Abstract
266 Background: The global cancer burden has increasingly shifted to low and middle-income countries and is particularly pronounced in Africa. However, there remains a lack of comprehensive information about cancer incidence due to limited development of cancer registries. In Moshi, Tanzania, a regional cancer registry exists at Kilimanjaro Christian Medical Center (KCR). The quality of the registry data is unknown. Our objective was to evaluate the completeness and quality of the KCR. Methods: In October 2015 we conducted a retrospective review, validating internal consistency of registry records compared with paper-based medical and pathology records. We randomly sampled approximately 3% of over 3000 registry cases (n = 100), focused on cases abstracted from 2014-15. Four independent reviewers not associated with the KCR manually collected and compared key data elements (e.g., cancer site, morphology, diagnosis date). Data were collected using Microsoft Excel. Data management and analysis were conducted in Stata. Results: The KCR contains information on over 3000 patients from 32 tribal groups and 8 geographic areas in the Kilimanjaro region. All of the 100 reviewed cases had complete cancer site and morphology in the registry. Six had a recorded stage. For the majority of cases (n = 92) the basis of diagnosis was pathology. Pathology records were found in the medical record for 41% of cases; for the remainder, pathology records were stored separately in the pathology department. Of sampled cases, the KCR and medical records were 98% and 94% concordant for primary cancer site and morphology, respectively. For 28% of cases, recorded diagnosis dates were within 14 days of what was found in the medical record, and for 32% of cases they were within 30 days. Conclusions: Although training is needed to standardize diagnosis date definitions, this study suggests that KCR data is high quality. Research is needed to determine effectiveness at ascertaining all patients in its catchment area. The registry may have utility for resource planning and research purposes.
Highlights
Cancer presents a significant burden around the globe and is largely indiscriminant of economic status
Pathology reports were found in the medical record for 40% of patients; for the remainder, these were stored separately in the pathology department
For 28%, recorded diagnosis dates were within 14 days of what was found in the medical record, and for 32%, they were within 30 days
Summary
Cancer presents a significant burden around the globe and is largely indiscriminant of economic status. Worldwide estimates suggest that in 2012, there were approximately 14.1 million new cancer diagnoses and 8.2 million cancer-related deaths.[1] In recent years, the cancer burden has shifted and is increasingly shouldered by low- and middleincome countries (LMICs). Cancer in LMICs accounts for about 57% of cancer cases and 65% of cancer-related deaths worldwide.[1] By 2030, this proportion is estimated to reach 70%.2. The increasing burden of cancer is pronounced in Africa,[3] with about three quarters of new cancer diagnoses and deaths occurring in sub-Saharan African countries,[4] which creates a unique set of challenges By 2030, this proportion is estimated to reach 70%.2 The increasing burden of cancer is pronounced in Africa,[3] with about three quarters of new cancer diagnoses and deaths occurring in sub-Saharan African countries,[4] which creates a unique set of challenges
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