Intro to HIT

Cassandra Booe
Disease Registry

The purpose of the article I chose was to evaluate the completeness, comparability and
diagnostic validity of Nigerias cancer registries. Many different methods and tools were used to
measure the effectiveness of the cancer registries such as, the childrens age-specific incidence
(ASI), registry questionnaires, percentages of death-certificate-only cases, morphologically
verified cases, and case registration errors to examine validity of the registries in comparability
and diagnostics. By using these methods, the effectiveness of Nigerias cancer registers was able
to be measured and evaluated which allowed for identification of areas of improvement.
Although Nigeria is working to improve the quality of its cancer registries, it has been
difficult due to economic, geographic, and other challenges. It is very important for Nigeria to
develop effective cancer registries because of the impact these registries have on characterizing
cancer epidemiology for the population. This study found that most Nigerian cancer registries are
identified as population-based and that Nigeria is actually unique to the rest of the continent
because cancer registries were begun there in 1960, soon after independence. As mentioned
earlier, Nigeria faces many challenges in developing cancer registries due to a weak health-sector
infrastructure and access, challenging geographies, inadequate case ascertainment in older
populations, insufficient diagnostic facilities, and poor collaboration among reporting sources.
With this being said however, it was found that Nigerias registration procedures are for the most
part comparable to each other as well as to international standards. While they were found to
have high rates of morphological verification and high diagnostic validity, there were still many
areas with issues in regards to incompleteness.
Because there were areas of incompleteness in the registries, it did cause for some of the
results to be skewed and their accuracy questioned. It was found that over half of all the cancers

Intro to HIT
Cassandra Booe
Disease Registry

in children were non-Hodgkin lymphoma, however there was also evidence of incompleteness in
this area. It was found that registries lacked potential evidence of cancer-specific cases due to an
inability to diagnose specific cancers. The one exception to this is that the study found high rates
of morphological verification of female breast, cervical and prostate cancers. The study did
reveal that while rates for male esophageal cancer and female breast cancer were comparable
with other registries in the region, rates for liver cancer in men and women were lower than those
of other registries in the region.
Since this study was able to determine areas of incompleteness in the Nigeria cancer
registry, it was also able to identify areas of improvement as well. One area of improvement is
that patient addresses need to be standardized to only the smallest census-based geographic unit
of residence in the year before seeking treatment. The study also revealed that regular reviews of
registry case-finding procedures would likely help to improve completeness. Another area that
the study identified as needing to be improved is the consistency of rules used in each registry.
One registry used SEER rules for multiple primaries, while the majority used rules from the
IARC. It was also found that few of the registries had special coding for autopsy-detected cases
or DCO cases.
This article provided a lot of great information and insight about cancer registries in
Nigeria. It is good to note that, although there are areas of incompleteness, Nigerian registries are
relatively comparable to each other as well as to international standards.

Intro to HIT
Cassandra Booe
Disease Registry

Resource:

Haddad, B., Jedy-Agba, E., Oga, E., Ezeome, E., Obiorah, C., Okobia, M., . . . Adebamowo, C.
(2015). Comparability, Diagnostic Validity and Completeness of Nigerian Cancer
Registries. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446152/