Today in the pathology session we talked about the importance of cancer staging as a tool for cancer control, population-based cancer control. Africa has very little information about the cancer incidence, there is very poor penetration of population-based cancer registries so cancer registration is an up and coming topic of discussion as a tool for cancer control in Africa. Most of the national cancer control plans include cancer registration as one of the fundamental elements of cancer control. So you have to have information in order to plan what services you need to provide prevention, screening, early detection and treatment of cancer.
I have been involved at the UICC with cancer staging classification; it’s called the TNM classification and cancer stage or extent of disease is a fundamental tool for providing prognosis. We’ve heard at this conference that the extent of disease of late presentations with cancer is the main problem in Africa; late presentation means advanced stage presentation. So knowing what is the stage would be very useful in order to guide the plans for cancer control in Africa. We have been talking this morning about using the TNM classification and including it in cancer registration right up-front to provide better tools of evaluation and progress. So stage shift or change in the pattern of cancer presentation from the late stage presentation to early stage presentation is the first indicator that the programmes in cancer screening and early detections are working. It is the first indicator before you see changes in mortality or improvement in survival and that’s why it’s important for people to become familiar with cancer staging classification and how to place it into cancer registries.
Do you have any suggestions on how to implement this?
We have a classification, the UICC has been publishing TNM classification for cancer staging for a number of years and we now have a global network of national cancer staging committees that work with us, both to disseminate the classification but also working within their own jurisdiction to educate about cancer staging and promote its use in cancer registries. So we’ve put out a call at this meeting for the creation of more national cancer staging committees that would work together with cancer registries and cancer professionals to make sure that there is connectedness between those involved in clinical practice and recording of stage and the registries and planning.
This AORTIC conference, because of the total dedication to the cancer problem in Africa and the great participation by African experts, is a great tool for improving the collaboration partnerships and encourage learning from one part of the world to another. Sometimes we don’t do enough of that, sometimes we repeat our research, repeat our development and don’t adopt and adapt the tools developed elsewhere for a particular country.
