TY - JOUR
T1 - Estimating cancer incidence in Uganda
T2 - a feasibility study for periodic cancer surveillance research in resource limited settings
AU - Nakaganda, Annet
AU - Spencer, Angela
AU - Orem, Jackson
AU - Mpamani, Collins
AU - Wabinga, Henry
AU - Nambooze, Sarah
AU - Kiwanuka, Gertrude N.
AU - Atwine, Raymond
AU - Gemmell, Isla
AU - Jones, Andrew
AU - Verma, Arpana
N1 - Funding Information:
The authors would like to thank the following people for their contribution to the development and implementation of this research project: Francis Okongo, Gulu cancer registry Uganda; Franco Afyusisye, Mwanza cancer registry in Tanzania; Cissy Nassolo of the Uganda Cancer Institute; Charles Stiller of the National Disease Registration Service NHS UK, and Bernard Masaba, Kyambogo University Uganda. This work would not have been possible without the partnership and collaboration of the health facilities who shared their views and accepted the researchers into their facilities to collect the data.
Funding Information:
The study was funded by the African Development Bank, which had no role in the design of the study and collection, analysis, and interpretation of data, nor in writing the manuscript.
Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - 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: 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: 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: 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.
AB - 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: 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: 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: 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.
KW - Cancer
KW - Incidence
KW - Registration
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=85168334159&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/ed04cd23-2e65-317e-be33-fe60f4980eae/
U2 - 10.1186/s12885-023-11124-6
DO - 10.1186/s12885-023-11124-6
M3 - Article
C2 - 37596529
AN - SCOPUS:85168334159
SN - 1471-2407
VL - 23
JO - BMC Cancer
JF - BMC Cancer
IS - 1
M1 - 772
ER -
