Integrating Cancer And Other Disease Surveillance Systems: A Framework For Action

Marion PIŅEROS, International Agency for Research on Cancer, France
ZNAOR A. 1 , MERY L. 1 , BRAY F. 1

1 Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France

Purpose:
Given the growing burden of noncommunicable diseases (NCDs) including cancer, it is critical to understand the differing characteristics of the major disease forms and their surveillance, particularly in economically transitioning countries where NCDs have equalled or surpassed communicable diseases (CDs) as major public health problems. We compare approaches to the global surveillance of cancer, relative to CDs as well as other NCDs, proposing a framework to support integrating cancer into national disease surveillance systems.
Methods:
A comparison of the major features of the surveillance of cancer versus CDs and NCDs was performed. We propose a basic framework for cancer and NCDs surveillance at the global level and provide schema to ensure key requirements for cancer incidence surveillance are met.
Results:
There are communalities in the surveillance of the major diseases; a general framework for cancer surveillance – applicable to all NCDs – shares population status attributes (‘Healthy’, ‘New disease’, ‘Living with the disease’ and ‘Dying from the disease’) as well as basic outcome measures (risk factor prevalence, incidence, prevalence, survival, mortality). There are also inherent differences however, in the appropriate surveillance strategies that should be applied. While risk factor surveys are used widely in the surveillance of the main NCDs, population-based cancer registries (PBCR) play a unique, fundamental role, in the surveillance of cancer incidence. Implementation of PBCR requires clear definitions in order to provide reliable data; these are examined in detail.
Conclusions:
Although the surveillance of NCDs necessitates an approach that utilises a common framework, the strategies for implementation must be tailored to support complete integration across disease domains. PBCR are the only means to obtain cancer incidence for cancer control at the population level.