Epidemiology of Cancer in Patients Seeking Palliative Care in Nyeri Hospice, Nyeri County-Kenya, 2011-2012 - PowerPoint PPT Presentation


Title: Epidemiology of Cancer in Patients Seeking Palliative Care in Nyeri Hospice, Nyeri County-Kenya, 2011-2012


1
Epidemiology of Cancer in Patients Seeking
Palliative Care in Nyeri Hospice, Nyeri
County-Kenya, 2011-2012
  • Dr Nelson Muriu
  • Kenya Field Epidemiology and
  • Laboratory Training Program (KFELTP)
  • 18th November 2013

2
Global Burden of Cancer
  • A Leading cause of morbidity and mortality
    worldwide
  • Annual incidence estimated at 10 million
  • Accounted for 7.9 million deaths in 2009
  • gt 70 of all cancer deaths occur in low and
    middle-income countries
  • By 2030, cases and deaths will increase by 69
    and 72 respectively

3
Cancer in Kenya
  • Ranked 3rd leading cause of death
  • Causes 7 of total national mortality every year
  • Annual incidence 28,000 cases
  • Annual mortality gt22,000
  • Only two population-based registries exist
    (regional)
  • National cancer control strategy (2011-2016)
    developed
  • Strengthen cancer prevention and control in
    various sectors
  • Investment in cancer awareness, human resource,
    equipments, surveillance and research

4
Justification
  • Comprehensive data on the burden and trends of
    cancer lacking in most sub Saharan Africa
  • Data on cancer in Kenya are limited yet research
    is a key pillar in the national cancer control
    strategy
  • No similar studies have been published in Central
    Kenya

5
Objectives
  • To determine the various types of cancers in
    patients attending Nyeri Hospice in Central Kenya
  • To characterize the cases in time, place and
    person

6
Study Site
  • Nyeri hospice, Nyeri county, Central-Kenya
  • Started in 1995
  • Caters for cancer patients
  • Offers pain relief and treatment of opportunistic
    infections

7
Study Design
  • Retrospective descriptive study
  • We reviewed patients files and registers for a
    two year period
  • New cancer cases registered between Jan 2011 and
    Dec 2012 were identified and extracted
  • Study population Cancer patients attending
    Nyeri hospice for palliative care
  • Case definition A reported diagnosis of cancer
    at any age admitted to Nyeri hospice between Jan
    2011 and Dec 2012 for palliative care

8
Data Management
  • Data collection
  • Socio-demographic and cancer data were
    abstracted from registers and files using a
    standardized form
  • Data entry and cleaning
  • Epi info version 3.5.4 software and Ms Excel
    2007 used
  • Data analysis
  • Means ,medians, proportions and frequencies
    calculated for categorical and continuous
    variables

9
Records Review
RESULTS
Socio-Demographics
  • Females were 270(60)
  • Married -260(63)
  • Majority of the patients 335 (83) resided within
    the county

10
Leading Cancers as Registered by Nyeri Hospice,
2011-2012(N452)
Type of cancer n() Cases
Breast 56(21)
Prostate 32(17)
Cervix 46(17)
Oesophagus 73(16)
Stomach 41(9)
Liver 39(9)
Rectum 21(5)
Pancreas 19(4)
Ovary 13(3)
Others 112(24)
11
Distribution of Leading Cancers in Nyeri Hospice
by Sex, 2011-2012(N452)
12
Distribution of Cancer Cases by Age in Nyeri
Hospice, 2011-2012 (n448)
Median age of the patients-62 (Range 9-99)
13
Clinical Characteristics of Cancer Cases in Nyeri
Hospice, 2011-2012
  • Median duration from diagnosis to death-95
    days(range8-2615, IQR 165)
  • Median duration from admission to death -44
    days(range0-530 ,IQR 76)
  • Forty-nine percent(223) of the cancer cases had
    evidence of pathological diagnosis
  • Median duration from first complaint to
    diagnosis-810 days(range25-3463,IQR-482)

14
Referral Methods of Cancer Patients to Nyeri
Hospice, 2011-2012(N452)
15
Distribution of Cancer Cases by Outcome in Nyeri
Hospice ,2011-2012
16
Annual Distribution of Cancer Deaths in Nyeri
Hospice, 2011-2012(n352)
17
Discussion
  • Cancer are an important public health problem in
    this region
  • Breast and cervical cancer main cancers in women
  • The study showed low levels of pathological
    diagnosis(fifty-percent)
  • Inadequate diagnosing capacity
  • Lung cancer was not among the top ten cancers
  • Potential deficiencies in diagnosis

18
Recommendations
Conclusion
  • Oesophagus, stomach and prostate were the
    leading cancers in men.
  • Commonest cancers among females were breast,
    cervix and oesophagus
  • Short median duration from diagnosis to death (95
    days) indicates late diagnosis
  • Scaling up of cancer screening programs to
    enhance early diagnosis
  • Improve on recording at the hospice to guarantee
    data quality
  • Public awareness on cancer prevention control
  • Strengthened diagnosing capacity
  • Further epidemiological studies in cancer
    prevention and control

19
Acknowledgements
  • Nyeri Hospice CEO and staff
  • Kenya field epidemiology and laboratory Training
    program
  • Dr J. Kibachio-(Medical Epidemiologist-DNCD)
  • County Health Management Team
  • AFENET

20
  • THANK YOU
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Epidemiology of Cancer in Patients Seeking Palliative Care in Nyeri Hospice, Nyeri County-Kenya, 2011-2012

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Title: Epidemiology of Cancer in Patients Seeking Palliative Care in Nyeri Hospice, Nyeri County-Kenya, 2011-2012


1
Epidemiology of Cancer in Patients Seeking
Palliative Care in Nyeri Hospice, Nyeri
County-Kenya, 2011-2012
  • Dr Nelson Muriu
  • Kenya Field Epidemiology and
  • Laboratory Training Program (KFELTP)
  • 18th November 2013

2
Global Burden of Cancer
  • A Leading cause of morbidity and mortality
    worldwide
  • Annual incidence estimated at 10 million
  • Accounted for 7.9 million deaths in 2009
  • gt 70 of all cancer deaths occur in low and
    middle-income countries
  • By 2030, cases and deaths will increase by 69
    and 72 respectively

3
Cancer in Kenya
  • Ranked 3rd leading cause of death
  • Causes 7 of total national mortality every year
  • Annual incidence 28,000 cases
  • Annual mortality gt22,000
  • Only two population-based registries exist
    (regional)
  • National cancer control strategy (2011-2016)
    developed
  • Strengthen cancer prevention and control in
    various sectors
  • Investment in cancer awareness, human resource,
    equipments, surveillance and research

4
Justification
  • Comprehensive data on the burden and trends of
    cancer lacking in most sub Saharan Africa
  • Data on cancer in Kenya are limited yet research
    is a key pillar in the national cancer control
    strategy
  • No similar studies have been published in Central
    Kenya

5
Objectives
  • To determine the various types of cancers in
    patients attending Nyeri Hospice in Central Kenya
  • To characterize the cases in time, place and
    person

6
Study Site
  • Nyeri hospice, Nyeri county, Central-Kenya
  • Started in 1995
  • Caters for cancer patients
  • Offers pain relief and treatment of opportunistic
    infections

7
Study Design
  • Retrospective descriptive study
  • We reviewed patients files and registers for a
    two year period
  • New cancer cases registered between Jan 2011 and
    Dec 2012 were identified and extracted
  • Study population Cancer patients attending
    Nyeri hospice for palliative care
  • Case definition A reported diagnosis of cancer
    at any age admitted to Nyeri hospice between Jan
    2011 and Dec 2012 for palliative care

8
Data Management
  • Data collection
  • Socio-demographic and cancer data were
    abstracted from registers and files using a
    standardized form
  • Data entry and cleaning
  • Epi info version 3.5.4 software and Ms Excel
    2007 used
  • Data analysis
  • Means ,medians, proportions and frequencies
    calculated for categorical and continuous
    variables

9
Records Review
RESULTS
Socio-Demographics
  • Females were 270(60)
  • Married -260(63)
  • Majority of the patients 335 (83) resided within
    the county

10
Leading Cancers as Registered by Nyeri Hospice,
2011-2012(N452)
Type of cancer n() Cases
Breast 56(21)
Prostate 32(17)
Cervix 46(17)
Oesophagus 73(16)
Stomach 41(9)
Liver 39(9)
Rectum 21(5)
Pancreas 19(4)
Ovary 13(3)
Others 112(24)
11
Distribution of Leading Cancers in Nyeri Hospice
by Sex, 2011-2012(N452)
12
Distribution of Cancer Cases by Age in Nyeri
Hospice, 2011-2012 (n448)
Median age of the patients-62 (Range 9-99)
13
Clinical Characteristics of Cancer Cases in Nyeri
Hospice, 2011-2012
  • Median duration from diagnosis to death-95
    days(range8-2615, IQR 165)
  • Median duration from admission to death -44
    days(range0-530 ,IQR 76)
  • Forty-nine percent(223) of the cancer cases had
    evidence of pathological diagnosis
  • Median duration from first complaint to
    diagnosis-810 days(range25-3463,IQR-482)

14
Referral Methods of Cancer Patients to Nyeri
Hospice, 2011-2012(N452)
15
Distribution of Cancer Cases by Outcome in Nyeri
Hospice ,2011-2012
16
Annual Distribution of Cancer Deaths in Nyeri
Hospice, 2011-2012(n352)
17
Discussion
  • Cancer are an important public health problem in
    this region
  • Breast and cervical cancer main cancers in women
  • The study showed low levels of pathological
    diagnosis(fifty-percent)
  • Inadequate diagnosing capacity
  • Lung cancer was not among the top ten cancers
  • Potential deficiencies in diagnosis

18
Recommendations
Conclusion
  • Oesophagus, stomach and prostate were the
    leading cancers in men.
  • Commonest cancers among females were breast,
    cervix and oesophagus
  • Short median duration from diagnosis to death (95
    days) indicates late diagnosis
  • Scaling up of cancer screening programs to
    enhance early diagnosis
  • Improve on recording at the hospice to guarantee
    data quality
  • Public awareness on cancer prevention control
  • Strengthened diagnosing capacity
  • Further epidemiological studies in cancer
    prevention and control

19
Acknowledgements
  • Nyeri Hospice CEO and staff
  • Kenya field epidemiology and laboratory Training
    program
  • Dr J. Kibachio-(Medical Epidemiologist-DNCD)
  • County Health Management Team
  • AFENET

20
  • THANK YOU
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