The role of a national cancer registry in effective implementation and monitoring of the Global Breast Cancer Initiative (GBCI) framework in Ghana: a narrative review.

Abstract

Background and objective: In 2023, the World Health Organization (WHO) launched the Global Breast Cancer Initiative (GBCI) framework to achieve a 2.5% reduction in annual breast cancer mortality through its three key performance indicators of early screening, timely breast diagnosis, and comprehensive treatment management. National cancer registries serve as a vital tool for implementing the GBCI framework, providing a robust mechanism to track progress, evaluate outcomes, and ensure accountability in its execution. The objective of this study was to evaluate the status of cancer registries in West Africa as a marker for the region's preparedness to implement the GBCI framework.

Methods: This narrative review searched for published literature in PubMed, international health and conference websites, and world population data sources using our search keywords to identify the status of cancer registries in West Africa. Published literature on Ghana's journey towards registry development was additionally utilized to develop a descriptive case analysis of the barriers and facilitators of registry development within the region.

Key content and findings: The only countries possessing a national registry in West Africa are Cape Verde and the Republic of Gambia. Benin, Burkina Faso, Cote d'Ivoire, Ghana, Guinea, Mali, Niger, and Nigeria possess sub-national registries, namely hospital-based and population-based registries with minimal catchment areas. In Ghana, the Kumasi Cancer Registry represents the country's only population-based registry. Partnerships with international organizations and participation in regional capacity building efforts have facilitated its maintenance of operations in cancer continuous data collection. Despite this, barriers to its expansion have included limited funding, challenges with data linkage across data collection sites, and a lack of an automatized electronic data collection system for cancer cases.

Conclusions: Implementation of the GBCI framework crucially depends on routinely collected cancer data covering a country's entire population, highlighting the importance of national cancer registries. To date, all countries in West Africa, except two, lack national cancer registries and face barriers to implementation, including limited mortality data access, low funds, and difficulties with data linkage, as highlighted by the case study of Ghana. Future work should be dedicated towards (I) automatizing and standardizing the data collection systems among sub-national registries and (II) pursuing structured regional capacity-building training on robust cancer registration practices within West Africa.