Establishing and Evaluating Cancer Surveillance System in KwaZulu-Natal, South Africa

Abstract

Background: The increasing cancer burden remains a public health challenge. Quality and accurate population data is important to improve cancer control, screening, and treatment programmes for the sub-Saharan Africa region. Aim: The aim of this study was to establish hospital-based cancer surveillance system, thereby reporting the burden that cancer diagnosis and treatment place on 3 hospitals – an approach of health systems strengthening. Methods: A hospital-based cancer surveillance was established in 3 public health facilities that provide oncology services in KwaZulu-Natal. An active method was used for finding cancer cases. The cancer surveillance database was evaluated according to the criteria recommended for cancer registries. Analyses of data included descriptive and crude incidence rates. Results: A total of 2307 newly diagnosed cancer cases were reported in 2018, with a majority from Inkosi Albert Luthuli Central hospital (65.3%), followed by Greys hospital (30.8%) and then Addington hospital (3.94%). Most of the cancer cases were from the 2 major urban areas of the province (eThekwini and uMgungundlovu district). The most commonly diagnosed cancers from all combined 3 facilities for both sexes were breast, cervix, colorectal, Kaposi Sarcoma, and lung. Approximately half of the cancer cases had no staging, and 12.8% of the cases were diagnosed at stage 4. The mostly prescribed treatments for the patients were radiotherapy and chemotherapy. Conclusions: Based on our hospital-based surveillance, cancer burden is high in the 3 facilities. Strengthening cancer screening and diagnostic policies and procedures that will allow expansion of accurate cancer surveillance system is essential in KwaZulu-Natal and South Africa as a whole.

Experiences of Patients with Cancer regarding Decentralization of Oncology Services at a Tertiary Hospital in the Eastern Cape

“…The South African National Cancer Registry report of 2018 shows that 52% of cancer patients in the country are females. Although this study could not delineate the kinds of cancers, researchers concur with these results to say those female cancers in the country are on the rise, especially breast cancer and cervical cancer(Mbeje et al, 2021).…”

Knowledge Attitude and Practices of Health Care Workers towards Colorectal Cancer Screening in Primary Care Settings in Durban, South Africa: A Cross-Sectional Survey

“…However, the National Institute of Communicable Disease of South Africa (2017) planned to establish a national cancer surveillance programme using the population-based cancer registry, which is not yet operationalised, but will go a long way to accurately report on CRC in the future. However, local surveillance system development efforts are also underway in selected hospitals within the country (Mbeje, 2021).…”

Establishing the utility of Recursive Partitioning Analysis for patients with intra-cranial metastases managed in a KwaZulu-Natal state sector Oncology unit

“…This is unsurprising given the low numbers of lung cancer patients seen in our centre coupled with the high prevalence of breast cancer. 4 Furthermore, the breast cancer records are wellmaintained because of ongoing disease-specific research at the centre and are therefore more accessible.…”

“…19 While our small sample size complicates the interpretation of results, it is likely a reflection of the high burden of cervical cancer in the patient population that this unit serves. 4 This study did not account for treatment and its potential influence on survival. The study cohort was unfortunately too small to allow for useful analysis of subgroups that did and did not receive radiotherapy.…”

“…Cervical cancer is also common accounting for 21.0%. 4 Treatment modalities for brain metastases include radiotherapy, surgery and systemic therapies. 5 Given the central therapeutic role that radiotherapy plays, an understanding of its appropriate use relative to actual outcomes is critical.…”