Estimating cancer incidence in Uganda: a feasibility study for periodic cancer surveillance research in resource limited settings.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
18 Aug 2023
Historique:
received: 14 12 2022
accepted: 28 06 2023
medline: 21 8 2023
pubmed: 19 8 2023
entrez: 18 8 2023
Statut: epublish

Résumé

Population based cancer registries (PBCRs) are accepted as the gold standard for estimating cancer incidence in any population. However, only 15% of the world's population is covered by high quality cancer registries with coverage as low as 1.9% in settings such as Africa. This study was conducted to assess the operational feasibility of estimating cancer incidence using a retrospective "catchment population" approach in Uganda. A retrospective population study was conducted in 2018 to identify all newly diagnosed cancer cases between 2013 and 2017 in Mbarara district. Data were extracted from the medical records of health facilities within Mbarara and from national and regional centres that provide cancer care services. Cases were coded according to the International Classification of Diseases for Oncology (ICD-0-03). Data was analysed using CanReg5 and Excel. We sought to collect data from 30 health facilities serving Mbarara district, southwestern Uganda. Twenty-eight sources (93%) provided approval within the set period of two months. Among the twenty-eight sources, two were excluded, as they did not record addresses for cancer cases, leaving 26 sources (87%) valid for data collection. While 13% of the sources charged a fee, ranging from $30 to $100, administrative clearance and approval was at no cost in most (87%) data sources. This study registered 1,258 new cancer cases in Mbarara district. Of the registered cases, 65.4% had a morphologically verified diagnosis indicating relatively good quality of data. The Age-Standardised Incidence Rates for all cancers combined were 109.9 and 91.9 per 100,000 in males and females, respectively. In males, the most commonly diagnosed cancers were prostate, oesophagus, stomach, Kaposi's sarcoma and liver. In females, the most common malignancies were cervix uteri, breast, stomach, liver and ovary. Approximately, 1 in 8 males and 1 in 10 females would develop cancer in Mbarara before the age of 75 years. Estimating cancer incidence using a retrospective cohort design and a "catchment population approach" is feasible in Uganda. Periodic studies using this approach are potentially a precious resource for producing quality cancer data in settings where PBCRs are scarce. This could supplement PBCR data to provide a detailed and comprehensive picture of the cancer burden over time, facilitating the direction of cancer control efforts in resource-limited countries.

Sections du résumé

BACKGROUND BACKGROUND
Population based cancer registries (PBCRs) are accepted as the gold standard for estimating cancer incidence in any population. However, only 15% of the world's population is covered by high quality cancer registries with coverage as low as 1.9% in settings such as Africa. This study was conducted to assess the operational feasibility of estimating cancer incidence using a retrospective "catchment population" approach in Uganda.
METHODS METHODS
A retrospective population study was conducted in 2018 to identify all newly diagnosed cancer cases between 2013 and 2017 in Mbarara district. Data were extracted from the medical records of health facilities within Mbarara and from national and regional centres that provide cancer care services. Cases were coded according to the International Classification of Diseases for Oncology (ICD-0-03). Data was analysed using CanReg5 and Excel.
RESULTS RESULTS
We sought to collect data from 30 health facilities serving Mbarara district, southwestern Uganda. Twenty-eight sources (93%) provided approval within the set period of two months. Among the twenty-eight sources, two were excluded, as they did not record addresses for cancer cases, leaving 26 sources (87%) valid for data collection. While 13% of the sources charged a fee, ranging from $30 to $100, administrative clearance and approval was at no cost in most (87%) data sources. This study registered 1,258 new cancer cases in Mbarara district. Of the registered cases, 65.4% had a morphologically verified diagnosis indicating relatively good quality of data. The Age-Standardised Incidence Rates for all cancers combined were 109.9 and 91.9 per 100,000 in males and females, respectively. In males, the most commonly diagnosed cancers were prostate, oesophagus, stomach, Kaposi's sarcoma and liver. In females, the most common malignancies were cervix uteri, breast, stomach, liver and ovary. Approximately, 1 in 8 males and 1 in 10 females would develop cancer in Mbarara before the age of 75 years.
CONCLUSION CONCLUSIONS
Estimating cancer incidence using a retrospective cohort design and a "catchment population approach" is feasible in Uganda. Periodic studies using this approach are potentially a precious resource for producing quality cancer data in settings where PBCRs are scarce. This could supplement PBCR data to provide a detailed and comprehensive picture of the cancer burden over time, facilitating the direction of cancer control efforts in resource-limited countries.

Identifiants

pubmed: 37596529
doi: 10.1186/s12885-023-11124-6
pii: 10.1186/s12885-023-11124-6
pmc: PMC10436406
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

772

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Annet Nakaganda (A)

Uganda Cancer Institute, Kampala, Uganda. annet.nakaganda@uci.or.ug.
Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. annet.nakaganda@uci.or.ug.

Angela Spencer (A)

Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

Jackson Orem (J)

Uganda Cancer Institute, Kampala, Uganda.

Collins Mpamani (C)

Uganda Cancer Institute, Kampala, Uganda.

Henry Wabinga (H)

Kampala Cancer Registry, Kampala, Uganda.
Makerere University College of Health Sciences, Kampala, Uganda.

Sarah Nambooze (S)

Kampala Cancer Registry, Kampala, Uganda.
Makerere University College of Health Sciences, Kampala, Uganda.

Gertrude N Kiwanuka (GN)

Mbarara University of Science and Technology, Mbarara, Uganda.

Raymond Atwine (R)

Mbarara University of Science and Technology, Mbarara, Uganda.

Isla Gemmell (I)

Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

Andrew Jones (A)

Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

Arpana Verma (A)

Department of Public Health and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

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