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

 描述（由申请人提供）：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，在许多非洲国家变得非常普遍。然而，只有1%的非洲大陆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%来自所有州的登记）。由于缺乏基于人群的癌症监测数据，很难量化非洲癌症的确切负担，也很难制定有效的癌症预防和控制战略。为了帮助满足发展基于人口的登记的需要，以提供信息来指导癌症预防和控制工作，加州癌症预防研究所（CPIC）正在与加纳大学医学院（UGMS）、Korle Bu教学医院（KBTH; UGMS附属医院）和非洲癌症登记网（AFCRN;国际癌症研究机构的一个合作伙伴）在加纳首都阿克拉开发一个示范性试点癌症登记项目。作为阿克拉人口为基础的癌症登记的第一步，我们建议在KBTH建立一个医院为基础的癌症登记。KBTH是阿克拉大都市地区最大的医院，为阿克拉三分之二的人口提供服务（AFCRN认为70%的覆盖率是以人口为基础的）。在KBTH开发的癌症登记处预计将成为加纳癌症登记卓越中心，并将成为将癌症登记扩展到阿克拉其他医院的培训中心，以提高人口覆盖率超过70%。这项拟议的研究将为2014-2015年诊断的癌症病例的KBTH范围内的主动病例发现以及2016-2017年诊断的癌症病例的主动病例报告建立有效的程序和培训（目标1）。我们还将开发程序，将癌症登记与KBTH的肿瘤档案联系起来，以创建一个与登记相关的组织库，可用于有效检索病理材料，用于未来的分子研究（目标2）。最后，我们将调查阿克拉的其他医院，以评估他们是否愿意为基于人群的癌症登记提供癌症数据（目标3）。我们将举办癌症登记工作坊，并为提供者提供有关癌症登记重要性的培训，以帮助提高对癌症登记的认识和兴趣。成功完成我们的目标将为今后在阿克拉建立一个基于人口的登记册铺平道路，该登记册将产生高质量的监测数据，以协助加纳的艾滋病预防和控制工作。加纳的登记数据可以与非裔美国人的癌症模式进行比较，以澄清为什么非裔人容易患某些癌症，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.