NATIONAL POPULATION BASEDCANCER REGISTRY-
Dr. G.Z. Mutuma
Principal Research Officer,
Head, Non-Communicable Diseases Research Programme,
Kenya Medical Research Institute,
Nairobi, Kenya.
Pathology & Oncology Research
Unit (PORU)
Non-Communicable Diseases Research
Programme. (NCD)
1. Registries
Cancer registry - Since 2001
Other NCD registries -Not yet
2. NCD Research- Cancer research
Cervix, Burkitt’s Lymphoma, Oesophagus, Liver, NSC, Breast.
3. DIAGNOSTIC-Histology, cytology and Immunohistochemistry.
Pathology & Oncology Research
Unit (PORU)
COLLABORATORS.
1.
2.
3.
4.
5.
6.
7.
MOH
WHO
NCI- US
UICC
IARC and IACR
INCTR
OTHER ORGANIZATIONS-
Nairobi Cancer Registry –
POPULATION.
Population based Cancer registry: An
important tool for cancer Research, control, prevention and
treatment
Nairobi Cancer Registry covers a
population of 4 Million.
Nairobi city and its Adjacent divisions.
NAIROBI CANCER REGISTRYMAP.
Nairobi Cancer Registry Background:
Nairobi Cancer Registry is a populationbased registry that was established in
the year 2001 at the Kenya Medical
Research Institute (KEMRI), Nairobi.
The initial three years was funded by
National Cancer Institute (NCI) of USA
Population-based cancer
registry
A population-based registry records all new
cases in a defined population with emphasis
on epidemiological research, and evaluation
of health services for prevention, diagnosis
and treatment of the disease.
In Kenya:
Nairobi Cancer Registry – KEMRI
Eldoret Cancer Registry - MTRH
The goals of population-based
registries.
Research
Cancer prevention
Early detection
Determination of cancer rates and trends
Patterns of care and outcomes
Evaluation of control efforts
Nairobi Cancer Registry. Roles.
Provide data on:
Statistics –
Incidence rates
Age Standardized Rates
Mortality rates
Treatment strategies
Public health initiatives
Quality control
To assure that every cancer patient has been
reported
To avoid over-counting and under-counting
cases
To monitor multiple primaries
To document completeness of the registry
What to collect:
Eligible cases
Newly diagnosed returns
Tissue and clinical diagnoses
Treated and untreated
Current status
Sources of Data.
Hospitals – hospital-based cancer registries
Cancer centers / Hospices
Pathology labs. Imaging centers
Physician offices - Private clinics
(chemotherapy and radiotherapy
Death certificates
Public health sources – screening
programmes
Hospital sources:
In-patient records
Out-patient records
Histopathology labs
Radiology units
Hematology labs
Private physicians attached to the hospital
Surgery
Autopsy reports
Pathology department
Tissue – histology
Cells – cytology
Biopsies, excisions
Pap smears, ascites, pleural fluid, sputum
Bone marrow – hematology
Autopsy
Medical records department
Admission form/Patient registration form
Discharge summaries
Disease index cards – ICD books
Reports
Pathology
Imaging
Operations
Consultation
Treatments – Chemotherapy, Radiotherapy
– patient appointment schedules
NCR relation with IACR &
IARC
IARC supported the registry trough training of
registrars both locally and abroad. (4 cancer
registrars have been trained in Lyon and
South-Africa)
One fellowship offered to the supervisor
through IACR to train in Thames Cancer
Registry , UK
Registrars have benefited through Annual
conferences by presenting abstracts on
various topics.
Most Common Cancers as Registered by Nairobi Cancer
Registry - KEMRI
In the Nairobi population the 16 most
common cancer sites among males are
prostate, oesophagus, stomach, liver,
larynx, pancreas, trachea, bronchus and
lung, rectum, mouth, colon, NonHodgkin lymphoma, Multiple Myeloma,
Brain, nervous, nasopharynx, bladder
and bone. They account for 69.1% of
incident male cancer cases.
In the Nairobi population the 20 most common
cancer sites among females are Breast, Cervix,
Uteri, Stomach, Oesophagus, Colon, Ovary, Liver,
Corpus Uteri, Bone, Trachea, Bronchus, Lung,
Pancreas, Uterus unspecified, Multiple Myeloma,
Rectum, Non-Hodgkin lymphoma, Mouth,
Nasopharynx, Larynx, Brain, Nervous system and
Bladder. They account for 78.1% of incident
females cancer cases.
POINTS TO NOTE
1. Lung cancer becoming more
common.
2. Stomach cancer the 3rd common in
adults
LUNG CANCER ? MORE COMMON Nairobi
Cancer Registry – KEMRIMales
Females
25.0%
20.0
Percent of Cancers by Sex
20.0%
19.3
15.0%
12.1
10.2
10.0%
6.1
6.0
5.9
5.8
5.3
4.6
4.3
5.0%
3.3
4.4
3.2
3.1
1.9
1.6
0.8
3.8
3.1
2.7
1.9
2.9
2.8
1.6
0.5
2.4
1.9
1.1
ICD-10
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Lung Cancer is not among the
top ten cancers in Kenya
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Lung cancer in Europe
Lung cancer is the most common cancer in Europe
and other developed countries and Oesophagus is the
least common yet the most frequent cancer in Kenya
Childhood cancers as reported to Nairobi Cancer Registry
Future Plans:
Establishment of a National Cancer Registry;
The government is interested in the National
statistics to show burden of cancer in the whole
country
With some support Nairobi Cancer Registry is well
place to set up a National Cancer Registry. i.e. we
have trained personnel, equipment and
established good relation with hospitals.
Initial coordination funding from WHO 2007
ON-GOING REGIONAL REGISTRIES :
1. RIFT VALLEY- ALREADY GOING ON (MRTH)
2. WESTERN KENYA- KISUMU- Kisumu
cancer registry has so far been set up and
there is ongoing case abstraction and
registration
3. CENTRAL REGION – NYERI COUNTY
4. COASTAL REGION- MOMBASA
Future Plans:
1. COASTAL REGION
2. EASTERN –
MOMBASA COUNTY
EMBU COUNTY
MACHAKOS COUNTY
3. RIFT VALLEY
NAKURU – COUNTY
BOMET COUNTY
Eradication of NCDs
Healthy living = Healthy eating
Cancer
Diabetes
Chronic
Respiratory
Diseases
Cardiovascular
Disease
Long life hospitalization
Other NCDs
Death
Financial constrains
Permanent disability
Increased incidence rates
Unhealthy
Diets
Physical
inability
Obesity
Smokin
g
Harmful uses
of alcohol
Cancer Registrars’ Training: August 2011,
KEMRI
Thank you for your
attention!
