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CANCER REGISTRATION IN AFRICA ~ Dr D. M. Parkin IACR course, Entebbe, 11-12 th September 2005. HISTORY OF AFRICAN CANCER DATA. 1900 –1950 Case reports. 1950’s Case series (hospitals, pathology). 1960’s the first registries

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slide1

CANCER REGISTRATION IN AFRICA

~

Dr D. M. Parkin

IACR course, Entebbe, 11-12th September 2005

slide2

HISTORY OF AFRICAN CANCER DATA

1900 –1950 Case reports

1950’s Case series (hospitals, pathology)

1960’s the first registries

Johannesburg 1953 (Higginson & Oettle)

Capetown 1956 (Muir Grieve)

Durban 1964 (Schonland and Bradshaw)

Kampala 1954 (Davis, Templeton)

Lourenco Marques 1956 (Prates)

Ibadan 1960 (Edington)

Bulawayo 1963 (Skinner)

1970’s Black hole………..

1980’s Renaissance

slide3

African Cancer registries in

Cancer Incidence in Five Continents

Volume Period Registries Populations

I 1950s 4 4

II 1956–67 4* 7

III 1968–72 2* 2

IV 1973–77 1 1

V 1978–82 0 0

VI 1983–87 3 3

VII 1988–92 5 5

VIII 1993–97 6 6

* One updates the entry in previous volumes

slide4

Algiers

Tunisia

Morocco

ALGERIA

Libya

Egypt

Saudi Arabia

Mauritania

Oman

MALI

Niger

Chad

Eritrea

Yemen

Sudan

Senegal

Bamako

THE GAMBIA

Burkina Faso

Djibouti

Guinea Bissau

Guinea

Benin

Somalia

Nigeria

Ethiopia

Côte d’Ivoire

Togo

Sierra Leone

Ghana

Central African Republic

Liberia

Cameroon

UGANDA

Equatorial Guinea

Kyadondo

Kenya

Gabon

Rwanda

Congo

Indian Ocean

Dem. Rep. of The Congo

Burundi

Tanzania

Angola

Mozambique

Zambia

Malawi

Harare

Madagascar

ZIMBABWE

Namibia

South Atlantic Ocean

Botswana

La Réunion

Swaziland

South Africa

Lesotho

Africa

slide5

Tizi Ouzou

Tunis

Annaba

Alger

Constantine

Oran

Sousse

Blida

Sétif

Tlemcen

Sfax

Sidi Bel Abbes

Batna

Rabat

TUNISIA

MOROCCO

ALGERIA

MALI

NIGER

SENEGAL

Niamey

Dakar

BURKINA FASO

Bamako

THE GAMBIA

ETHIOPIA

Zaria

GUINEA

Ouagadougou

NIGERIA

Ifé Ijesha

Addis Ababa

Eruwa

COTE D’IVOIRE

Conakry

Engu

Ibadan

Yirga Alem

CAMEROON

Calabar

West Nile

Yaounde

Abidjan

Nyankunde

KENYA

CONGO

UGANDA

Kyadondo

(Kampala)

Eldoret

(Uasin Gishu)

Libreville

Mbarara

Lambaréné

RWANDA

Butare

GABON

Katana

Nairobi

Kilimanjaro

Brazzaville

DEM. REP. OF THE CONGO

TANZANIA

Dar Es Salaam

Luanda

MALAWI

ANGOLA

Ndola

ZAMBIA

Blantyre

Lusaka

Harare

MOZAMBIQUE

Antananarivo

MAURITIUS

NAMIBIA

Bulawayo

ZIMBABWE

Windhoek

MADAGASCAR

REUNION

Elim

Maputo

(Laurenco Marques)

Johannesburg

SWAZILAND

Pietermaritzburg

SOUTH AFRICA

Durban

Transkei

  • Butterworth
  • Kentani
  • Bizana
  • Lusikisiki
  • Umtata Cancer Registry

Capetown

slide8

Cumulative incidence (0–64 years) %

Uganda, Kampala

11.3%

Harare, Zimbabwe

12.6%

England

15.2%

France*

14.0%

Sweden

14.4%

CANCER IS NOT RARE IN AFRICA

Cumulative incidence of cancer (excluding Kaposi sarcoma and non-melanoma skin cancer) in women, 0–64 years of age, 1993–97 (Parkin et al., 2002)

* 9 cancer registries

slide10

447 Males

179 Females

Squamous

Transitional

Other

Unspecified

SOME SPCIAL FEATURES:

BLADDER CANCER CASES : BULAWAYO 1963-1977

slide12

Kampala, Uganda

36.1

Blantyre, Malawi

35.8

Ibadan, Nigeria

18.0

Harare, Zimbabwe

2.4

Namibia

1.9

Bamako, Mali

1.7

US. White

2.5

Age adj. rates (per 10 6)

BURKITT LYMPHOMA IN AFRICA

(International Incidence of Childhood Cancer Vol. II)

slide14

25

Kampala (1960-1971)

Tanzania (1969-1974)

Bulawayo (1963-1972)

20

15

Incidence rate per 100 000

10

5

0

0-

5-

10-

15-

20-

25-

30-

35-

40-

45-

50-

55-

60-

65-

70-

75+

Age group

Endemic KS- age specific rates

slide15

Time Trends, Kampala Cancer Registry

Evolution of the epidemic of Kaposi Sarcoma

slide18

CANCER SURVIVAL IN A SOUTHERN AFRICAN URBAN POPULATION

Adam GONDOS, Eric CHOKUNONGA, Hermann BRENNER, Donald Maxwell PARKIN, Risto SANKILA, Margaret Z. BOROK,

Z. Michael CHIRENJE, Anna M. NYAKABAU and Mary Travis BASSETT.

Int. J. Cancer: 112, 860–864 (2004)

slide19

Uganda cohort study (De Thé et al., 1978)

VCA antibody titres in sera collected from BL cases ( ) before tumour manifestation compared with antibody titres in a random sample of the population of the study area ( ). Numbers against solid line incidence number of sera tested at these ages in the random sample

2,560

1,280

640

38

VCA titres

320

66

88

160

63

191

24

80

12

29

56

840

1 2 3 4 5 10 15 20

Age (yr)

slide20

MONITORING A PREVENTION PROGRAMME

6

5

4

Tanzania: N. Mara

Incidence per 100 000

3

2

Uganda: W. Nile

1

0

1960 1965 1970 1975 1980 1985

Year of diagnosis

Trends in the incidence rate (three-year moving average) of Burkitt lymphoma in East Africa

(data from Geser et al., 1989)

slide22

Surveillance is critical to development and implementation of health policy

Rational planning is not possible without a means to identify

health problems, decide priorities for preventive and curative

programmes, evaluate whether goals are reached,

and compare resource input and outcomes

THE POPULATION BASED CANCER REGISTRY IS THE

INDISPENSIBLE FOUNDATION OF A

SURVEILLANCE SYSTEM