Ghana Cancer Registry - from Hospital to Population: a Pilot Study

 描述(申请人提供)：尽管传染病仍然是非洲的主要疾病负担，但临床数据表明，非洲的癌症发病率正在迅速增加，其速度快于发达国家。还有证据表明，“西方癌症”，包括乳腺癌、前列腺癌、结肠癌和肺癌，在许多非洲国家正变得非常常见。然而，该大陆只有1%的人口被基于人口的登记所覆盖(在美国，28%的人口被NCI的监测、流行病学和最终结果计划所覆盖，83%的人口被所有州的登记所覆盖)。由于缺乏以人群为基础的癌症监测数据，很难量化非洲癌症的确切负担，也难以制定有效的癌症预防和控制战略。为了帮助满足建立基于人口的登记以提供指导癌症预防和控制工作的信息的需要，加州癌症预防研究所正在与加纳大学医学院、科勒-布教学医院和非洲癌症登记网络合作，在加纳首都阿克拉制订一个示范试点癌症登记项目。作为建立基于阿克拉人群的癌症登记的第一步，我们建议在KBTH建立一个以医院为基础的癌症登记。KBTH是阿克拉大都市区最大的医院，为阿克拉约三分之二的人口提供服务(AFCRN认为70%的覆盖率是基于人口)。KBTH开发的癌症登记预计将成为加纳癌症登记卓越中心，并成为一个培训中心，将癌症登记扩展到阿克拉的其他医院，将人口覆盖率提高到70%以上。这项拟议的研究将为2014-2015年确诊的癌症病例的KBTH全系统积极病例发现和2016-2017年确诊的癌症病例的积极病例报告建立有效的程序和培训(目标1)。我们还将制定程序，将癌症登记与KBTH的肿瘤档案联系起来，创建一个登记联系的组织库，可用于为未来的分子研究有效检索病理材料(目标2)。最后，我们将对阿克拉的医院进行调查，以评估它们是否愿意将癌症数据提供给以人群为基础的癌症登记系统(目标3)。我们将举办癌症登记工作坊，并为癌症登记提供者提供有关癌症登记重要性的培训，以提高人们对癌症登记的认识和兴趣。我们的目标的成功完成将为阿克拉今后的人口登记铺平道路，该登记将产生高质量的监测数据，以帮助加纳预防和控制癌症的努力。加纳的登记数据可以与非洲裔美国人的癌症模式进行比较，以澄清为什么非洲裔人不成比例地受到某些癌症的影响，例如前列腺癌和肾癌。

 DESCRIPTION (provided by applicant): Although communicable diseases still represent the major disease burden in Africa, clinical data suggest that cancer incidence is increasing rapidly in Africa and at a rate that is faster than that in the developed world. There is also evidence tha "Western cancers," including cancers of the breast, prostate, colon, and lung, are becoming very common in many African countries. However, just 1% of the continent's population is covered by population-based registries (in the US, 28% of the population is covered by NCI's Surveillance, Epidemiology, and End Results Program and 83% from all state registries combined). The lack of population- based cancer surveillance data makes it difficult to quantify the exact burden of cancer in Africa and develop effective strategies for cancer prevention and control. To help address the need for developing population- based registries to provide information to guide cancer prevention and control efforts, the Cancer Prevention Institute of California (CPIC) is partnering with the University of Ghana Medical School (UGMS), Korle Bu Teaching Hospital (KBTH; a UGMS-affiliated hospital), and the African Cancer Registry Network (AFCRN; a partner of the International Agency for Research on Cancer) to develop a demonstration pilot cancer registration project in Accra, the capital city of Ghana. As a first ste towards an Accra population-based cancer registry, we propose to establish a hospital-based cancer registry at KBTH. KBTH is the largest hospital in the Accra metropolitan area and serves about two-thirds of the Accra population (70% coverage is considered population-based by the AFCRN). The cancer registry developed at KBTH is expected to become the Center for Excellence in Cancer Registration in Ghana, and to be a training center for extending cancer registration to other hospitals in Accra to enhance population coverage beyond 70%. This proposed study will establish effective procedures and training for KBTH-wide active case finding for cancer cases diagnosed in 2014-2015, and for active case reporting for cancer cases diagnosed in 2016-2017 (Aim 1). We will also develop procedures to link the cancer registry with KBTH's tumor archives to create a registry-linked tissue bank that can be used for efficient retrieval of pathology materials for future molecular studies (Aim 2). Finally, we will survey othe hospitals in Accra to assess their willingness to contribute cancer data to a population- based cancer registry (Aim 3). We will hold a workshop on cancer registration and provide training to providers on the importance of cancer registration to help increase awareness and interest in cancer registration. Successful completion of our aims will pave the way for a future population-based registry in Accra that will generate high-quality surveillance data to aid the effort of cancr prevention and control in Ghana. The Ghana registry data can be compared with cancer patterns among African Americans to clarify why persons of African descent are disproportionally affected by certain cancers, such as cancers of the prostate and kidney.