Cancer Surveillance in South Africa, Johannesburg International Airport
23 January 2006
Distinguished guests,
Members of Witwatersrand University Research Ethics Committee,
Members of University of Cape Town Research Ethics Committee
Members of the Medical Research Councilâs Working Group on Research
Ethics,
WHO and International Agency Research for Cancer Representatives
Members of Cancer Association of South Africa
Members of National Health Laboratory Service
Members of the Academia,
Ladies and Gentlemen
I hope you had a good festive season and you were able to regain the energy
that is needed to continue our endeavour to improve the health of South
Africans.
I would like to thank you for inviting me to this important meeting. I am
glad that you have convened this consultative session right at the beginning of
the year so that we can have adequate time to consult and to implement the
decisions that come out of this consultation.
As you know, cancer is major health challenge facing health systems in both
developing and developed countries. The World Health Organisation (WHO)
estimates that globally, more than 10 million people are diagnosed with cancer
every year and projects that if we do not make the necessary interventions,
these cases will increase to 15 million each year by the year 2020.
There is therefore a need to strengthen our surveillance systems and
research in this area to ensure that we fully understand the challenge facing
us and to inform the necessary policy interventions.
South Africa has the largest national cancer registry system in Africa and
is one of the world leaders in the research of cancer. Although registry in
South Africa provides valuable data for planning and for informing policy, the
data underestimate the magnitude of the prevalence of cancer, with probably
gross underreporting in the African population. We have been informed that the
Cancer Registry is experiencing special challenges with data that is currently
being collected.
It is common knowledge that in the previously disadvantaged communities of
South Africa, awareness about cancer is insufficient and there is lack of
information about the incidence and implications of cancer. This often results
in people from these communities seeking medical intervention when their cancer
is already at an advanced stage, making a successful outcome of treatment less
likely. This is also exacerbated by the fact that there is a disparity in the
provision of services for diagnosis and treatment between urban and rural, high
and lower income communities.
Population based cancer registries provide a comprehensive data collection
system from all possible cancer diagnosing facilities and are the standard
cancer data collectors that are recommended by the World Health
Organisation.
Cancer - a group of diseases characterised by the unrestrained growth of
cells - poses a lifetime risk to all South African men and women.
A total of 30 480 new cancer cases amongst women and 29 428 men were
reported in the National Cancer Registry in 1999, and these figures were
similar to the cases reported in 1998. Cancers of the prostate, lung,
oesophagus colorectal and bladder, in that order, were the five leading cancers
amongst men. Cancer of the breast, cervix, colorectal, oesophagus and uterus,
were the five leading cancers in females.
Although cancer is a condition of great public health concern, it is not a
notifiable or a reportable condition. As such, it becomes difficult to collect
data relating to the conditions for purposes of research to inform policy
interventions. There is therefore a need to discuss options to improve
reporting.
As we take this direction, we need be conscious of the fact that patients
have a right to consent to the collection, use and disclosure of, and access to
their health information. Health practitioners also have an obligation to
protect their patients and to maintain confidentiality. We also need to address
the challenges relating to the use of codes for patients that can be linked
with laboratories and the use of unique identification numbers as unique
identifiers in the health system
I hope that through this consultation, firm proposals and agreements will be
made on the use of data with laboratories as a medium term measure within the
limitation of the principles of privacy and confidentiality.
Consultation on this critical issue in our efforts to address the major
challenge of cancer in the country should not end today. We should strive to
get input of most stakeholders and ensure that we agree on an appropriate
approach as early as possible.
Programme Director, cancer will continue to become an increasingly
significant contributor to the burden of diseases if we do not intensify the
implementation of preventative interventions we have put in place. Many cancers
are preventable through avoiding tobacco use, eating healthy food and having
clean environment.
We have included these messages as main elements of our Healthy Lifestyle
Programme which we will be intensifying its implementation this year. Working
together with various partners, we want to ensure that our people:
* Eat nutritious food,
* They exercise regularly
* They do not smoke or abuse alcohol
* And that they adopt safe sexual behaviour
We have also put in place legislation and policies in an effort to reduce
cases of cancer. This includes the Tobacco Control Amendment Act, cervical
cancer screening programme and Hepatitis B immunisation. Effective
implementation of these programmes should have an impact in reducing cancers
associated with these factors.
We have to have to raise awareness amongst our people about how some of the
cancers can be prevented. We have to highlight the fact that early detection,
prompt treatment and effective monitoring are critical in the management of
cancer.
I would like to recognise the good work that is done by the National Cancer
Registry of South Africa in maintaining and developing national awareness of
the growing problem of cancer in the South African population. The government
has been supporting the Cancer Registry for many years and will continue to
work together with you and all other partners in addressing this challenge.
I wish all of us a fruitful discussion.
Issued by: Department of Health
23 January 2006
