National Cancer Registry

Although radiotherapy is an essential part of comprehensive cancer care, access is heavily limited in most sub-Saharan African (SSA) countries. Patients' barriers to care can be grouped as availability, accessibility, accommodation, affordability, and acceptability. We aimed to assess cancer patient- and caregiver-reported barriers in nine SSAn countries (Republic of the Congo, Ethiopia, Gabon, Kenya, Mali, Nigeria, Tanzania, Uganda, and Zimbabwe). We conducted a telephone-based survey among 553 randomly selected patients with breast, cervical, colorectal, and prostate cancer, Kaposi sarcoma and non-Hodgkin lymphoma diagnosed between 2018 and 2019 registered in population-based registries of the African Cancer Registry Network. We inquired about receipt of radiotherapy and barriers irrespective of recalling a recommendation. Among all categories, 21.6% (Use of alternative medicine) to 39.6% (Cost of treatment) of patients reported severe barriers. Most common was problematic Cost of treatment (69.0% overall). A high share of patients from Congo, Kenya, Nigeria, and Tanzania reported barriers. Higher education and wealth were associated with reduced problems in all categories except increased problems with Fear and Use of alternative medicine. Receipt of radiotherapy was associated with fewer problems with Availability of transport (odds ratio [OR]: 0.34; 95% confidence interval [CI], 0.13-0.88) and Trust in healthcare workers (OR: 0.44; 95% CI, 0.24-0.8), and increased Fear (OR: 2.33; 95% CI, 1.33-4.05). Seeing that one-third of the patients reported severe problems in all dimensions, shortage of radiotherapy units is not the only problematic aspect of access to radiotherapy. Improvements in affordability, patient-healthcare worker communication, and psychosocial support are needed.

Pleural mesothelioma (PM) is a lethal cancer primarily caused by asbestos exposure. Not all exposed individuals develop PM, suggesting the involvement of additional factors. This underscores the need for robust predictive models integrating biomarkers from multi-omic domains to improve risk stratification and early detection. We developed and evaluated polygenic risk scores (PRS) and methylation risk scores (MRS) using a retrospective case-control study (749 participants: 387 PM cases, 362 controls) and a nested case-control European Prospective Investigation into Cancer and Nutrition (EPIC)-Meso study (268 participants: 134 preclinical PM cases, 134 matched controls) within the EPIC cohort. Genome-wide association analyses in the retrospective case-control study identified PM-associated variants. The PRS (1123 SNPs with p < 0.001) in the retrospective training subset stratified disease risk in the test set (ORs 3.46-9.54 across top percentiles) and improved model discrimination (AUC = 0.75 vs. 0.71 in baseline model, p = 0.04). In EPIC-Meso, PRS performance was limited (AUC = 0.52). External validation in the UK-Biobank (UKBB) confirmed a modest but consistent association with PM-risk. A Meta-PRS derived from the UKBB-FinnGen meta-analysis replicated this trend in the full retrospective dataset, showing higher OR across top percentiles (2.5-12.3) and improved discrimination (AUC 0.74 vs. 0.72, p = 0.016). MRS, with 68 differentially methylated CpGs (effect-size >|0.10|, FDR p < 0.05) in the retrospective training set, increased the AUC from 0.66 to 0.85 (p < 0.001) in the test set and from 0.51 to 0.62 in EPIC-Meso. PRS was most predictive in low-exposure groups, while MRS remained robust across exposure levels. Combined PRS-MRS models improved discrimination. Integrating multi-omic biomarkers can enhance PM-risk stratification and support earlier, targeted interventions in high-risk asbestos-exposed groups.

Malignant ovarian germ cell tumors (MOGCT) and ovarian sex cord stromal tumors (SCST) are rare ovarian tumors. Since 2013, all German federal states are obliged to record data on diagnosis, pathology, therapy, and clinical course of tumor diseases. We gathered data on MOGCT and SCST from thirteen federal cancer registries and the German Childhood Cancer Registry. Each of the participating registries provided aggregated data on MOGCT and SCST with date of diagnosis between 01.01.2016 and 31.12.2021. 629 MOGCT and 872 SCST were included, age peaks at diagnosis for MOGCT and SCST were between 20 and 24 years and between 55 and 59 years, respectively. Of all MOGCT, 23%, 22%, 13% and 12% were malignant teratoma, dysgerminoma, neuroendocrine tumors and yolk sac tumors, respectively. The large majority (94%) of SCST represented malignant granulosa cell tumors. Most tumors were diagnosed in FIGO stage I (66% of MOGCT and 85% of SCST). Surgery was reported in 58% of patients with MOGCT and in 73% of patients with SCST. Chemotherapy was administered to 26% of MOGCT patients and 8% of SCST patients. This study highlights the great potential of cancer registries as high numbers of patients are recorded, however, data are highly dependent on the reporting institutions.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-32998-5.

Abstract Purpose: The current National Cancer Strategic Framework for South Africa (NCSF 2017–2022) identifies the “top five plus one” priority cancers as breast, cervix, prostate, lung, colorectal, and childhood cancers. We aimed to explore the differences by gender, age group and ethnicity (population group) in the incidence of the most diagnosed cancers. Methods: De-identified data on pathologically diagnosed cancer cases in the most recently published report (2022) from the National Cancer Registry (NCR) were analyzed. The Age Standardized Incidence Rates (ASIR/100,000 population) were used to rank the most diagnosed cancers overall and stratified by gender and by population group. Results: Of the 41,860 males diagnosed with cancer, prostate cancer was the most common cancer (ASIR=52/100,000) followed by the following: colorectal (ASIR=11/100,000), lung (ASIR=7/100,000), melanoma (ASIR=5/100,000) and Non-Hodgkin’s lymphoma (NHL) (5/100,000). The ranking in 45,707 females with cancer was as follows: breast (ASIR (ASIR=36/100,000), cervical (ASIR=24/100,000), colorectal (ASIR=7/100,000), uterine (ASIR=6/100,000), and then both melanoma and NHL (ASIR=3/100,000). Melanoma ranked second in White females. Cervical cancer ranked top among Black females whereas breast cancer ranked top in White, Asian and Coloured female population groups. Oesophageal cancer and NHL ranked third and fifth in Black males and females respectively. Stomach cancer ranked fourth and fifth among Coloured and Asian males respectively. Uterine cancer ranked second among Asian females. There were more females than males diagnosed with cancer in those below 45 years old, with breast cancer and cervical cancer being diagnosed most. Cervical cancer was most common in the age group 30–44 years while breast cancer was most common among those above 50 years old. Prostate cancer was most common among 50-year-olds and above. Leukaemias and lymphomas were the most diagnosed cancers among children (0–14 years old). There were more boys than girls diagnosed with lymphomas and the reverse was true for cancers of the central nervous system. Conclusion: The disparities could be driven by socioeconomic factors, access to diagnostic services, healthcare provider/patient knowledge. There is need for more in-depth analysis of priority cancers by population group to inform priority settings for the NCSF, the National Health Insurance and cancer prevention and control programs for tailor-made interventions. Citation Format: Judith Mwansa-Kambafwile, Nkhensani Mhlanga, Ann Chao, Bilqees Sayed, Makandwe Nyirenda, Natasha Abraham, Mazvita Muchengeti. Beyond “Top Five Plus One” Cancers in South Africa: An Analysis of the 2022 Pathology-Based Registry Data [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 90.

Abstract Cancer remains a leading cause of morbidity globally, largely driven by modifiable risk factors. We provide estimates of the global and national cancer burden attributable to these factors, namely tobacco smoking, alcohol consumption, high body mass index (BMI), insufficient physical activity, smokeless tobacco and areca nut, suboptimal breastfeeding, air pollution, ultraviolet radiation (UVR), infections (due to nine agents), and occupational (due to 13 agents) exposures to inform prevention efforts. We estimated 2022 cancer cases attributable to 30 modifiable risk factors in 185 countries using GLOBOCAN data for 36 cancer sites. Risk factors were grouped as behavioural, environmental, infectious, or occupational, with prevalence data from around 2012 to reflect latency between exposure and cancer diagnosis. Population-attributable fractions (PAFs) were estimated using the Levin or Miettinen formulas, or derived directly from prevalence data where applicable, and adjusted for cancer subtypes when relevant. Combined PAFs accounting for overlapping exposures were derived by cancer, sex, country, and region. In 2022, an estimated 7.1 million of 18.7 million new cancer cases (37.8%) worldwide were attributable to 30 modifiable risk factors – 2.7 million (29.7%) in women and 4.3 million (45.4%) in men. The proportion of preventable cancers varied across regions and by sex, ranging from 24.6% of all new cancer cases in Northern Africa and Western Asia to 38.2% in sub-Saharan Africa for women and from 28.1% in Latin America &amp; the Caribbean to 57.2% in East Asia for men. Smoking, infections, and alcohol consumption were the leading contributors to cancer burden globally, accounting for 15.1%, 10.2%, and 3.2% of all new cancer cases, respectively. Lung, stomach, and cervical cancers showed the greatest potential for prevention, together representing nearly half of all preventable cancers. Reducing exposure to modifiable risk factors offers major opportunities for cancer prevention worldwide, underscoring the importance of tailored, evidence-based and gender-sensitive strategies across populations.

Abstract Background Socio-economic inequalities in breast cancer survival persist globally, including in the UK. Area-based deprivation measures may underestimate true socio-economic effects by assigning average levels to all individuals within an area. This study investigated associations between house value (individual-level socio-economic indicator) and area-based deprivation with breast cancer outcomes in Northern Ireland. Methods Women diagnosed with breast cancer 2011 to 2021 were identified using the Northern Ireland Cancer Registry. House value was determined from Valuation and Lands Agency property valuation data, and area-based deprivation was determined from the Northern Ireland Multiple Deprivation Measure. The primary outcome was breast cancer-specific mortality. Secondary outcomes included stage at diagnosis. Cox regression models calculated adjusted hazard ratios (HR) and (95%CIs) for cancer-specific mortality by house value category and separately for deprivation, adjusting for confounders. Results Among 12,766 women with breast cancer, associations were much more pronounced for house value than area-based deprivation. Women in the lowest house value category, compared to the highest value category, had a 60% increase in mortality (adjusted HR=1.60 95%CI 1.34, 1.92) and were more likely to be diagnosed with stage 4 disease (7.5% versus 4.1%; P&lt;0.001). Women living in the most versus least deprived areas had a 26% increase in mortality (adjusted HR=1.26 95%CI 1.08, 1.47) and were more likely to be diagnosed with stage 4 disease (5.9% vs 5.0%; P =0.157). Conclusion House value demonstrated stronger associations with breast cancer outcomes than area-level deprivation, suggesting it may serve as a more sensitive indicator for monitoring health inequalities in cancer. What is already known Lower socioeconomic status is associated with worse breast cancer survival in the UK and internationally. Area-based measures of deprivation are widely used in epidemiological research but have recognised limitations. What this study adds We observed socio-economic gradients for both late-stage at diagnosis and breast cancer survival for both house value and area-deprivation. However, associations were stronger for house value and effects persisted after adjustment for area deprivation. How this might affect research, policy and practice Our findings establish that publicly available property valuations provide a feasible and sensitive measure for monitoring socioeconomic health inequalities at the population level

Background:The use of antibiotic-loaded bone cement (ALBC) in primary total knee arthroplasty (TKA) is debated. Some argue that ALBC might only be justified in high-risk patients. This study assessed the effectiveness of ALBC vs. plain bone cement (PBC) in reducing risk of revision for periprosthetic joint infection (PJI) in TKA patients considered to have a high risk of infection.Methods:Cohort study of primary TKAs in 11 national or regional arthroplasty registries from 2010 to 2020. The 1-year risk of revision for PJI in TKAs with ALBC vs. PBC among patients with high American Society of Anesthesiologists (ASA) classification, body mass index (BMI), and/or diabetes was compared. Cumulative percent revision (1 minus Kaplan-Meier) based on 685,818 TKAs and Cox regression analyses (adjusted Hazard Rate Ratios [aHRRs]) were performed for TKAs with ALBC (reference) vs. PBC restricted to the following high-risk subgroups of patients: (1) ASA ≥3 (n = 335,612 vs. 35,997), (2) BMI ≥35 (n = 278,927 vs. 24,737), (3) ASA ≥3 and BMI ≥35 (n = 99,407 vs. 11,407), (4) diabetes (n = 38,341 vs. 21,838), and (5) ASA ≥3, BMI ≥35, and diabetes (n = 3,347 vs. 4,261). Advanced distributed meta-analyses were performed to combine all aggregate data and assess 1-year risk of revision for PJI.Results:Each registry reported a 1-year cumulative percent revision of ≤1.6% for PJI following TKAs both for ALBC and PBC in all high-risk subgroups. Similar 1-year risks of revision for PJI were found in TKAs with ALBC (reference) and PBC among patients with ASA ≥3 (aHRR: 1.09; 95% CI, 0.90-1.31); BMI ≥35 (1.06; 0.54-2.12); ASA ≥3 and BMI ≥35 (1.12; 0.83-1.50); diabetes (0.95; 0.74-1.20); and ASA ≥3, BMI ≥35, and diabetes (1.40; 0.86-2.29).Conclusions and Relevance:Similar 1-year revision risk of PJI was found for TKAs with ALBC vs. PBC in high-risk patients. Confirmation of the efficacy of ALBC in high-risk TKA patients needs to be evaluated in clinical trials.Level of Evidence:Level III. See Instructions for Authors for a complete description of levels of evidence.