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Cancer Incidence in Namibia 2010 NAMIBIA NATIONAL CANCER REGISTRY (NNCR) CANCER INCIDENCES IN NAMIBIA 2010 - 2014 Data collected and entered by the Namibia National Cancer Registry (NNCR) Dr Annelle Zietsman Sr Johanna Pontac Sr Sophy Lawrence Ms Lizette Horn Mrs Lizelle van Schalkwyk As National Director: Namibia National Cancer Registry Mrs Reinette Koegelenberg (previous director) Mr Rolf-Jürgen Hansen (current director) Data analysis and report written by Mr Henri Carrara Consultant Analytical Epidemiologist (RSA) Report reviewed by Dr Maxwell Parken African Cancer Registry Network (AFCRN) Supported by Published February 2017 FOREWORD NAMIBIA NATIONAL CANCER REGISTRY REPORT 2010 - 2014 The Namibia National Cancer Registry is a combined project between the Ministry of Health and Social Services (MOHSS) and the Cancer Association of Namibia (CAN) with data analysis done by IARC. This collaboration started in 1995 and this report is the fith published report. I would like to congratulate and thank everyone involved in this project - the doctors and nurses from MOHSS collecting data; the CAN staff doing data entry and follow-up; IARC doing data- analysis and the sponsors involved in producing the report. Without the hard work of each individual this very important research project would not be possible. This information is essential for the action that must be taken by the Namibian National Cancer Control Program – another collaborative program to start soon. In our collective battle against cancer our vision and mission is to: 1. Prevent cancers - create awareness, provide education about healthy lifestyle, promote HPV vaccination 2. Promote early detection - screening 3. Provide information about the most common cancers in Namibia 4. Provide adequate medical treatment for all Namibian cancer patients 5. Provide palliative and supportive care for all Namibians This battle can only be fought by a multidisciplinary team which include MOHSS, CAN, all healthcare professionals, the government of Namibia, the media, churches, NGOs and every Namibian citizen. With sincere gratitude Annelle Zietsman Dr. A.B. May Cancer Care Centre – Windhoek Central Hospital MOHSS A SPECIAL THANK YOU A special word of thanks to Morten Ervik of IARC for help answering many questions relating to CanReg5 software. The Cancer Association of Namibia would like to thank all medical practitioners, medical and treatment establishments and volunteers who have supported data collection. We would also like to thank the African Cancer Registry Network (AFCRN) for their continued support on cancer reporting in not only Namibia, but Africa as a whole. 2 CONTENTS Message from the Cancer Association of Namibia (CAN) and Namibia National Cancer Registry (NNCR) ...... P6 SUMMARY ......................................................................................................................................................... P7 INTRODUCTION ................................................................................................................................................. P8 Background of the Namibia National Cancer Registry History of the registry Location of registry Source of finance Previous publications Aims of the Namibia National Cancer Registry Namibia: A brief introduction MATERIALS AND METHODS ............................................................................................................................ P12 Data collection by the Namibia National Cancer Registry Sources of information for the registry Death registry Methods of registration Data management Data analysed in this report Years analysed Variables examined Population denominators Data analysis and presentation RESULTS .......................................................................................................................................................... P14 Overall burden of cancer in Namibia 2010-2014 Leading cancers among males Prostate cancer Kaposi sarcoma Non-Hodgkin lymphoma Eye cancer Lung/trachea/bronchus cancer Other notable cancers in males Leading cancers among females Breast cancer Cervix cancer Kaposi sarcoma Eye cancer Ovarian cancer Other notable cancers in females Childhood cancers Basis of diagnosis of cancers DISCUSSION .................................................................................................................................................... P23 Limitations Increasing burden of cancer in Namibia Cancers associated with Human Immunodeficiency Virus infection Prostate cancer Tobacco and alcohol-related cancers Female-specific cancers Colon cancer Basal and squamous cell skin cancers Cancers among children RECOMMENDATIONS ..................................................................................................................................... P26 Accurate collection of regional data Provision of population statistics by ethnic group CONCLUSION .................................................................................................................................................. P26 3 REFERENCES ............................................................................................................................................. …….P26 FIGURES AND TABLES Figure 1: Map of Namibia: regions and population ............................................................................................. P8 Figure 2: Map of Namibia: regional in SADC situation ......................................................................................... P8 Figure 3: NAMIBIA ................................................................................................................................................ P9 Figure 4: NAMIBIA ................................................................................................................................................ P9 Figure 5: CAN ..................................................................................................................................................... P10 Figure 6: A.B. MAY ............................................................................................................................................. P10 Figure 7: NOC ..................................................................................................................................................... P11 Figure 8: Population of Namibia (2012, middle of analysis period) ................................................................... P14 Figure 9: Bar Chart showing Top 10 Cancers in Namibia (2010-2014), excluding C44, Male ............................ P15 Figure 10: Age-specific Incidence rates per 100 000 in 2010-2014, Prostate (C51) .......................................... P16 Figure 11: Age-specific Incidence rates per 100 000 in 2010-2014, Kaposi sarcoma (C46) ............................... P16 Figure 12: Age-specific Incidence rates per 100 000 in 2010-2014, Non-Hodgkin lymphoma (C82-85, C96) ... P17 Figure 13: Age-specific Incidence rates per 100 000 in 2010-2014, Eye (C69) .................................................. P18 Figure 14: Age-specific Incidence rates per 100 000 in 2010-2014, Trachea, bronchus and lung (C33-34) ...... P18 Figure 15: Bar Chart showing Top 10 Cancers in Namibia (2010-2014), excluding C44, Female ....................... P15 Figure 16: Age-specific Incidence rates per 100 000 in 2010-2014, Breast (C50) .............................................. P20 Figure 17: Age-specific Incidence rates per 100 000 in 2010-2014, Cervix uteri (C53) ..................................... P20 Figure 18: Age-specific Incidence rates per 100 000 in 2010-2014, Kaposi sarcoma (C46) ............................... P21 Figure 19: Age-specific Incidence rates per 100 000 in 2010-2014, Eye (C69) .................................................. P22 Figure 20: Age-specific Incidence rates per 100 000 in 2010-2014, Ovary (C56) ............................................. P22 Table 1: NAMBIA (2010-2014) Annual incidence per 100 000 by age group - Male .......................................... P29 Table 2: NAMIBIA (2010-2014) Annual incidence per 100 000 by age group - Female ...................................... P29 Table 3: NAMIBIA (2010-2014) Cancer frequencies by ethnic group – Males ................................................... P30 Table 4: NAMIBIA (2010-2014) Cancer frequencies by ethnic group – Females ............................................... P30 Table 5: NAMIBIA (2010-2014) Cancer frequencies by region – Males ............................................................. P31 Table 6: NAMIBIA (2010-2014) Cancer frequencies by region – Females ......................................................... P31 Table 7: NAMIBIA (2010-2014) Basis of diagnosis of cancers – Males .............................................................. P32 Table 8: NAMIBIA (2010-2014) Basis of diagnosis of cancers - Females............................................................ P32 Appendix: NAMBIA Annual incidence per 100 000 by age group and sex for single years ............................... P33 4 Appendix: CI5 editorial tables ............................................................................................................................ P38 Appendix: Data quality indicators Namibia National Cancer Registry ............................................................... P42 5 MESSAGE FROM THE CANCER ASSOCIATION OF NAMIBIA (CAN) AND NAMIBIA NATIONAL CANCER REGISTRY (NNCR) Founded in 1968 by the late Dr A Bernard May, the
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