A. H. Siddiqui2, S. Zafar1 1University Of Maryland,Department Of Surgery,Baltimore, MD, USA 2Aga Khan University Medical College,Medical College,Karachi, Sindh, Pakistan
Introduction:
The availability of cancer registries has significantly enhanced cancer research, especially that related to cancer epidemiology, survival and outcomes. However, this data is not consistently available in all parts of the world. In an attempt to understand surgical outcomes related to cancer we first attempted to determine the availability of cancer registry data on a global level. We also aimed to test the association of cancer registry data with metadata such as country income and cancer related policy.
Methods:
The World Health Organization (WHO) International Agency for Research on Cancer (IARC) and Global Cancer Observatory (GCO) was queried to extract data on the availability and scope of cancer registries in each of the 190 WHO countries. Policy related data, country profiles, and GDP were also extracted. Information on country income classification and expenditure on health was collected from the World Bank database.
We used the chi square and t-tests to determine associations between the availability of cancer registry data and each countries income level, per capita health expenditure, and cancer control policy. Results were tabulated and depicted as choropleth maps using eSpatial. SPSS version 19 was used for data management and statistical analysis.
Results:
Figure 1 shows the global variation in the availability of cancer registry data. Of the 190 countries 20% did not have any kind of cancer registry. The availability of registry data varied by country income status with only 61% in low income countries (LIC) and 95% in high income countries (HIC). Of the low-income countries that did have a cancer registry, only 50% were population based of which 64% had subnational coverage. An overall 60% of countries had a national cancer policy which ranged from 31% in LICs to 79% in HICs. The availability of having registry data was not associated with country income level (p=0.306). However, countries with a national cancer policy were more likely to have a cancer registry in place (p<0.001). Furthermore, countries with high mean per capita health expenditure were more likely to have a national cancer policy (p=0.023), and a population based (p=0.003) cancer registry with national coverage (p<0.01).
Conclusion:
Country level cancer registry data is inconsistent. Low and lower-middle income countries have the least cancer registry data. The availability of data is related to the mean per capita health expenditure of these countries and presence of a national cancer control policy.
