Globocan is very widely used, it’s taken up by WHO and all the international organisations as the source of information on cancer but very few people know where the data in Globcan comes from. So I was explaining to people how do these estimates of cancer in Kenya or in Rwanda, where do they come from, how do we collect this information, how are the estimates made. Essentially for Africa most of them are coming from the cancer registries, actually, that’s where the data is coming from. So I was explaining to people what data is available, how we can use it, how these estimates are put together and how we might be able to improve this in the future when better information comes along. It’s just so people appreciate when these figures are banded about – there are 850,000 new cases of cancer in Africa – where does this information come from.
Really stressing that the data, yes, they’re coming from real cancer registries, it’s not fictitious data, it’s actual data that has been collected painfully and with a lot of difficulty. There’s a lot of room for improvement but it’s a circular process – the figures are there, we can improve them so we should be able to improve the data collection systems in Africa, that was the message.
You’re also involved generally in talks on cancer survival in Africa?
Yes, that was the roundtable discussion this morning in the hall here. That had a huge number of people coming to follow that; there are a lot of people interested in this issue. A lot of the discussion came back to this issue of we were talking about how to measure cancer survival and that it’s quite a difficult thing to do but in interpreting survival the importance of having the stage at diagnosis otherwise it’s difficult to interpret the figures. So then some of the other discussion moved on to why are cancer patients being diagnosed at a late stage in Africa and what can we do about it.
So what can be done?
It’s difficult. One thing that emerges is that very often the patient is blamed for late diagnosis – they don’t come, they don’t know, they leave it too late before they come. But a lot of the people there with clinical experience pointed out that patients sometimes do come early and they’re not diagnosed, they’re just seen very briefly, given some antibiotics and sent away, they’re reassured. Three months later they come back because the symptoms are persisting, they’re still not diagnosed, they’re pushed off to another clinic. Often they can wait months and months and months before a proper diagnosis is made. So it’s a mistake always to blame the patients, there are system failures that the medical system should be able to deal with, even within the framework of a low income setting. So that was an interesting point in the discussion, we often blame the patient for this but actually the system sometimes discourages patients from being diagnosed early. It discourages them from coming and when they come they’re fobbed off with a couple of antibiotic pills and told to come back if it doesn’t get better without just doing a simple examination to see could this be a cancer.