A Registry-Based Analysis of Incidence, Stage at Presentation and Treatment of Cancers in Accra, Ghana

Background Cancer incidence is increasing more rapidly in low- and middle-income countries including Ghana. Country estimates of incidence is based on extrapolation of data from limited number of sites with population-based registries. We established a population-based cancer registry to determine the incidence of various cancers in a Ghanaian subsite to facilitate inclusion of such data in the country profile for cancer. Treatment received and stage of cancer at presentation were determined. Methods The jurisdiction to capture data from and its population pyramid were defined using existing boundaries according to districts in the Greater Accra Region of Ghana. New cases of cancer presenting between September 2016 and August 2017 were manually derived from all hospitals that managed cancer, death registry, pathology laboratories, and postmortem records with related epidemiological data. Patients must have lived in the Region for at least six months. The information was captured on an abstraction form which included stage and treatment received and was analyzed using Canreg5 software. Known risk factor profile of the common cancers identified were examined. Comparison was made with available cancer statistics in the country. Results One thousand and thirty-nine cases were analyzed. The Age Standardized Rates per 100,000 were determined to be 28.4, 24.6, 7.0, 6.9,6.0, 3.8, 3.2, 3.2, 2.5 and 2.5 for breast, prostate, colorectal, cervical, uterine, stomach, lymphomas, liver, and mouth and pharynx cancers respectively. Forty percent of all cancers presented with stage three disease. Among breast cancer patients only 5% presented with stage I disease, whilst 8% presented with metastatic disease. Twenty-one patients received at least two treatment modalities of Surgery, Radiotherapy and Systemic treatment in different combinations. Conclusions Age Standardized Rates vary across the country. A high proportion of patients present with advanced disease. Almost all breast cancer patients present with symptomatic disease. Mutidisciplinary oncological care requires intensification in the Region.