Resource Requirements For Cancer Registration: Comparative Cost Data From Five Countries

Sujha SUBRAMANIAN, Research Triangle Institute International, United States
TANGKA F. 1 , SUBRAMANIAN S. 2 , EDWARDS P. 2 , COLE-BEEBE M. 2 , HOOVER S. 2 , JOSEPH R. 1

1 Office of International Cancer Control, CDC
2 Research Triangle Institue

Purpose: High quality population-based cancer registry data are critical for implementing cancer control policies. Data on the resources needed to support cancer registration are essential for increasing global capacity in cancer surveillance and control. The aims of this study are to (1) Engage global stakeholders to identify and quantify the resources needed to strengthen and expand existing registries or establish new registries where none exist to support the collection of high quality cancer data; and (2) Share estimates of the costs for establishing and maintaining cancer registries with stakeholders to guide policies and facilitate planning.
 
Methods: A tool was developed to collect activity-based cost data from cancer registries.  Working with registry staff and in-country consultants, training webinars were conducted. Cost and resource use data were collected from 12 registries in India, Kenya, Uganda, Barbados and Colombia.  All monetary and non-monetary contributions to registry activities were collected for a comprehensive assessment.
 
Results: Host institution contributions provide valuable support for registry activities and account for 42% to 79% of registry operating expenditures.  The largest budget component incurred by cancer registries is labor costs and this contributes to over half the total cost.  The cost per case for registries in low income and lower middle income countries ranged from $2.47 to $32.76.  Registries that were largely supported by research activities incurred higher costs than the more established long-standing registries.
 
Conclusions: Based on our preliminary assessment, the collection of information on the cost of operating cancer registries in LMICs is feasible. Some of the approaches to reduce the cost of operating population-based registries are to partner with universities and hospitals as infrastructure and other high fixed cost expenditures can be shared or donated, and to streamline data collection activities to reduce labor cost (e.g. travel to data sources and time spent accessing medical records).