The need for national cancer registries: Comparison of a Peruvian regional cancer registry with WHO cancer estimates

Ashley N. Elsensohn, MSIII1, Natalie Channell2, Antonio Zavaleta, MD3, Jane H. Ricks, MD2, Daniel J. Ricks, MSc, MD2

University of Utah School of Medicine1, University of Utah2, Universidad de Cesar Vajello3

Background: Cancer registries serve as an important tool for cancer surveillance, population-based interventions, and ongoing research. Although national registries exist, many countries like Peru have only minimal or no available data. In these countries, WHO cancer estimates are created utilizing aggregate data from neighboring countries. The aim of our study was to compare WHO Peruvian cancer estimates with those of a regional Peruvian cancer registry.

Methods:  Records of cancer incidence in Trujillo, Peru were collected using the Trujillo Cancer Registry (data 1996-2002). WHO cancer data was obtained using the GLOBOCAN 2008 website (data 1999-2000). GLOBOCAN 2008 estimated Peruvian national incidence using a mathematical model based on an aggregation of recorded cancer registry data from Colombia, Brazil, and Ecuador. We reported incidence using Age Standardized Rate (ASR) of the top five cancers in the Trujillo Cancer Registry with the same five cancers from the GLOBOCAN 2008 project. We then compared incidence by taking the absolute difference of ASR values per cancer and dividing by the respective WHO ASR to create a percentage deviation for each cancer pair.

Results: Trujillo incidence (per 100,000) of the five most common cancers in men was: Prostate-25.8; Stomach-23.8; Lung-5.4; Non-Hodgkins Lymphoma-8.8; and Colorectal-8.2. WHO incidence estimates of these cancers (and percentage deviation from the Trujillo registry) in men were: Prostate-37.1(30.5%); Stomach-22.6(5.3%); Lung-7.8(30.8%); Non-Hodgkins-7.8(0.0%); and Colorectal-7.6(7.9%). Trujillo incidence of the five most common cancers in women was: Cervical-43.2; Breast-28.1; Stomach-17.2; Non-Hodgkins Lymphoma-7.6; and Colorectal-7.5. WHO incidence estimates of these cancers in women were: Cervical-34.5(25.2%); Breast-34.0(17.4%); Stomach-20.0(14.0%); Non-Hodgkins-5.6(35.7%); and Colorectal-8.8(14.8%).

Conclusion:  This study shows that the Trujillo Cancer Registry data differs from current WHO models by up to 30.8% in men and 35.7% in women. While Trujillo represents only a portion of Peru, its registry is more accurate than current mathematical models extrapolated using neighboring country data. We believe that it is essential to create national cancer registries to provide more accurate information on a country’s cancer profile, and we recommend supporting and developing national cancer registries as the optimal way to improve cancer surveillance, population-based interventions, and further research.

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