Brazil''Canada'Cancer' Surveillance'Collabora3ve' - - PowerPoint PPT Presentation

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Brazil''Canada'Cancer' Surveillance'Collabora3ve' - - PowerPoint PPT Presentation

Mar 01, 2023 370 likes •580 views

Brazil''Canada'Cancer' Surveillance'Collabora3ve' Where'Sand'Meets'Snow:'' Mutual'Learning's'Across'Con3nents*' ' *'L.Mery'and'M.'Rebelo'on'behalf'of'the'' Brazil''Canada'Cancer'Collabora3ve' ' 29'August'2012' UICC'Congress'

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SLIDE 1

Brazil'–'Canada'Cancer' Surveillance'Collabora3ve'

Where'Sand'Meets'Snow:'' Mutual'Learning's'Across'Con3nents*' '

*'L.Mery'and'M.'Rebelo'on'behalf'of'the'' Brazil'–'Canada'Cancer'Collabora3ve' ' 29'August'2012' UICC'Congress'

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SLIDE 2

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 2%

Outline'

  • Context%
  • Context%
  • Brazil%and%Canadian%Cancer%Registry%Systems%
  • Objec>ves%for%the%Collabora>on%%
  • Results%to%date:%%
  • Selected%Areas%of%Common%Issues%
  • Standards;%Capacity;%and%Integra>on;%%
  • Unique%Country%Perspec>ves%%
  • pera>ons%
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SLIDE 3

Context:%Cancer%Registry%Systems%

Brazil ''

  • Origins%with%local%registries%
  • Origins%with%local%registries%

(1960s),%evolving%to%a%strategy% for%na>onal%coordina>on%by% INCA%(1970%–%1980s)%

  • Na>onal%incidence%and%

mortality%es>mates%(1990s)% were%set%as%a%goal%to%plan% were%set%as%a%goal%to%plan% na>onal%and%state%level% ac>ons,%leading%to%the% forma>on%of%the%Registry% forma>on%of%the%Registry% Associa>on% Associa>on% cancer%registry%(PCBR%/%HBCR)% across%private%/%public%systems% with%varying%completeness%% with%varying%completeness%%

  • Efforts%focused%on%linkage%and%
  • Efforts%focused%on%linkage%and%

Canada'

  • Origins%with%provincial%registries%
  • Origins%with%provincial%registries%

(1935):%legislated%responsibility% yielding%popula>on%coverage%%%

  • Na>onal,%collated%by%Sta>s>cs%

Canada:%tumour%based,% 1969[1991;%person%based,% 1992+%

  • Common%standards;%comprised%
  • f%many%sources%and%derived%

from%mul>ple%methods%that%are% individual%to%each%province%/% territory%

  • Distributed%accountability%
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SLIDE 4

Source: INCA/Conprev/ Cancrer Information Division

State-of-the art of Brazilian Population-Based Cancer Registries ( PBCR )

The background of Brazilian PBCR 60’s ..... 2 70’s ..... 2 80’s ..... 2 90’s ..... 9* After 2000 ..... 15

Current situation: from 32 PBCR implemented, 27 are active 19 in capital cities 1 federal capital 6 cities are not capital

1 state cancer registry (State of

Roraima) 22 PBCR with available information (19 with more than 3 years)

Cancer information in Brazil: current performance

Porto Alegre - 1973 Curitiba - 1997 São Paulo - 1969 Goiania 1986 Salvador - 1996 Natal - 1996 Fortaleza - 1971 Belém - 1987 Vitoria – 1999** Campinas - 1991 Aracaju - 1998 Distrito Federal - 1996 Joao Pessoa Manaus Palmas Teresina** Belo Horizonte Campo Grande Cuiaba Florianopolis** Jau - 2005 Caxias do Sul - 2005 Santa Rosa - 2005 Recife - 1967 Boa Vista Barretos

* * * * * * * * * * * * * *

*

* * * * * * * * * * * *

Santos

21 PBCR receive government financial support with resources from Health Surveillance Secretariat (SVS) US$ 500,000 by year ( the resources are distributed in according by PBCR population size)

On implantion process( ): Barretos, Santos, Boa Vista

*

On implantion process( ): Barretos, Santos, Boa Vista

*

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SLIDE 5

Web system, free, multi-platform, flexible, easily maintained and developed with free software - * for consolidation of data from HBCR * HBCR data exported will go encrypted to ensure the integrity and confidentiality and confidentiality

Source: INCA/Conprev/ Division of Cancer Information

SisBasepop Web SisBasepop Web

Technical Reports

State A State B

Data from Hospital Based Cancer Registries

P B C R P B C R

HBCRBrasil

P B C R H B C R

HBCRBrasil HBCRBrasil

*%30[70%%%from%HBCR%databases%are% transferred%automa>cally%to%PBCR%system%%

HBCRBRAZIL: national centralized

database for HBCRs

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SLIDE 6

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 6%

Cancer'Registry'Process'in'Canada'

…..

Level%

Hospital%%/% laboratory% Provincial%%/%Territorial%% Cancer%Registries% Na>onal:%% Sta>s>cs%Canada%%

The%Canadian%Cancer%Registry%

Iden>fica>on%

  • f%new%cases%

Ac>vity%

Record%% consolida>on%% +%diagnos>c% %confirma>on%% Record%% consolida>on%% +%mortality%% follow[up%

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SLIDE 7

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 7%

Objec>ves%for%the%%Collabora>on%

1. To%share%knowledge%and%approaches%in%cancer%registra>on%and%surveillance%

  • To%establish%partnerships%to%promote%epidemiological%studies%based%on%informa>on%produced%

by%cancer%registries%

2. To%assess%cancer%registry%programs%(including%%hospital,%regional%and%na>onal)% in%order%to%provide%recommenda>ons%for%future%enhancements;%%%%

  • To%examine%jointly%the%feasibility%of%assistance%that%would%facilitate%the%linkage%the%cancer%

registries%database%with%others%health%databases%

  • To%develop%and%strengthen%HBCR%and%PBCR%structure%to%ensure%regular%collec>on%for%follow[up%

data%to%perform%survival%studies%%

3. To%iden>fy,%priori>ze%and%implement%specific%areas%for%joint%collabora>on%

  • To%promote%a%workshop%in%Brazil%with%PBCR%and%representa>ves%of%the%State%Coordina>on%of%

HBCR%to%integrate%INCA’s%and%Canada%Teams;%

  • To%establish%priori>es%based%on%Brazilian%burden%of%cancer,%resource%availability%and%health%

system%capacity%for%cancer%preven>on%and%control%%

4. To%foster%opportuni>es%for%training%through%workshops,%mentorship%and% educa>onal%exchanges%

  • %To%establish%partnerships%in%training%on%cancer%informa>on%for%cancer%registries%
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SLIDE 8

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 8%

Results:%Common%Issues%

  • 1. Applica3on'of'Standards'

Applica3on'of'Standards'

(IARC)%forms%the%founda>on%in%coding,%training%

  • The%Interna>onal%Agency%for%Research%on%Cancer%

(IARC)%forms%the%founda>on%in%coding,%training% material%and%analy>c%tools%

  • Benefits%of%na>onal%leadership%to%regions%
  • Interoperability%among%electronic%systems%
  • Necessity%is%well%understood%but%involves%many%

stakeholders:%governments;%hospitals;%vendors;%…%

  • Capturing%the%benefit%of%new%technologies%to%increase%

efficiency%

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SLIDE 9

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 9%

Results:%Common%Issues%–%con’t Results:%Common%Issues%–%

  • 2. Capacity'

Capacity'

ascertainment%and%repor>ng%

  • Challenges%in%mee>ng%the%demands%of%case%

ascertainment%and%repor>ng%

  • Increasing%focus%on%new%clinical%elements,%requiring%

new%data%fields%that%can%stretch%resources%

  • Analy>c%support%ohen%secondary%to%data%collec>on%
  • Training%and%staff%reten>on%
  • How%to%meet%the%needs?%Tools%to%assist%and%models%of%

delivery%across%large%geographic%countries%%%%

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SLIDE 10

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 10%

Results:%Common%Issues%–%con’t Results:%Common%Issues%–%

  • 3. The'Integra3on'of'Surveillance'within'

broader'cancer'control'community'

  • Demonstra>ng%and%explaining%the%poten>al%u>lity%
  • f%surveillance%to%other%disciplines%
  • How%to%develop%the%requisite%rela>onships?%
  • Requirements%for%new%skill%sets%to%achieve%

paradigm%shih%

  • Incorpora>on%of%knowledge%transla>on%to%
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SLIDE 11

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 11%

Country%Perspec>ves%

  • 1. Case'Ascertainment'and'Consolida3on''
  • Brazil%faces%a%significant%challenge%to%integrate%

hospital%with%popula>on%based%cancer%registries% (HBCRs%and%PBCRs,%respec>vely)%

  • Issue%is%complex%and%results%in%part%from:%funding%models;%

health%care%delivery%systems%(combined%private%and% public);%and%lack%of%consistent%unique%iden>fiers%

  • Popula>on%coverage%varies%across%two%countries%
  • Ranging%from%21%%to%near%complete%coverage%%
  • Differing%approaches%(and%results)%to%case%follow[up%

and%death%clearance%

  • Highly%dependent%on%vital%sta>s>cs%records%and%record%

linkage%

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SLIDE 12

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 12%

Country%Perspec>ves%–%con’t%(2)%

  • 2. Cancer'Burden''

%

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SLIDE 13

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 13%

Country%Perspec>ves%–%con’t%(3)%

% % %

Brazil:%%

Source:%Ferlay%J,%Shin%HR,%Bray%F,%Forman%D,%Mathers%C%and%Parkin%DM.%

GLOBOCAN%2008%v1.2,%Cancer%Incidence%and%Mortality%Worldwide:%IARC%CancerBase%No.%10%[Internet].% Lyon,%France:%Interna>onal%Agency%for%Research%on%Cancer;%2010.%Available%from:%hpp://globocan.iarc.fr,%accessed%on%24%August%2012%

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SLIDE 14

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 14%

Country%Perspec>ves%–%con’t Country%Perspec>ves%–%

% % %

Canada:%%

Source:%Ferlay Source:%Ferlay%J,%Shin%HR,%Bray%F,%Forman%D,%Mathers%C%and%

Parkin%DM.% GLOBOCAN%2008%v1.2,%Cancer%Incidence%and%Mortality%Worldwide:%IARC% CancerBase %No.%10%[Internet].%

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SLIDE 15

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 15%

Country%Perspec>ves%–%con’t%(4)%

  • 3. Other:'
  • Canada’s%reliance%on%US%registry%efforts,%

especially%in%standard%development%

  • Funding%models%for%remunera>on%of%data%

collec>on%(does%not%exists%in%Canada)%and%their% impact%on%overall%governance%of%registry%system%

  • Brazil’s%crea>vity%in%the%delivery%of%training%and%

adop>on%of%standard%reference%material%

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SLIDE 16

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 16%

Opportuni>es%

  • 1. Examina3on'of'common'cancers,'especially'
  • Poten>al%to%inform%planning%prac>ces%through%

cervical'and'breast'

analyses%of%current%and%projected%trends%

  • Poten>al%to%inform%planning%prac>ces%through%

analyses%of%current%and%projected%trends%

  • Imbeds%a%prac>cal%issue%to%further%pursue%
  • bjec>ves%of%the%collabora>ve%
  • Training%/%twining%%
  • Metrics%to%beper%capture%issues%arising%from%PBCR%and%

HPCR%integra>on%

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SLIDE 17

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 17%

Opportuni>es%–%con’t Opportuni>es%–%

2. 2. Ini3a3ve'for'Cancer'Registry'Development''

  • Current%effort%by%IARC%to%support%the%

development%of%cancer%registries%in%low[%and% middle[income%countries%

  • Model%based%on%regional%hub%approach%%
  • Incorporates%many%of%same%objec>ves%of%the%

Collabora>ve%within%a%wider%context%

  • Poten>al%access%to%addi>onal%training%resources%(ie

.% workshops,%webinars%and%electronic%tools)%

  • Wider%network%from%which%to%seek%consulta>on%and%
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SLIDE 18

UICC,%Montreal,%August%2012%%% Brazil%–%Canada%Cancer%Surveillance%Collabora>ve% 18%

Summary'

  • Brazil%–%Canada%cancer%surveillance%based%on%

mutual%benefit%to%both%countries%

  • Despite%short%>me%frame,%this%has%occurred%
  • Results%to%date%have%iden>fied%common%issues%

(standards,%capacity%and%integra>on)%in%addi>on% to%unique%perspec>ves%(cases%ascertainment%and% cancer%burden)%

  • Opportuni>es%in:%joint%analysis%of%screened%

cancers;%specific%methods;%and%IARC%Global% Ini>a>ve%%%%

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SLIDE 19

Collaborators%%

Brazil' Esteves%da%Costa% Esteves%da%Costa% Claudio%Pompeiano%Noronha% Claudio%Pompeiano%Noronha% Marise%Souto%Rebelo% Paulo%Rebelo% Luiz%Antônio%San>ni% Marceli%de%Oliveria%Santos% % Canada'' Kim% Kim%Elmslie % Derrick%Jolicoeur % Maureen%McIntyre% Les%Mery % Howard%Morrison% Louise%Pelle>er% Dawne%Rennie % Simon%Sutcliffe% %

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SLIDE 20

Thank%You!%

Contact: %Les%Mery% %Public%Health%Agency%of%Canada% %les.mery@phac[aspc.gc.ca% %+1%%613.%957.%8926%