every time a new notification is entered, the database is checked for duplicates. IACR/IARC multiple primary rules are incorporated into the software. After the end of each data year, all cancer cases for that year are checked for missing data, and completed if possible.

 

Data Analysis/Recent Results

The most common male and female cancers 2011-2012 period, and the age-standardised rates per World Standard Population (ASR(W)) are presented below. The distribution of most common cancer sites differs from estimates for East Africa from GLOBOCAN 2008 database, which also reflects different age-structure of the population. Overall male cancer incidence is high, the only other African countries with estimated incidence ASR of more than 200/100,000 according to the GLOBOCAN 2008 database are South African Republic and La Reunion. The prostate cancer incidence is higher than estimated for any other African country. It is however, hard to estimate to which extent is this due to PSA testing and possible registration of prevalent cases due to relatively recent start of the registry operation. The proportions, as well as ASRs of colorectal cancer for each sex are also higher than in other African countries. In women, breast cancer is the most common site, comprising 43% of new cases. However, breast cancer incidence rates compared to other African countries are intermediate. The distribution by summary stage for the period 2011-2012 was: 15% stage I, 20% stage II, 25% stage III, 30% stage IV and 10% unknown. Even though cervical cancer is the second most common female cancer site, both the contribution to incidence and the ASR are very low. This is also substantiated by very few registered cases of CIN III in spite of intense screening activity.

 

The Seychelles National Cancer Registry Triennial Report for 2009-2011 is available now. Please click attachment below.

Eastern Cape Province Cancer Registry

HISTORY

Eastern Cape Province Cancer Registry is population-based and was established in the 1980s as a special registry by the Programme on Mycotoxin and Experimental Carcinogenesis (PROMEC) of the South African Medical Research Council (SAMRC). Initially the register was set up to monitor trends in the incidence and spatial geographical variations of oesophageal cancer in four magisterial areas of the former Transkei region of the Eastern Cape Province. These were Butterworth and Centane; the so-called high incidence areas and Bizana and Lusikisiki the low incidence areas then. In 1998 the registry expanded its scope to collect data on all cancers and expanded the geographic coverage as well covering a population of eight (8) magisterial areas that include the initial four and Idutywa, Nqamakwe, Willowvale and Flagstaff. These magisterial areas are in the municipalities of Ntabankulu, Mbizana and Qaukeni in the north-eastern part of the former Transkei region and Mnquma and Mbashe in the south-western part of the region. The registry is funded mainly by the SAMRC.

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National Cancer Registry of South African (NCR-SA)

The NCR-SA was established as pathology-based cancer registry in 1986 by the then South African Institute of Medical Research, Pathology Division, and the Department of Health. Recognised methods of analysis and routine reporting were introduced in 1990 when Dr F Sitas was appointed as Director. In addition, a Cancer Research Unit funded by the South African Medical Research Council (MRC) was introduced. Between 2002 and 2009, competing burdens of disease in South Africa meant that chronic diseases, and particularly cancers, were not perceived as a priority in the country. As a result, the progress and development of the NCR-SA was arrested due to a lack of funding and human resources support. This lead to a lag in reporting of cancer incidence data, and a decline in publications.

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