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 ID: 913382
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Slide1
Role of Cancer Registries for Cancer Control
Slide2Risk 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
Slide3Organized
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?
Slide4Disease 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
?
Slide5Types of Registries
Slide6Research Questions Appropriate for Registries
“Registry is not a means in itself but, means towards an end”
Slide7Data Sources for Registries
Death Indexes
Civil registration system – Medical Certificate of cause of death data
Slide8Uses of
Health Data Registries
Slide9National 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
Slide10GLOBAL CANCER DATA AVAILABILITY
Slide11Slide12Recent Reports
NCRP Activities
Slide13Hospital Based Cancer Registries
Population Based
Cancer
Registries
Slide14Importance 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.
Slide15Population 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
Slide16Population Based Cancer Registry
NCDIR-NCRP
Slide17Hospital 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
Slide18CHANGE 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.
Slide19Cancer 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
Slide20Variations
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.
Slide21Increasing 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.
Slide22Relative 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
Slide23Relative proportion (%) of patients according to clinical extent of disease, 2012-2016
Source: Report of National Cancer Registry Programme (ICMR-NCDIR), Bengaluru, India 2020
Slide24CANCER 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
Slide25Development of an Atlas of Cancer in Haryana State
District wise Comparison of AAR- All Sites (ICD-10: C00-C96)
Males
Females
Digital Health Objectives (ICMR-NCDIR’s check list)
page
26
Slide273/26/2021
27
Slide28Cancer 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?
Slide29THANK YOU !!