Project Lead(s): Jamilla Rajab
It is estimated that 20–30% of HIV-positive adults will develop cancer and 1.6 million Kenyans currently live with HIV.
Cancer ranks third as a cause of death in Kenya and contributes 7% to the total national mortality yearly, with an annual mortality rate of over 22,000.
There is a low awareness of cancer and even less knowledge of the link with HIV infection.
Cancer registration in Africa is lacking, but enactment of the National Cancer Act in 2012 in Kenya made cancer a notifiable disease, meaning that national and regional governments must collect and report all cancer cases, for control, management and resource allocation.
This project tested the viability of setting up a population-based cancer and HIV-linked registry to document cancer patterns in two counties in Kenya.
A unique mobile telephony cancer–HIV-linked registry was developed to address the knowledge, planning and intervention needs for various stakeholders, as well as to act as a platform for cancer data.
Based on most common cancers and HIV-linked data, the project set out to stimulate demand for novel interventions based on regional differences in disease burden, as well as providing uniquely tailored tools to inform resource allocation.
Cancer and HIV data was collected by trained cancer registrants, and was entered into standard CANREG 5 data entry software. Cancer diagnosis was based on morphology (histology, cytology), and published imaging and clinical guidelines.
The data was then analyzed to obtain specific cancer and HIV prevalence and trends.
To tailor specific messages to improve communication in the community, a survey was carried out among the general population and cancer patients in the pilot counties, to obtain information regarding gaps in cancer knowledge, attitude and practices.
To facilitate access to the data, a simple, web-based application was designed that is hosted on a secure server, running on a platform that imported the summarized registry data.
The project resulted in the successful development of a cancer database, linking two counties, Embu and Nakuru, in Kenya.
For the first time, the Ministry of Health has a quality cancer data/HIV-linked registry for two counties.
A total of 1,071 cancer cases (59.9% female and 40.1% male) were entered into the database in Nakuru County. In Embu County, there were 1,490 cases.
Cancer incidence peaked at different age groups in the counties.
The most common documented cancers among women in Nakuru were breast cancer (24.3%) and cervical cancer (22.4%). In Embu, however, the most common was cervical cancer (39.4%), followed by breast cancer (30.7%).
Among males in Nakuru, the top two cancers were esophageal (17.9%) and prostate (16.8%) while, in Embu County, these were prostate (27.1%) and esophageal cancer (24.5%).
For Embu County, HIV test results were only available for 139 cancer cases. In Nakuru County, only 334 cases had similar information available.
In the Embu County registry, there were 106 HIV-positive cancer cases (female 60.4%, male 39.6%) while, in Nakuru, there were 57 HIV-positive cases (female 73.7%, male 26.3%).
Results of this project were widely disseminated in conferences and through publications.