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International audience; Background: Africa and the Caribbean are projected to have greater increases in Head and neck cancer (HNC) burden in comparison to North America and Europe. The knowledge needed to reinforce prevention in these populations is limited. We compared for the first time, incidence rates of HNC in black populations from African, the Caribbean and USA. Methods: Annual age-standardized incidence rates (IR) and 95% confidence intervals (95%CI) per 100,000 were calculated for 2013-2015 using population-based cancer registry data for 14,911 HNC cases from the Caribbean (Barbados, Guadeloupe, Trinidad and Tobago, N = 443), Africa (Kenya, Nigeria, N = 772) and the United States (SEER, Florida, N = 13,696). We compared rates by sub-sites and sex among countries using data from registries with high quality and completeness. Results: In 2013-2015, compared to other countries, HNC incidence was highest among SEER states (IR: 18.2, 95%CI = 17.6-18.8) among men, and highest in Kenya (IR: 7.5, 95%CI = 6.3-8.7) among women. Nasopharyngeal cancer IR was higher in Kenya for men (IR: 3.1, 95%CI = 2.5-3.7) and women (IR: 1.5, 95% CI = 1.0-1.9). Female oral cavity cancer was also notably higher in Kenya (IR = 3.9, 95%CI = 3.0-4.9). Blacks from SEER states had higher incidence of laryngeal cancer (IR: 5.5, 95%CI = 5.2-5.8) compared to other countries and even Florida blacks (IR: 4.4, 95%CI = 3.9-5.0). Conclusion: We found heterogeneity in IRs for HNC among these diverse black populations; notably, Kenya which had distinctively higher incidence of nasopharyngeal and female oral cavity cancer. Targeted etiological investigations are warranted considering the low consumption of tobacco and alcohol among Kenyan women. Overall, our findings suggest that behavioral and environmental factors are more important determinants of HNC than race.

Background Data from population-based cancer registries (PBCRs) are a useful resource for estimating the incidence of cancers. PBCR data is useful in the planning and implementation of cancer prevention and control strategies. Ghana’s plan for control of non-communicable diseases recognises the need for good quality data to facilitate the attainment of set goals. Methods We reviewed data from the Kumasi Cancer Registry for the year 2015. Data collected included clinical and demographic information, laboratory reports and source of case information. Data was entered into the Canreg-5 software. Data was initially analysed using Canreg-5 to estimate the incidence and age standardised rates (ASR) for various tumours. Data was also exported to Microsoft Excel for further analysis using Epi Info version 7.1.4. Microsoft Excel was used to generate charts and graphs. Aggregated data for the years 2013 and 2014 were also analysed for trends in cancer incidence and ASR. Results A total of 736 cancer cases were recorded among the residents of Kumasi for the year 2015. Females accounted for 62.4% of all cases. The overall incidence of cancer in Kumasi for 2015 was 46.1 per 100,000. The mean age of all cases was 51.3 years (with a range of 1 to 99 years). The incidence among female residents was estimated at 54.1 per 100,000 compared with 37.1 per 100,000 in males. Among females, breast and cervical cancers recorded the highest incidences of 16.1 per 100,000 and 13.7 per 100,000 respectively. Among males, prostate cancer had the highest incidence of 10.5 per 100,000. Breast, cervical and liver cancers were the commonest in both sexes accounting for 19.7, 14.7 and 11.4% of cases respectively. Conclusion There has been significant improvement in data quality and coverage since the inception of our PBCR in 2012. PBCRs are feasible; therefore there is the need for more such registries to improve data on cancers in Ghana. Consistent with other evidence, we found breast cancer as the commonest female cancer in Ghana.

Objective To discuss the implementation of confidentiality practices at the Kumasi Cancer Registry. Introduction Cancer registration involves collecting information on patients with cancer. Population-based cancer registries in particular are useful in estimating the disease burden and to inform the institution of prevention and control measures. Collecting personal information on patients with cancer requires strict adherence to principles of confidentiality to ensure the safety of the collected data. Failure may have legal and medical implications. The Kumasi Cancer Registry was established as a population-based cancer Registry in 2012. The registry collects data on cases of cancer occurring among residents of the Kumasi Metropolitan area of Ghana. Issues bordering on confidentiality were an integral part of the establishment of the registry. We discuss the implementation of confidentiality plans during the four years of existence of the Kumasi Cancer Registry. Methods The registry has a designed abstraction form which is used to collect data. Data sources for the Registry are all major hospitals in Kumasi providing cancer treatment services. Data sources also include private pathology laboratories and the Births and Deaths Registry. Trained research assistants collect data from the folders of patients. This is followed by coding and then entering into the Canreg 5 software. Coded and entered into the Canreg5 software for management and analysis. After data entry, the forms are filed in order of registry numbers as generated by the canreg5 software for easy reference. Results Confidentiality of KsCR data is ensured through the following measures. The signing of a confidentiality agreement by all registry staff. The confidentiality agreement spells out terms for the release of data to third parties in particular but even staff of the various facilities. The agreement also spells out the consequences of a breach of any of the clauses. No direct contact is made with patients during the process of abstraction of data by registrars. The data abstraction forms are kept in a secured safe in the registry office. The computers that house the registry data are password enabled and are changed on a regular basis to ensure security. The Canreg5 software used for electronic data management also has individual profiles with passwords for all registrars and supervisors. The scope of access to Canreg data is limited by the profile status of the respective staff members. Supervisors have full access to all data including summarized reports. Registrars have limited access mostly restricted to data entry. Access to the registry office is restricted to registry staff and other personnel authorized by the Registry Manager or Director. An established Registry Advisory Board is responsible for assessing requests and approval of data from the registry. Where files have to be sent electronically, they are password protected and sent in several parts in separate emails. Conclusions Despite the potential challenges to maintaining confidentiality of data in developing outcries, evidence from four years of cancer data management in Kumasi suggests stringent measure can ensure confidentiality. The use of multiple measures to ensure confidentiality is essential in surveillance data management

Population-based cancer registration is not common practice in developing countries. Ghana's first PBCR, the Kumasi Cancer Registry was established in 2012. We review data from the registry from 2012 to 2014. Females accounted for the majority (64.2%) of the 1,078 cases of cancer were recorded. Breast (35.1%), Cervix (23.7%), Ovary (7.9%), Liver (3.8%) and Endometrium (3.2%) were the top five cancers among females. Among males, the commonest cancers were Liver (21.8%), Prostate (17.9%), Stomach (4.1%), Lung (3.4%) and Bone marrow (2.9%). Histology was the basis of diagnosis for 58.7%. There is the need to establish more such registries in Ghana.

Cancer-related deaths have been projected to increase in sub-Saharan Africa. Cancer control programmes require good quality data in order to provide information for planning and implementing cancer control and prevention activities. Cancer registration and follow-up of cancer cases to estimate survival are useful tools in cancer control programmes. We followed up 136 cases of breast cancer diagnosed from the year 2006 to 2008. The majority of cases (62.5%) could not be reached either by phone or at the residential address indicated in the folders. We recommend a strengthened system of demographic information collection on cases for effective surveillance.

Background Data on cancers is a challenge in most developing countries. Population-based cancer registries are also not common in developing countries despite the usefulness of such registries in informing cancer prevention and control programmes. The availability of population-based data on cancers in Africa varies across different countries. In Ghana, data and research on cancer have focussed on specific cancers and have been hospital-based with no reference population. The Kumasi Cancer Registry was established as the first population-based cancer registry in Ghana in 2012 to provide information on cancer cases seen in the city of Kumasi. Methods This paper reviews data from the Kumasi Cancer Registry for the year 2012. The reference geographic area for the registry is the city of Kumasi as designated by the 2010 Ghana Population and Housing Census. Data was from all clinical departments of the Komfo Anokye Teaching Hospital, Pathology Laboratory Results, Death Certificates and the Kumasi South Regional Hospital. Data was abstracted and entered into Canreg 5 database. Analysis was conducted using Canreg 5, Microsoft Excel and Epi Info Version 7.1.2.0. Results The majority of cancers were recorded among females accounting for 69.6% of all cases. The mean age at diagnosis for all cases was 51.6 years. Among males, the mean age at diagnosis was 48.4 compared with 53.0 years for females. The commonest cancers among males were cancers of the Liver (21.1%), Prostate (13.2%), Lung (5.3%) and Stomach (5.3%). Among females, the commonest cancers were cancers of the Breast (33.9%), Cervix (29.4%), Ovary (11.3%) and Endometrium (4.5%). Histology of the primary tumour was the basis of diagnosis in 74% of cases with clinical and other investigations accounting for 17% and 9% respectively. The estimated cancer incidence Age Adjusted Standardised Rate for males was 10.9/100,000 and 22.4/100, 000 for females. Conclusion This first attempt at population-based cancer registration in Ghana indicates that such registries are feasible in resource limited settings as ours. Strengthening Public Health Surveillance and establishing more Population-based Cancer Registries will help improve data quality and national efforts at cancer prevention and control in Ghana.