Background and Context: The incidence of cancers in low and middle income countries (LMIC) is rising rapidly necessitating the need for improved cancer registration. Nigeria with about 20% of the population of Africa is a major contributor to the overall cancer burden in Africa. We therefore established the Nigerian National System of Cancer Registries (NSCR) to provide representative cancer registry coverage in Nigeria. We describe the implementation of this system, highlight the key challenges encountered in implementation and how these were overcome.
Aim: To improve cancer registration in Nigeria by creating a coordinating system that liaises with international partners to provide training, mentoring and capacity building for registries and collate data from registries to generate national statistics on cancer.
Strategy/Tactics: In 2009, The Nigerian Ministry of Health, Society of Oncology and Cancer Research of Nigeria and the Institute of Human Virology Nigeria conceptualized the NSCR to provide technical and scientific support that strengthens cancer registries, develops new registries and generates quality data on cancer incidence.
Programme/Policy Process:We trained 80 staff from 24 cancer registries over a period of 5 years. Training focused on the principles of cancer registration, use of CanReg 4 & 5 software, coding and classification, presentation of data and presentation of reports.
Outcomes/What was learned: We ensured that data from 3 Nigerian registries (Ibadan, Abuja and Calabar) were included in GLOBOCAN 2012; transitioned the Enugu Cancer registry to a population-based registry, and established a new PBCR in Sokoto, North-Western Nigeria.
Large population, limited health care infrastructure, poor vital statistics and funding are challenges to cancer registration. Nigerian laws and constitutional arrangements which put legislative responsibility for health care on the concurrent agenda of the government offer uniques challenges. A coordinating system that trains, monitors and provides support to registries is critical in countries with large populations like Nigeria.