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高分辨率疾病图在资源匮乏环境下的癌症控制中的应用:乌干达坎帕拉宫颈癌发病率的空间分析。

High-resolution disease maps for cancer control in low-resource settings: A spatial analysis of cervical cancer incidence in Kampala, Uganda.

机构信息

Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Makerere University, Kampala, Uganda.

出版信息

J Glob Health. 2022 Apr 23;12:04032. doi: 10.7189/jogh.12.04032. eCollection 2022.

Abstract

BACKGROUND

The global burden of cervical cancer is concentrated in low-and middle-income countries (LMICs), with the greatest burden in Africa. Targeting limited resources to populations with the greatest need to maximize impact is essential. The objectives of this study were to geocode cervical cancer data from a population-based cancer registry in Kampala, Uganda, to create high-resolution disease maps for cervical cancer prevention and control planning, and to share lessons learned to optimize efforts in other low-resource settings.

METHODS

Kampala Cancer Registry records for cervical cancer diagnoses between 2008 and 2015 were updated to include geographies of residence at diagnosis. Population data by age and sex for 2014 was obtained from the Uganda Bureau of Statistics. Indirectly age-standardized incidence ratios were calculated for sub-counties and estimated continuously across the study area using parish level data.

RESULTS

Overall, among 1873 records, 89.6% included a valid sub-county and 89.2% included a valid parish name. Maps revealed specific areas of high cervical cancer incidence in the region, with significant variation within sub-counties, highlighting the importance of high-resolution spatial detail.

CONCLUSIONS

Population-based cancer registry data and geospatial mapping can be used in low-resource settings to support cancer prevention and control efforts, and to create the potential for research examining geographic factors that influence cancer outcomes. It is essential to support LMIC cancer registries to maximize the benefits from the use of limited cancer control resources.

摘要

背景

宫颈癌的全球负担集中在中低收入国家(LMICs),其中负担最重的是非洲。将有限的资源集中用于最需要的人群,以最大限度地发挥影响力,这一点至关重要。本研究的目的是对乌干达坎帕拉基于人群的癌症登记处的宫颈癌数据进行地理编码,为宫颈癌的预防和控制规划创建高分辨率疾病地图,并分享经验教训,以优化其他资源有限环境中的工作。

方法

对 2008 年至 2015 年间宫颈癌诊断的坎帕拉癌症登记处记录进行了更新,以纳入诊断时居住的地理位置。2014 年的年龄和性别人口数据从乌干达统计局获得。使用教区级数据,根据年龄对各分区进行间接年龄标准化发病率比计算,并在整个研究区域内进行连续估计。

结果

在总共 1873 份记录中,89.6%包含有效的分区,89.2%包含有效的教区名称。地图显示了该地区宫颈癌发病率高的特定区域,分区内存在显著差异,突出了高分辨率空间细节的重要性。

结论

在资源有限的环境中,可以使用基于人群的癌症登记处数据和地理空间制图来支持癌症的预防和控制工作,并为研究影响癌症结果的地理因素创造潜力。支持中低收入国家癌症登记处,最大限度地发挥有限癌症控制资源的效益至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c04/9022722/bf20a661993d/jogh-12-04032-F1.jpg

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