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RESEARCH AND DEVELOPMENT

37 CANCER CONTROL 2021

their policy initiatives.

Such evidence can come from "high-resolution" studies,

in which detailed clinical data that are not systematically

captured at cancer registration are obtained directly from

the medical records, such as the stage of disease at diagnosis,

the investigations carried out to identify the stage of disease,

and the types of treatment provided for each patient. Analysis

of these data can show the extent to which international

differences in survival are likely to be due to differences in

stage at diagnosis or, for example, to under-treatment in the

elderly.

High-resolution studies can thus identify the key drivers of

inequalities in cancer survival.

VENUSCANCER will be a particularly important highresolution study,

because it is both population-based and

worldwide. It will provide details of the biological and

molecular characteristics of tumours in all women diagnosed

with cancer of the breast, ovary or cervix in a given country or

region, and on patterns of care, as well as short- and mediumterm survival, in over

40 countries.

Analysis of the VENUSCANCER data will highlight the

strengths and weaknesses of the health system in providing

care for all women diagnosed with one of these three common

cancers in each country.

Trends over time in the number of avoidable premature

deaths among cancer patients will offer a powerful contrast

with outcomes in better-performing health systems in

neighbouring countries. They stimulate policymakers to

plan more appropriate cancer control strategies. Avoidable

premature deaths are a powerful

way to express inequalities in

survival as a single number that

is suitable for policymakers:

"Politicians do not like to do things

that are too difficult. Simple,

clear messages are important"

(Baroness Delyth Morgan, Breast

Cancer Now).

Even in the twenty-first century,

safe and effective surgery is not

yet available in many countries

in the world. In some countries,

radiotherapy may be considered

a luxury, or may simply be

unavailable (4). Examination of

recent trends in cancer survival,

and in the number of avoidable

premature deaths, in the light of

the distribution of patterns of care,

will contribute key evidence for

widest possible geographic scope (option 1). Nevertheless,

we will also perform parallel analyses by tumour sub-type for

those registries that can provide data on biomarkers (option 2),

and analyses by socioeconomic status for the small proportion

of registries that aim to submit this information (option 3).

Over 100 registries submitted questionnaires for each

cancer; incidence for 2015-2017 was complete in over 90 of

these registries. Data completeness was high for stage, staging

procedures and treatment, only moderate for molecular

biomarkers, and low for comorbidities and socioeconomic

status.

Most cancer registries were willing to improve their data

completeness before submitting their data to VENUSCANCER.

Results for breast cancer are shown in Figures 3-5. Similar

results are available for cervical and ovarian cancers (data not

shown).

The call for data was issued on 21 December 2019. The

original deadline for data submission was 30 June 2020. Due

to the COVID-19 pandemic, this deadline was postponed to

September 2020. Since the pandemic has been affecting the

various areas of the world at different times, data collection

is still ongoing. By mid-September 2021, we had received data

sets from 49 cancer registries: 44 data sets for breast cancer,

42 for cervical cancer and 27 for ovarian cancer (Figure 2). We

expect to receive more data sets in the coming months.

Expected results

Health policymakers need good evidence on the reasons for

international disparities in cancer survival, in order to focus

BREAST CERVIX OVARY

§ Morocco

§ Nigeria

§ Algeria

§ South Africa

§† Mali

Mauritius *

Martinique *

Costa Rica *

Argentina

Puerto Rico *

§ Algeria

§ Nigeria

§ South Africa

Mauritius *

§ Costa Rica *

Cuba *

Puerto Rico *

Brazil

Martinique *

§† South Africa

§ Algeria

§ Nigeria

Mauritius *

Costa Rica *

§ Cuba *

Argentina

Ecuador

§ Uruguay *

0

20

40

60

80

100

Less

2Percentage of registries

0

20

40

60

80

100

Percentage of registries

Less

2

100ries

Data completeness

Percentage of registries

20 20

60

43

57

20

10

70

4

17

79

5

13 13

68

4

88

79

0

20

40

60

80

100

Less than 25% 25-49% 50-74% 75-100%

Percentage of registries

Data completeness

2012 (5 registries)

2013 (7 registries)

2014 (10 registries)

2015 (24 registries)

2016 (38 registries)

2017 (24 registries)

0

20

40

60

80

100

Less than 25% 25-49% 50-74% 75-100%

2012 (5 registries)

2013 (7 registries)

2014 (10 registries)

2015 (24 registries)

2016 (38 registries)

2017 (24 registries)

20 20

60

43

57

20

10

70

4

17

79

5

13 13

68

4

8 8

79

Figure 3: Breast cancer - stage availability by year of diagnosis (from questionnaires

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