cancer in kenya by anne korir
TRANSCRIPT
Nairobi Cancer Registry, KEMRI
Cancer in KenyaPresented
by:
Anne Korir,
Head of Nairobi Cancer Registry
Kenya Medical Research Institute
Background: Cancer registries in KenyaPopulation-based registries• Two registries have been in existence for more than 10
years• Eldoret Cancer Registry located at MTRH established in 1998• Nairobi Cancer registry at KEMRI established in 2001
• Three registries are in early stages of development• Kisumu Cancer Registry partly funded by NCI• Embu and Nakuru Cancer registries - Grant Challenges Canada
(PAC Kenya)
Hospital-based registries• Moi Teaching & Referral hospital• Agakhan University hospital• Kenyatta National hospital
Background: Cancer registries in Kenya
• Nairobi PBCR• Covers the Nairobi County a
population of 3.2 million (2009 census)
• Data is collected from over 20 hospitals in Nairobi
• Trained Cancer Registrars or Research Assistants visit the institutions on daily/regular basis to collect the data
Results (2004-2008)
Distribution of cases registered (2004-2008), by age group and sex.
Top 10 Male cancers in Nairobi (numbers)
109
109
154
157
192
194
243
293
333
606
0 200 400 600 800 1000
Bone
Larynx
Nasopharynx
Non-Hodgkin lymphoma
Liver
Kaposi sarcoma
Stomach
Large bowel
Oesophagus
Prostate
Top 10 cancers Males (numbers)
Number of cases
Top 10 Female Cancers in Nairobi (numbers)
97
100
107
115
175
193
242
248
1073
1154
0 500 1000 1500
Brain, nervous system
Kaposi sarcoma
Non-Hodgkin …
Liver
Ovary
Stomach
large bowel
Oesophagus
Cervix uteri
Breast
Top 10 cancers Female (numbers)
Top 10 Male Cancers (cumulative incidence 0-74)
0.4
0.5
0.5
0.8
0.8
0.9
1.4
1.6
1.8
5.2
0.0 2.0 4.0 6.0 8.0
Non-Hodgkin lymphoma
Mouth
Pancreas
Lung
Larynx
Liver
Stomach
Large bowel
Oesophagus
Prostate
Cum rate(0-74)
Top 10 cancers in males (cumulative incidence 0-74)
The chances or probability of being diagnosed with each of these cancers by age 74
Top 10 Female Cancers (cumulative incidence 0-74)
0.2
0.3
0.5
0.7
1.1
1.5
1.6
1.9
5.4
6.1
0.0 2.0 4.0 6.0 8.0
Kaposi sarcoma
Brain, nervous system
Non-Hodgkin lymphoma
Liver
Ovary
Stomach
large bowel
Oesophagus
Cervix uteri
Breast
Top 10 cancers in females (cumulative incidence 0-74)
Cum rate (0-74)
Age specific incidence rates (per 100,000) for major cancers in males
Age specific incidence rates (per 100,000) for major cancers in females
Cancer incidence and mortality in Kenya: MaleKenya estimates for year 2012
(GLOBOCAN, 2014)
• Prostate 14.4%; No. of new cases 2527; ASR 31.6/100,000; Mortality 12.6% No. of deaths 1692
• Oesophagus 10.7%; No. of new cases 1872; (ASR 20.5/100,000); Mortality 12.6%; No. of deaths 1692
Kenya 2012All Cases Numbers 40,999 (Male17531, Female 23468) or (41,000 cases annually)All deaths 28,453 per year (Male 13414; Female 15039)
Cancer incidence and mortality in Kenya: Female
Estimates for year 2012 GLOBOCAN, 2014
• High incidence of both breast and cervix• Cervix 20.5%; No. of new
cases 4802; (ASR 40.1 per 100,000) Mortality 16.3%; No. of deaths 2451
• Breast 19%; No. of new cases 4465; (ASR 38.3 per 100,000); Mortality 13.1%; No. of deaths 1969
-There is need to advocate for more resources to support cancer registries in the country
Incidence Reports:2000 – 20022004 – 2008Can be accessed at www.afcrn.orgwww.kemri.org
• In 2011 Nairobi Cancer Registry included HIV data as part of routine data collection.
• A pilot study linking Cancer and HIV was done and results were published in Jan 2014.
• Demographic and medical information missing/ not recorded in the patient’s notes
• Population boundaries – residence confused with place of birth
• Inadequate institutional support. Personnel, office space, equipment, office supplies
• Limited Funding• Capacity building, technical support• Lack of electronic hospital databases – data
capture is manual hence slow and prone to errors.• Hospitals data collection tools not standardized
• Personnel working in Medical records units not trained, basic tools e.g. ICD 10 coding manuals missing in some facilities
Challenges
Overcoming some challenges
• Establishment of East Africa Registry Network in 2011
• Later (2012) upgraded to Africa Cancer Registry Network (AFCRN) now 26 members
• Opportunity for technical support (CanReg5)
• Capacity building• Annual meetings – sharing
data and point research work
Ongoing studies
• Cancer survival studies (Breast, Cervix, Prostate, Oesophagus)
• Breast cancer staging study• Breast cancer biology study• Costing analysis study – to determine the cost of maintaining a population-based cancer registry (funded by CDC)
• Childhood cancer survival study
Acknowledgement
1Kenyatta National Hospital (KNH) 14Nairobi Women’s hospital
2Nairobi hospital and Oncology Centre 15Metropolitan hospital
3MP Shah hospital 16Jamaa hospital
4Cancer Care Centre 17Gurunanak hospital
5Aga Khan hospital 18Nairobi West hospital
6Karen hospital 19South B hospital
7Mater hospital 20South C Alliance hospital
8Armed Forces Memorial hospital 21Mariakani Cottage hospital
9Nairobi hospice 22Kikuyu Hospital
10St. Mary's hospital 23Civil Registrar of births & deaths
11Nazareth hospital 24UoN Dental School
12Avenue hospital 25Kikuyu hospital
13Texas Cancer Centre 26Lion’s Eye unit
All Hospitals / institutions that contribute to the registry
Acknowledgement
• KESHO Organizing Committee• Our sponsors – International Agency for Research on
Cancer (IARC)• Africa Cancer Registry Network (AFCRN)
Thank You!
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