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Background: With the cancer burden rising in sub-Saharan Africa, countries in the region need surveillance systems to measure the magnitude of the problem and monitor progress in cancer control planning. Based on the national estimates built from data provided by cancer registries in sub-Saharan Africa, we summarise key patterns of the regional burden and argue for investments in locally produced data.Methods: To present national estimates of the cancer incidence and mortality burden in sub-Saharan Africa countries, new cancer cases and deaths were extracted from International Agency for Research on Cancers' GLOBOCAN database for the year 2020. Given weak vital statistics systems, almost all of the information on the cancer burden in sub-Saharan Africa was derived from population-based cancer registries. Of the 48 countries included in GLOBOCAN (national populations must be larger than 150 000 inhabitants in 2020), relatively recent cancer registry data (up to 2019) were directly used to produce national incidence estimates in 25 countries, while the absence of such data for 16 meant that estimates were based on data from neighbouring countries. Tables and figures present the estimated numbers of new cases and deaths, as well as age-standardised (incidence or mortality) rates per 100 000 person-years and the cumulative risk of developing or dying from cancer before the age of 75 years.Findings: 801 392 new cancer cases and 520 158 cancer deaths were estimated to have occurred in sub-Saharan Africa in 2020. Cancers of the breast (129 400 female cases) and cervix (110 300 cases) were responsible for three in ten of the cancers diagnosed in both sexes. Breast and cervical cancer were the most common cancers, ranking first in 28 and 19 countries, respectively. In men, prostate cancer led in terms of incidence (77 300 cases), followed by liver cancer (24 700 cases) and colorectal cancer (23 400 cases). Prostate cancer was the leading incident cancer in men in 40 sub-Saharan Africa countries. The risk of a woman in sub-Saharan Africa developing cancer by the age of 75 years was 14·1%, with breast cancer (4·1%) and cervical cancer (3·5%) responsible for half of this risk. For men, the corresponding cumulative incidence was lower (12·2%), with prostate cancer responsible for a third of this risk (4·2%). Cervical cancer was the leading form of cancer death among women in 27 countries, followed by breast cancer (21 countries). Prostate cancer led as the most common type of cancer death in 26 countries, with liver cancer ranking second (11 countries).Interpretation: The estimates indicate substantial geographical variations in the major cancers in sub-Saharan Africa. Rational cancer control planning requires capacity to be built for data production, analysis, and interpretation within the countries themselves. Cancer registries provide important information in this respect and should be prioritised for sustainable investment in the region.Funding: None. [ABSTRACT FROM AUTHOR]

Accurate information on the extent of disease around the time of diagnosis is an important component of cancer care, in defining disease prognosis, and evaluating national and international cancer control policies. However, the collection of stage data by population-based cancer registries remains a challenge in both high-income and low and middle-income countries. We emphasise the lack of availability and comparability of staging information in many population-based cancer registries and propose Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent. Essential TNM aims at staging cancer in its most advanced disease form by summarising the extent of disease in the order of distant metastasis (M), regional lymph node involvement (N), and tumour size or extension, or both (T). Flowcharts and rules have been developed for coding these elements in breast, cervix, prostate, and colon cancers, and combining them into stage groups (I-IV) that correspond to those obtained by full TNM staging. Essential TNM is comparable to the Union for International Cancer Control TNM stage groups and is an alternative to providing staging information by the population-based cancer registries that complies with the objectives of the Global Initiative for Cancer Registry Development. [ABSTRACT FROM AUTHOR]

Lung cancer is the most common cancer in the world. In men, the highest incidence rates are seen in Europe (especially eastern Europe) and North America. In women, high incidence rates are found in North America and in Europe, particularly in northern and western Europe. It is estimated that there were about 375 000 cases of lung cancer in Europe in 2000; 303 000 in men and 72 000 in women. The number of resulting deaths was about 347 000 (280 000 in men and 67 000 in women). Tobacco smoking is well established as the main cause of lung cancer and about 90% of cases are thought to be tobacco related. There is a clear dose-response relation between lung-cancer risk and the number of cigarettes smoked per day, degree of inhalation, and age at initiation of smoking. Someone who has smoked all their life has a lung-cancer risk 20–30 times greater than a non-smoker. However, risk of lung cancer decreases with time since smoking cessation. Recently, there has been renewed interest in screening because spiral computerised tomography can detect small asymptomatic lesions more effectively than conventional radiography. Although cure rates for such lesions are very good, there is to date no evidence for effectiveness of mass-screening strategies. [Copyright &y& Elsevier]