Prostate Cancer Patterns and Trends in the Eastern Cape Province of South Africa; 1998-2017.

Background: Globally, prostate cancer is rated the second most common cancer and the sixth leading cause of death. In South Africa, it is ranked as leading cancer among men. This study describes prostate cancer patterns and trends in the rural Eastern Cape Province population. Methodology: Secondary data were used from which a sample of 723 prostate cancer (C61) patients was extracted from the database into STATA version 14.0 for descriptive analysis. A direct standardization method was used to estimate age-specific and age-standardized incidence rates. Keyfitz method was used to calculate the standard error and confidence interval, whereas the Joinpoint program the annual percentage change. Results: The mean age was 64 years, with a standard deviation of 9.9. Trends in prostate cancer incidence increased significantly (p = 0.026) from 7.4% in 2010 to 12.6% in 2017. Incidence rates varied across the region, with the lowest of 4.5 per 100,000 in 1998 to the highest of 21.4 per 100,000 in 2017 period. Lusikisiki had the highest incidence rates of 53.4 per 100,000 population (95% CI 0.8-61.4), while Centane with 21.7 per 100,000 (95% CI 2.3-27.6) rated the second. Other magisterial areas showed a constant increase (p > 0.05) throughout the observation period except for Idutywa and Willowvale, with no apparent increase. Conversely, in Butterworth, incidence rates decreased from 15.2 per 100 000 (95% CI 8.6-21.9) to 11.5 per 100,000 (95% CI 6.2-16.7). Conclusion: As experienced globally and regionally, prostate cancer has become a public health concern in this population. Incidence variations across the surveillance area in the Eastern Cape were noted with hotspots.

Active case-finding method improves completeness and accuracy of data reported to the rural Eastern Cape Cancer Registry in South Africa.

The quality and accuracy of the data provided by cancer registries has a significant impact on decision making. Over decades, high-income countries have been successful in monitoring their cancer burden because of well-established data abstraction techniques such as digital systems. Conversely, in low- and middle-income countries, sparsely distributed cancer registries, using alternative less costly, but imprecise methods are struggling to capture all cancer cases. A population-based cancer registry in South Africa covering a resource-limited rural population is faced with challenges in case finding yet the quality and accuracy of the data provided has a significant impact on decision making. The objective of this study was to assess data quality using two data quality attributes 'completeness and accuracy' and also to determine the benefits of using active and passive case-finding methods for cancer registration in this population. Data used were collected between January 2014 and December 2015 from four hospitals to compare the quality of both active and passive case-finding methods. From all four hospitals during the same period, a first set of data obtained through passive reporting was compared with a second set of data obtained through active case finding. Covering multiple facilities during active case finding can significantly improve quality of data, while passive case finding is challenged by data collection being confined to one specific health facility, only. Better investment in active case finding is recommended in settings with resource-distribution disparities.