Role of Cancer Registries for Cancer Control - PowerPoint Presentation

Slide1

Role of Cancer Registries for Cancer Control

Slide2

Risk factors

Incidence

Survival

Mortality

Population Surveys

PBCRs

PBCRs

Vital statistics

By Cancer Type

By stage

Attributable Risk

Prevalence

DALYs

Associated Economic Costs

Cancer Control Measures

Population

Core Surveillance MeasuresSurveillance StrategyExtended Surveillance Measures

Prevention Early Detection Treatment/ Care Palliative end-of-Life Care

MEASURES AND STRATEGIES FOR CANCER SURVEILLANCE AT THE POPULATION LEVEL

.

Wingo

et al 2005

Slide3

Organized

system of

continuing, systematic

collection,

storage, retrieval, analysis and dissemination of information on the occurrence and characteristics of

Persons who have either a particular disease, A condition (e.g., a risk factor

) that predisposes to the occurrence of a health-related event Prior exposure to substances (or circumstances) known or suspected to cause adverse health effects

Continuing: main feature that distinguishes registration from a

surveySystematic:

implies complete coverage of the various sources of data in a systematic

mannerWhat is a Registry?

Slide4

Disease Registry Pathway

Prevention, Control and Policy level action

Process of continuing,

systematic collection

of data on

the occurrence

and

characteristics

of

reportable diseases

;

Continuing:

main

feature that distinguishes

registration

from a

survey

- which is for a limited period of

time

Systematic: implies complete

coverage of the various

sources of

cases in a

given population in a systematic manner

Types

of Registries

Population

Based, Hospital

Based, Patterns of care and survival studies,

Special purpose:

Environment

–

Exposure related, by Anatomical site of cancer, Age group-Childhood, Morphology specific (Retinoblastoma)

What is

Cancer Registry

?

Slide5

Types of Registries

Slide6

Research Questions Appropriate for Registries

“Registry is not a means in itself but, means towards an end”

Slide7

Data Sources for Registries

Death Indexes

Civil registration system – Medical Certificate of cause of death data

Slide8

Uses of

Health Data Registries

Slide9

National Cancer Registry Programme in India

Atlas on Cancer in India was initiated

1981

2021

ICMR started the Cancer registry operations

Published: Comprehensive NCRP

Report

Cancer burden in North East

First all India report 2001 - 2002

First Annual Report of 1982

No. of PBCR Centres Registered –

6

No. of

PBCRs

Centres -

33Cancer

Atlas provided the geographical pathology of cancerNo. of HBCRs Centres Registered– 177 No. of HBCR Centres Registered –

6No. of PBCRs Centres -38

No. of

HBCRs Centres

-250

Backbone of Cancer Control Initiative in India

1981-

2000

2001-

2002

2003-

2016

2017-

2020

6

North East PBCRs initiated

Patterns of Care Studies for Cervix, Breast and Head & Neck launched

Population Based Cancer Survival for Cervix, Breast and Head & Neck launched

Punjab Cancer Atlas

Haryana Cancer Atlas

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GLOBAL CANCER DATA AVAILABILITY

Slide11

Slide12

Recent Reports

NCRP Activities

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Hospital Based Cancer Registries

Population Based

Cancer

Registries

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Importance of cancer registry

Source of accurate and complete national level cancer data

Provides information on aetiology, diagnosis and treatment of cancer

to determine cancer patterns among various populations or sub-populations, Monitor cancer trends over time

Guide planning and evaluation of cancer control effortsTo help prioritize health resource allocationsTo advance clinical, epidemiological, and health services research.

Slide15

Population Based Cancer Registries

Records all new cases in a defined population (Specified geographical area such as a district or state)

Population level incidence, prevalence and pattern

Overall patient survival in the community

Research – descriptive and analytical studies

Public health planning and policies

Provides indicator for cancer control

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Population Based Cancer Registry

NCDIR-NCRP

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Hospital Based Cancer Registries

Maintain data on all patients diagnosed and/or treated for cancer at a particular facility. 

FOCUS on clinical care, treatment and outcome

Helps in active follow up and clinical down staging

Assessment of hospital care and planning

Professional education and research

Promotes institution based cancer control activities

Contributes to PBCRs in the respective areas

Slide18

CHANGE IN CRUDE ANNUAL INCIDENCE

RATE OF ALL CANCERS TOGETHER IN THE STATES OF INDIA, 1990 AND 2016

India State-Level Disease Burden Initiative Cancer Collaborators. The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990-2016. Lancet Oncol. 2018 Oct;19(10):1289-1306.

doi

: 10.1016/S1470-2045(18)30447-9.

Epub 2018 Sep 12. Erratum in: Lancet Oncol. 2018 Oct 3;: PMID: 30219626; PMCID: PMC6167407.

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Cancer numbers are expected to rise from 13 lakh in 2020 to 15 lakh in 2025

Projection of Cancers

Broad Anatomical Sites of Cancer

2020

2025

No. of cases

(%)

No. of cases

(%)

All Sites

1392179

100.0

1569793

100.0

Tobacco Related Cancers

377830

27.142727327.2Gatro Instestinal Tract

27398219.731014219.8

Cervix Uteri

75209

5.4

85241

5.4

Breast

205424

14.8

232832

14.8

Corpus Uteri and Ovary

70400

5.1

79765

5.1

Lymphoid and Haematopoietic Malignancies

124931

9.0

138592

8.8

Prostate

41532

3.0

47068

3.0

Central Nervous System

32729

2.4

36258

2.3

Slide20

Variations

Comparison of all cancer sites’ age-adjusted incidence rates (AARs) of all population-based cancer registries, 2012-2016. AARs are in blue and crude rates are given in parentheses in red.

Mathur P,

Sathishkumar

K, Chaturvedi M, Das P, Sudarshan KL, Santhappan S, Nallasamy V, John A, Narasimhan S, Roselind

FS; ICMR-NCDIR-NCRP Investigator Group. Cancer Statistics, 2020: Report From National Cancer Registry Programme, India. JCO Glob Oncol. 2020 Jul;6:1063-1075. doi: 10.1200/GO.20.00122. PMID: 32673076; PMCID: PMC7392737.

Slide21

Increasing five year

trends

over time in AARs among PBCRs for Breast Cancer

Chaturvedi M, Vaitheeswaran K,

Satishkumar K, Das P, Stephen S, Nandakumar A. Time Trends in Breast Cancer Among Indian Women Population: An Analysis of Population Based Cancer Registry Data. Indian J Surg Oncol. 2015 Dec;6(4):427-34. doi

: 10.1007/s13193-015-0467-z. Epub 2015 Sep 8. PMID: 27065669; PMCID: PMC4809853.

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Relative proportion (%) of cancer sites associated with the use of tobacco

Crude Rate

and

Age Adjusted Rate

given in parentheses Source: Report of National Cancer Registry Programme (ICMR-NCDIR), Bengaluru, India 2020

Slide23

Relative proportion (%) of patients according to clinical extent of disease, 2012-2016

Source: Report of National Cancer Registry Programme (ICMR-NCDIR), Bengaluru, India 2020

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CANCER ATLAS OF PUNJAB STATE FOR THE YEAR 2014-15

The main objective was to overview the pattern and incidence of cancer in the districts of Punjab state.

District wise Distribution of Cancer cases

Rates

CR

CI

ASR

CI

TR

CI

Males

39.8

39.1 - 40.5

41.2

40.4 - 42.0

73.670.2 - 77.0

Females53.7

52.8 - 54.6

51.7

50.8 - 52.6

114.2

112.0 - 116.4

Both sexes

46.4

45.4 - 43.7

46.4

45.8 - 47.0

93.6

92.1 - 95.0

Crude Rate (CR), Age Standardized Rate (ASR) Truncated Rate (TR) with Confidence Interval (CI) per 100,000 populations in Punjab state

Top leading site of Cancer District wise

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Development of an Atlas of Cancer in Haryana State

District wise Comparison of AAR- All Sites (ICD-10: C00-C96)

Males

Females

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Digital Health Objectives (ICMR-NCDIR’s check list)

page

26

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3/26/2021

27

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Cancer Screening Programme and Cancer Registry

Assessment of Cancer contro

l

This approach can be used to evaluate the success of interventions.

Early detection and screening

Should prevent invasive disease or mortality by programmes that are designed to detect early invasive cancers

Evaluating cancer care Linking with registry data can also catalyze research into causes of the disease and the effectiveness of national or regional intervention strategies.

SCREENED POSITIVE AT

SUB-CENTER/ PHC/CHC/DH

SCREENING PROGRAMME

The Missing Link

HOSPITAL REGISTRY

Referred?

Seeks treatment?

Loss to follow up?

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THANK YOU !!