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Data from 20 years of cancer registration in Harare (Zimbabwe) are used to investigate the risk of cancer in the white population of the city (of European origin), relative to that in blacks (of African origin). In the absence of information on the respective populations-at-risk, we calculated odds of each major cancer among all cancers, and took the odds ratios of whites to blacks. Some major differences reflect obvious phenotypic differences (the very high incidence of skin cancer-melanoma and nonmelanoma-in the white population), whereas others (high rates of liver cancer, Kaposi sarcoma and conjunctival cancers in blacks) are the result of differences in exposure to infectious agents. Of particular interest are cancers related to lifestyle factors, and how the differences in risk are changing over time, as a result of evolving lifestyles. Thus, the high risk of cancers of the esophagus and cervix uteri in blacks (relative to whites) and colorectal cancers in whites show little change over time. Conversely, the odds of breast cancer, on average four times higher in whites than blacks, has shown a significant decrease in the differential over time. Cancer of the prostate, with the odds initially (1991-1997) 15% higher in whites had become 33% higher in blacks by 2004-2010. [ABSTRACT FROM AUTHOR]

A questionnaire survey of all active population based cancer registries in sub-Saharan Africa obtained information on their characteristics (size, staffing, funding), methods of working, the nature of any links between registries and their respective Health Authorities (national and/or local), and the use of their data in research or cancer control planning. 23/25 registries (92%) responded. Sources of direct funding and estimated amounts from each source were established, and suggest that it is approximately US$8-9 per case registered. Almost half of the funding is used for routine data collection, processing and analysis. Staffing levels vary, partly as a function of the registry size (approximately one FTE per 300 cases registered). Most data collection is active, using multiple sources (median 10 per registry), and is largely paper-based (abstraction onto paper forms), although all use the computer system CanReg© for data entry, storage and analysis. Most reporting by the registries is remarkably timely, and in general, their results are widely used by health authorities and other stakeholders in planning and evaluating services, while research output is much more variable. These registries are the source of almost all the existing information on cancer incidence and mortality in sub-Saharan Africa, as published in IARC's 'Globocan'. [ABSTRACT FROM AUTHOR]

There are few cancer trend data reported in sub-Saharan Africa notably due to the scarcity of population-based cancer registries (PBCRs). The Eastern Cape Province PBCR is amongst the few registries in sub-Saharan Africa that reports data for a rural population. Trends in cancer incidence are reported for the period 1998-2012. Registered cases, age-standardized rates (ASRs) and standardized rate ratios are presented for the most common cancers in both males and females in three periods (1998-2002, 2003-2007 and 2008-2012). In males, the most commonly diagnosed cancer during the 15 year period was cancer of the oesophagus; incidence rates showed a significant decline over the 15 year period, entirely due to a 30% decrease between 2003-2007 and 2008-2012, to an ASR of 23.2 per 100,000 population. This was followed by prostate cancer, the incidence of which was more than doubled to a level of 9.9/100,000. In women, cancer of the cervix uteri has become the most common malignancy, with a significant increase in incidence during the period to 29.0/100,000. Oesophageal cancer is second in frequency, with (as in males) a significant decline in the final 10 years to an incidence of 14.5/100,000 in 2008-2012. The incidence of breast cancer increased by 61%, although the absolute rate remains low (12.2/100,000). The incidence rates of colorectal cancer are low, and the increases in incidence, although relatively large (35% in men, 63% in women) were not statistically significant. Kaposi sarcoma showed a dramatic increase in incidence in both sexes (3.5-fold in men, 11-fold in women) although the incidence remains relatively low by southern African standards. Cancer prevention and control activities in the area need to be informed by these data and strengthened. [ABSTRACT FROM AUTHOR]

Background: Accurately recorded vital status of individuals is essential when estimating cancer patient survival. When deaths are ascertained by linkage with vital statistics registers, some may be missed, and such individuals will wrongly appear to be long-term survivors, and survival will be overestimated. Interval-specific relative survival that levels off above one indicates that the survival among the cancer patients is better than expected, which could be due to the presence of immortals., Methods: We included colon cancer cases diagnosed in 1995-1999 within the 19 jurisdictions in seven countries participating in ICBP SURVMARK-2, with follow-up information available until end-2015. Interval-specific relative survival was estimated for each year following diagnosis, by country and age group at diagnosis., Results: The interval-specific relative survival levels off at 1 for all countries and age groups, with two exceptions: for the age group diagnosed at age 75 years and above in Ireland, and, to a lesser extent, in New Zealand., Conclusion: Overall, a subset of immortals are not apparent in the early years within the ICBP SURVMARK-2 study, except for possibly in Ireland. We suggest this approach as one strategy of exploring the existence of immortals, and to be part of routine checks of cancer registry data., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Information on cancer stage at diagnosis is largely missing or poorly documented among population-based cancer registries in sub-Saharan Africa (SSA). In an early field trial of Essential TNM staging, it was observed that some training was needed to enable cancer registrars to abstract the correct TNM from case records. In November 2018, the Addis Ababa City Cancer Registry hosted a training course attended by 17 participants from 16 cancer registries in SSA. The participants were asked to stage 16 cancer cases (from anonymized photocopies of case records obtained from the Global Initiative for Cancer Registry Development) before and after the training. The discrepancy of the stages from before and after were scored and compared. Results showed that there was a substantial improvement in the participants' performance after the training. The application of the Essential TNM staging system, with training in its use, would allow cancer registrars in SSA to abstract cancer stage at diagnosis in a clinically recognized format, which is crucial for cancer control and public health care policy making.