The figure above shows the pattern of cancer in East Africa, according to GLOBOCAN 2008 . The estimates are based on data from cancer registries in East Africa around the year 2000. An early priority of the Network was to produce more recent data on cancer incidence in the East African region

The early results confirm something that is not always obvious to those working outside Africa, "CANCER IS NOT A RARE DISEASE IN AFRICA". In fact, the risk to an individual woman is rather greater in East Africa than in Europe or North America.

Cumulative incidence of cancer (excluding Kaposi sarcoma and non-melanoma skin cancer) in women, 0–64 years of age, (East Africa: 2003-7)

*From GLOBOCAN 2008

Cancer Incidence in Five Continents

A major preoccupation of the longer established registries was to bring their databases up to date, so that they could submit their data for consideration by “Cancer Incidence in Five Continents, volume X” The period under consideration is 2003-2007. All four had prepared provisional submissions by year end.

There are very interesting variations in the cancer profiles in the different centres

Stage Of Disease

It is often stated that “all cases of cancer in Africa present at advanced stages”

But is this true?

To date, the only information available comes from case series, reported by clinicians reviewing their own practice.

It is important to know what is happening to the generality of cancer patients – unselected in advance. This sort of information can be collected in population-based cancer registries. But it is difficult and requires some medical expertise to stage all new cases of cancer.

In 2011 the registries of Nairobi, Kampala, Blantyre and Harare undertook a special study to stage the cases of breast and cervix cancer diagnosed and registered in a recent year (2010).

To do so, medical personnel were recruited to help in reviewing case notes of registered patients to assign a stage at diagnosis, based on all available data (including pathology reports, if they were available).

Cancer Survival

A diagnosis of cancer is not a “death sentence”, as patients may fear.

Indeed, even among the medical profession, there are misconceptions about the average prognosis for cancer patients in Africa.

Again, there is very little information relating to unselected patients, representing the totality (or a random sample) of cancer patients in the population.

To date, only two studies of cancer survival have been conducted, in the 1990’s, reviewing the outcome of a diagnosis of some of the common cancers in Harare (Zimbabwe)[1] and Kampala (Uganda)[2].

Survival at 5 years is clearly inferior to that of cancer patients in the USA, but perhaps nowhere near as bad as might have been predicted

The four longer established registries began a new study of cancer survival by following up a random sample (100 or more cases) of patients diagnosed with cancers of the breast, cervix, oesophagus and prostate in 2004-2008. They will be traced until the end of 2011, which will allow updated estimates of survival for these four cancers to be produced

Cancer patterns and trends

The registries of Blantyre, Kampala, Harare, Nairobi and Eldoret aim to have available incidence data for the period 2008-2010.

Some of these registries aim to publish a report of their activities for this period.

The registry of Rwanda is analyzing the retrospective data (for 2007-2011), collected in its first year of operation, with a particular interest in the changes in the cancer profile since 1991-1993 (the period of operation of the former registry in Butare)

The two oldest cancer registries (Harare and Kampala) aim to complete an analysis of time trends in cancer incidence over a 20-year period (1991-2010).

Survival

The registries will complete and/or update the follow up work on breast, cervix, oesophagus and prostate cancers, so that analysis of survival data can be undertaken.

Other activities

The registries also undertook to complete one or more of the following tasks:

• Develop guidelines for regional consultants (to include a checklist for visits, a model regional cancer registry dataset (with appropriate definitions), and a specimen budget).
• Develop teaching materials for the regional courses
• Develop a protocol, and test, methods for estimating completeness of registration
• Develop a model “Annual Report” for use in African registries
• Develop guidelines on “Confidentiality” (based on those published by IARC/IACR), appropriate to the African context.

[1] Gondos A, Chokunonga E, Brenner H, Parkin DM, Sankila R, Borok MZ, Chirenje ZM, Nyakabau 
AM, Bassett MT. Cancer survival in a southern African urban population. 
Int J Cancer. 2004 Dec 10;112(5):860-4. 

[2] Gondos A, Brenner H, Wabinga H, Parkin DM. Cancer survival in Kampala, Uganda. 
Br J Cancer. 2005 May 9;92(9):1808-12.