Nigeria - 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.

At the moment, the registry collects cases from 11 local governments within Ibadan and its environs.  The eleven local government areas include Akinyele, Egbeda, Ibadan North, Ibadan North East, Ibadan North West, Ido, Lagelu, Oluyole and Ona-ara.  Apart from these, the registry also receives cases from places such as Baptist Medical Centre (Ogbomosho North local Government Area), Ladoke Akintola University of Technology Teaching Hospital, Oshogbo, Obafemi Awolowo University Teaching Hospital (Ife North Local Government area) and many of the state and privately-owned hospitals.

 

Cancer Care Facilities in the Coverage Area

Diagnostic palliative and treatment facilities are available for cancer care in the University Teaching Hospital, where the registry is based, including Mammography, Pap smear and Assays for tumour markers.  There are also a few other laboratories and diagnostic centre within the registration area.  The core hospital has a pathology laboratory that provides histological, fine needle aspiration cytology (FNAC) and other diagnostic cytological services, radiation therapy, hematological, surgical, as well as chemotherapeutic services in cancer management.  In addition, the hospital is also staffed by many competent surgeons, oncologists and pathologist.

 

Registry Structure

The Ibadan Cancer Registry (IBCR) is one major unit in the Department of Pathology, University College Hospital, Ibadan and it is staffed by six members, excluding the Principal Investigator, who is a Consultant Pathologist /Professor and assisted by another consultant Pathologist in the same department where the registry is located. The registry personnel include a certified Cancer Registrar who is also a Chief Nursing Officer, a principal Nursing Officer (also trained in data abstraction and coding), who directly assists the Registrar in data collection and abstraction, a Secretary, a Clerical Officer and 2 Computer System Analysts. The registry is funded in part by both the University College Hospital and the College of Medicine of the University of Ibadan, as well as by grant support currently from the IARC. The registry enjoys professional support and advice from other consultant pathologists in the department where the registry is based.

 

Methods

The Ibadan Cancer Registry uses a proactive method for data collection, which means that the registry does not wait to be informed, but actively looks for information from certain specific sources.  The registry tries to find cases from well over 30 sources of data consisting of general hospitals, teaching hospitals,  pathology laboratories, and some privately owned hospitals and clinics.

The death registration system is inadequate and incomplete in the state where we operate; except for some of the death certificates written at our base hospital.  The registry staff undertake visits to these sources, where they scrutinize the records kept in medical records department, and registers of individual departments concerned with diagnosis and treatment of cancers, to identify and abstract information on cases of cancers, , diagnosed by all methods, among residents of the registry region.  Although cancer is not a notifiable disease, a few registration forms are received from private practitioners.  Arrangements are on the way to get the hospitals outside the registration area to notify the registry of resident cancer cases which are diagnosed and treated in their centers; even though, we try to visit them on monthly basis.

One major challenge in running the registry is the lack of a vehicle to pay regular visits to our collaborating centres.  Efforts to train some personnel and allocate to all these collaborating centres are being considered.

 

Factors which Influence Incidence Rates

A critical look at the incidence reports from the cancer registry for the period of 2004-2008 shows that cancer incidence continues to increase.  The major reason is the availability of diagnostic and treatment services in the main hospital abstracted.  Occasional reviews of cases may lead to revision/change in the diagnosis after proper histological verification is carried out and this may affect the incidence rate.  New information on cancer cases, changes in medical records knowledge, classification, and coding practice are also factors that contribute to minor changes in the cases reported.  For example the primary source may become unraveled a bit later after an initial diagnosis of metastatic carcinoma.  There might be a contribution from regular awareness campaigns against cancer that usually hold both within and outside the registration area.  Some delay in notification and reluctance to visit the hospitals on the part of the patients may have drastically affected the incidence rate in previous years.  Basically we employ histological and other diagnoses as methods of data collection in the registry.

 

 

Interpreting the Results

It is not possible to know exactly how many cancer cases remain undiagnosed in Ibadan and its environs, but as in many registries with limited resources, ensuring ascertainment from patients diagnosed within rural settings remains problematic.  However, the registry ensures proper abstraction of cases that enter into the hospital, be they hospital diagnosed or referrals, and also those cases from outside hospitals.  Breast, Cervix.  Prostate, Colorectum-, Lymphoma and Liver cancers still remain the leading cancers in Nigeria. There is a noticeable upsurge in cancers of the larynx and Nasopharynx.  The hospital has made important efforts to establish early cancer detection programmes, especially for cervix and breast cancers.

 

Use of Data

Data from Ibadan cancer registry is utilized by local and foreign researchers, lecturers, medical practitioners, students, conference participants, health educators, administrators, members of the press for management, planning and cancer control programmes.

The general analysis of 2009 – 2010 cases showed that a total of 3921 new cases were recorded 1288 (32.85%) male and 2633 (67.15%) female.

 

Registration Area

Ibadan and environs is the capital of Oyo State which lies 70 26’ North and 30 54’ east in the forest belt of West Africa. The total registry area is 80sq. kilometer.

Ibadan has urban settings within rural settlements.  According to the 2006 population census figures, the estimated figure for our catchment area (the eleven local government areas ) was 2,549265 of which females were 1,284,036 (50.4%) and males were 1,265,229 (49.6%)

 

 

Map of Oyo State showing Ibadan Cancer Registry target zones.

 

Publications

These are the publications among others derived directly from Ibadan Cancer Registry.

The cancer registry data featured in cancer incidence in five continents series volumes I, II, and III, the International Incidence of Childhood Cancer Vol. 1 and Vol. II, in journal articles and also participated in a variety of research studies, just to mention a few.

  1. Abioye AA, The Ibadan Cancer Registry. 1960-1980: Cancer in Africa proceedings of a workshop of the West African College of Physicians: Monrovia, Liberia: 6th-9th July, 1981.
  2. Adeyemi BF, Kolude BM, Akang EE. A retrospective histopathological review of oral squamous cell carcinoma in a Nigerian teaching hospital. Afr J Med Sci. 2011; 40(2):153-8.
  3. Adeyemi BF, Kolude BM, Ogun GO, Akang EEU. Paediatric head and neck malignancies in Ibadan, Nigeria. Afr J Med Sci 2009; 38:55-62.
  4. Adeyemi BF, Ogun GO, Akang EE, A retrospective analysis of intraoral salivary gland tumours in Ibadan, Nigeria West Afr J Med 2010; 29:292-4.
  5. Adeyemi BF, Adekunle LV, Kolude BM, Akang EE, Lawoyin JO. Head and neck cancer-a clinicopathological study in a tertiary care center. J Natl Med Assoc. 2008;100(6):690-7.
  6. Adisa AO, Adeyemi BF, Oluwasola AO, Kolude B, Akang EE, Lawoyin JO. Clinicopathological profile of head and neck malignancies at University College Hospital, Ibadan, Nigeria. Head Face Med. 2011;7:9.
  7. Ajaiyeoba IA, Akang EE, Campbell OB, Olurin IO, Aghadiuno PU. Retinoblastomas in Ibadan: treatment and prognosis. West Afr J Med. 1993; 12(4):223-7.
  8. Ajaiyeoba IA, Pindiga HU, akang EE. Tumours of the eye and orbit in Ibadan. East Afr Med J. 1992;69(9):487-9.
  9. Akang EE. Epidemiology of Cancer in Ibadan: Tumours in Childhood. Archives of Ibadan medicine. An international journal of medical science vol 1.No 2 April 2000.
  10. Akang EE, Ajaiyeoba IA, Campbell OB, Olurin IO, Aghadiuno PU. Retinoblastomas in Ibadan Nigeria: II-Clinicopathologic features. West West Afr J Med. 2000; 19(1):6-11.
  11. Akang EE. Tumours of childhood in Ibadan, Nigeria (1973-1990). Pediatr Pathol Lab Med. 1996; 16(5):791-800.
  12. Akang EE, Okpala JU, Iliyasu Y, Lawani J. Clinicopathological study of nephroblastomas in Ibadan. Br J Urol. 1992 Sep;70(3):318-21. Eratum in: Br J Urol 1992 Dec;70(6):702.
  13. Arotiba JT., Ogunbiyi JO., Obiechina AE., Odontogenic tumours: a 15-year review from Ibadan, Nigeria. British journal of oral and maxillofacial surgery (1977) 35, 363-367.
  14. Attah B, and Hendrickse ML, Patient dynamics in Cancer registration: Ibadan Cancer Registry, Nigerian Medical Journal Vol. 7, No. 4 1977.
  15. Brown BJ, Oluwasola AO, Childhood Rhabdomyosarcoma in Ibadan. (2006) Annals of tropical Peadiatrics. Annals of tropical Peadiatrics. 26, 349-355.
  16. Ibekwe PU, Ogunbiyi OA, Ogun GO, George OA. Kaposi’s sarcoma in HIV-infected Women and Men in Nigeria. AIDS Patient Care STDS. 2011;25(11):635-7.
  17. Iliyasu Y, Ladipo JK, Akang EE, Adebamowo CA, Ajao OG, Aghadiuno PU. A twenty year review of malignant colorectal neoplasms at University College Hospital, Ibadan, Nigeria. Dis Colon Rectum. 1996; 39(5):536-40.
  18. 18.  Junaid TA, Nkrumah F K,: The Gestational Trophoblastic Tumours in Ibadan. Cancer in Africa proceedings of a workshop of the West African College of Physicians: Monrovia, Liberia: 6th-9th July, 1981.
  19. Kamara T B, and Shittu O B, Carcinoma of the Prostate. Dokita vol. 25 No 1 July 1998.
  20. Nwaorgu. OGB, Ogunbiyi JO,: Nasopharynx Cancer at the U.C.H. Ibadan Cancer Registry: an update. WAJM vol 23 No 2 April-June 2004.
  21. NWAORGU O G B, Onakoya PA, Usman MA and Abdu A: Laryngeal Carcinoma – Clinical features as seen at the University College Hospital, Ibadan. Trop Doct.  2002; 32: 236 – 237.
  22. Odubanjo MO, Oluwasola AO, Ikuerowo SO, Akang EE. Histopathological pattern of renal cell carcinoma in Ibadan. Afr J Med Sci. 2010;39(4):317-21.
  23. Ogun GO, Ogun OA, Bekibele CO, Akang EE. Intraepithelial and invasive squamous neoplasms of the conjunctiva in Ibadan, Nigeria- A clinicopathological study of 46 cases. Int Ophthalmol 2009; 29:401-9.
  24. Ogun OA, Ogun GO, Bekibele CO, Akang EE. Squamous papillomas of the conjunctival: A retrospective clinicopathological study. Nig J Clin Pract 2012;15:89-92.
  25. Ogun GO, Oluwasola AO, Adeyemi BO, Ogundiran T, Akang EE, Ogunbiyi JO, Benign soft tissue tumours; analysis and histopathological analysis of 2,213 cases in an indigenous black African population Afr J Med Sci. 2012.
  26. Ogunbiyi JO, Epidemiology of Cancer in Ibadan: Tumours in Adults. Archives of Ibadan medicine. An international journal of medical science vol 1 No 2 April 2000.
  27. Ogunbiyi JO, Fabowale AO and Ladipo AA, Cancer Incidence and Top Ten Cancers in Eleven Local Government Areas in Ibadan and Environs 2004-2008. Ibadan Cancer Registry Technical Report October 2010.
  28. Ogundiran TO, Adeoye AO, Ademola AF, Akang EEU, Adebamowo CA. Male breast cancer in Ibadan. Annals of Ibadan Medicine (2008). 9; 1:16-19
  29. Ojesina AI, Akang EE, Ojemakinde KO. Decline in the frequency of Burkitt’s lymphoma relative to other childhood malignancies in Ibadan, Nigeria. Ann Trop Paediatr. 2002: 22(2):159-63.
  30. Okolo CA, Akinosun OM, Shittu OB, Olapade-Olaopa EO, Okeke LI, Akang EE, Ogunbiyi JO. Correlation of serum PSA and Gleason Score in Nigerian Men with Prostate Cancer. African Journal of Urology, 2008 14:15-22. (Cairo Egypt).
  31. Okolo Clement, Silvia Franceschi, Isaac Adewole, Jaiye O Thomas, Michele Follen, Peter JF Snijders, Chris JLM Meijer, Gary M Clifford. Human papilloma virus infection in women with and without cervical cancer in Ibadan. Infectious Agents & Cancer Journal Dec 2010;5,4.(USA).
  32. Okpala IE, akang EE, Okpala UJ. Lymphomas in University College Hospital, Ibadan, Nigeria. Cancer. 1991;68(6):1356-60.
  33. Oladokun R, Kolude B, Ogun G, Brown B, Osinusi K. Kaposi Sarcoma in HIV Positive Nigerian Children: A case series. World Journal of AIDS. 2011; 1: 63-69.
  34. Oluwasola AO, Olaniyi JA, Otegbayo JA, Ogun GO, Akingbola TS, Ukah CO, Akang EEU, Aken’Ova YA, A fifteen-year Review of Lymphomas in a Nigerian Tertiary Healthcare Centre, J Health Popul Nutr, 2011, Aug;29(4): 310-316.
  35. Omololu AB, Okolo CA, Ogunlade SO, Oyebadejo TY, Adeoye AO, Ogunbiyi JO, Akang EE, Gopaldasani VK. Primary malignant bone tumours in Ibadan, Nigeria: an update. Afr J Med Sci. 2009;38(1):77-81.
  36. Omololu AB, OgunbiyiJO, Ogunlade SO, Alonge TO, Adebisi A, Akang EE. Primary malignant bone tumour in a tropical African University teaching hospital. West Afr J Med. 2003 Oct-Dec;21(4):291-3.
  37. Onadeko BO, Ogunbiyi JO, Pindiga HU, The clinic pathological pattern of carcinoma of bronchus and lungs in Africa: African journal of medical science 1997 vol 26 31-34,  a 20- year clinical histopathological and autopsy study in Ibadan, Nigeria.
  38. Onakoya PA, Adeyi O A, NWAORGU OGB, Ojemakinde KO, Thomas JO, Primary  Extranodal Non-Hodgkin’s Lymphoma of the Upper Aerodigestive Tract- A descriptive analysis of the pattern seen in the University College Hospital Ibadan. Afri. J. Med. Med Sci. 2003; 32:59 – 63.
  39. Otegbayo JA, Oluwasola OA, Akere A, Ogunbiyi JO. (2006) Temporal and biological trends in liver cancers at a University hospital in Southwest Nigeria. Tropical Doctor. Jan; 36(1):28-30.
  40. Solanke TF, Cancer in the Nigeria setting with particular reference to Ibadan. Archives of Ibadan medicine. An International Journal of Medical Science. Vol. 1, No 2. April 2000.
  41. Solanke TF, Cancer statistics in Developing Countries. Cancer in Africa proceedings of a workshop of the West African College of Physicians: Monrovia, Liberia: 6th-9th July, 1981.
  42. Thomas JO, Cancer Registration and Diagnosis in Ibadan. Archives of Ibadan medicine. An international journal of medical science vol 1.No 2 April 2000.