I was presenting on how investing in population-based cancer registries and hospital cancer registries can provide important information that can be used to monitor and evaluate cancer control programmes and cancer prevention as well as early detection and treatment interventions. So I was showing some examples from different parts of the world where population-based cancer registries exist, hospital registries exist and how they provide data to evaluate what is going on in their populations. So I was showing, for example, in Kuwait in successive cohorts of women the breast cancer risk has substantially increased. In fact, compared to thirty years back, Kuwait has now almost a threefold increase in breast cancer. Many, many low and middle income countries have something like 1-5% annual percentage change increase in breast cancer incidence. This comes basically from population-based cancer registry data.

I was also showing how the registry data can be used to evaluate how people survive after cancer treatment. It is an indication of the efficiency of the health services and I was showing that people with the very early stages of cancer, for example breast cancer, have a survival rate approaching 90% in developed health services like in Turkey or in Singapore. As compared to that, in moderately developed health services like in India or in the Philippines or in Thailand, the five year survival of a stage 1 breast cancer is around 70-75% which reflects the efficiency of the health services.

Similarly, this you can demonstrate for many, many other cancers as well where treatment is very effective. I was also showing in the Gambia, where cancer treatment facilities do not exist, five year survival from any breast cancer is less than 10%. So I was showing some examples in how population-based registries can be used to evaluate cancer preventive, early detection and treatment interventions.

Can you give any examples of successful cancer registries in developing countries?

Take the African region, there are long-standing registries in Kyadondo County in Uganda and Harare in Zimbabwe. They have shown the evolution of the Kaposi’s sarcoma. The Kaposi’s sarcoma is an HIV/AIDS associated cancer and it was very low before the HIV epidemic evolved in East Africa. From 1991 it increased so rapidly, Kaposi’s sarcoma incidence increased very rapidly, reached a peak after seven or eight years, and became the number one cancer among men and the number three cancer among women. Then these countries introduced HIV infection control measures – education, improved access to anti-retroviral therapy and things like that – and the Kaposi’s sarcoma incidence, as rapidly as it climbed it went down as rapidly. So the existence of the registries in Uganda in Kyadondo County, which also encompasses Kampala, as well as in Harare, clearly showed how the Kaposi’s sarcoma epidemic evolved along with the HIV epidemic and then how the Kaposi’s sarcoma epidemic was controlled and was still coming down with the coming down, the stabilisation and decline, in the HIV infection epidemic with the introduction of anti-retroviral therapies and education.