Establishing a Cancer Registry in a Resource-Constrained Region: Process Experience From Ghana

Abstract

PURPOSE In a review of cancer incidence across continents (GLOBOCAN 2012), data sources from Ghana were classified as Frequencies, the lowest classification for inclusion, signifying the worst data quality for inclusion in the analysis. Recognizing this deficiency, the establishment of a population-based cancer registry was proposed as part of a broader cancer control plan. METHODS The registry was examined under the following headings: policy, data source, and administrative structure; external support and training; and definition of geographic coverage. RESULTS The registry was set up based on the Ghana policy document on the strategy for cancer control. The paradigm shift ensured subscription to one data collection software (CanReg 5) in the country. The current approach consists of trained registrars based in the registry who conduct active data abstraction at the departments and units of the hospital and pathologic services. To ensure good governance, an administrative structure was created, including an advisory board, a technical committee, and registry staff. External support for the establishment of the Accra Cancer Registry has come mainly from Stanford University and the African Cancer Registry Network, in collaboration with the University of Ghana. Unlike previous attempts, this registry has a well-defined population made up of nine municipal districts. CONCLUSION The Accra Cancer Registry was established as a result of the lessons learned from failed previous attempts and aim to provide a model for setting up other cancer registries in Ghana. It will eventually be the focal point where all the national data can be collated.

Burden of cancer in the general surgical population in the eastern region of Ghana

“…Because of this, LMIC countries such as Ghana must often rely on basic estimates of cancer burden when developing plans for the distribution and development of systems focused on cancer treatment. 18 While there have been significant advancements regarding planned development of cancer registries in primarily large, urban hospitals 9 such as those in Kumasi 10 and Accra, 19 the burden of malignancy faced by smaller suburban and rural hospitals, with extremely limited resources, is unknown and is unlikely to be captured by formal cancer registries for the foreseeable future. With this in mind, this study demonstrates the current need for cancer resources in the Eastern Region of Ghana.…”

“… 8 While attempts have been made to develop sustainable population-based cancer registries (PBCRs) in Ghana, inadequate funding, lack of personnel, insufficient coordination of reporting sources and the lack of available census data have made it difficult to implement. 9 10 Currently, the only existing PBCR in Ghana is the Kumasi Cancer Registry, which was established in 2012 and collects cancer data from Komfo Anokye Teaching Hospital and Kumasi South Regional Hospital. 11 In the absence of PBCRs, the majority of cancer incidence estimates for Ghana are based on mathematical modelling, which includes prevalence of risk factors and the use of data from other countries in Sub-Saharan Africa.…”

Health promotion interventions to increase cervical cancer screening uptake in sub-Saharan Africa: a scoping review protocol

“…Competing health care priorities, insu cient nancial resources, weak health systems, and limited numbers of trained providers have made high coverage for cervical cancer screening in most LMIC di cult to achieve [1,2,4]. Health promotion interventions among these poor regions will be able to increase the likelihood of women adopting pragmatic measures towards screening, early detection, and treatment.…”

“…Some of the associated barriers include poor nancial empowerment, high rate of illiteracy as women cannot afford basic screening and preventive services [3]. The case is even pejorative as there are only a few screening centers in sub-Saharan Africa (SSA) [1,4], while about 90% of cervical cancer cases cannot be treated in most of the sub region's health facilities due to late detection and late initiation of treatment [2,5].…”

“…However, due to poor access to screening and treatment services, the vast majority of deaths occur in women living in low and middle-income countries-(LMICs) [1,6,7]. The case is even more pervasive as it is estimated that in sub-Saharan Africa, the prevalence of the disease is likely to increase substantially [2,4].…”