OnCo
ideasIdea

Make a population cancer registry a condition of every cancer aid programme

You cannot fix what you cannot count. Every donor-funded cancer programme should fund and require a population-based cancer registry so results can be measured over time.

Fewer than one in five people in Africa are covered by a high-quality population-based cancer registry, so GLOBOCAN estimates for many countries are extrapolations. Registries are cheap relative to treatment programmes and are the only way to see stage shift, survival, and coverage. The proposal is a coordinated donor policy: a fixed percentage of every cancer grant supports a registry meeting IARC Global Initiative for Cancer Registry Development standards, with data deposited in the Global Cancer Observatory.

Hypothesis
Countries where registry funding is bundled with cancer programmes will reach high-quality registry coverage of at least 30% of their population within five years, against under 10% for comparators.
Rationale
IARC's GICR hubs have shown that modest, sustained support produces usable registries; the missing piece is consistent funding rather than method.
What would test it
Track registry coverage, data quality indicators, and inclusion in Cancer Incidence in Five Continents for countries under the policy versus those outside it.
Maturity
speculative
Who has to act
philanthropy
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks
  • Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
  • Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
  • Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.

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