1. Trends in cancer Incidence in the Republic of Mauritius, 1991-2015
MARVIN KOON SUN PAT
Dr Elizabete Weiderpass – IARC director

3. Background Population
Different ethnicities : India, East Africa, China, Europe
Upper middle income country with a GDP per capita of US dollars
Cancer care facilities: one radiotherapy department and a centralised pathology service. Chemotherapy is decentralised to the five regional hospitals over the island

4. The Mauritian National Cancer Registry
Established in 1993 by Dr S. MANRAJ
Data on Cancer Incidence has been collected on a continuous basis from 1989
Affiliation to the IACR in 1997
Population based in 2000
Hosted the 33rd annual meeting of IACR in October 2011
Affiliation to the AFCRN in 2014

5. The MNCR team
Team but not staff

6. Objectives
Trends in cancer incidence in the small state country for twenty five years ( )
Quality indicators of the registry ( )
Age unknown
Primary sites unknown
Percentage of cases with a morphologically verified diagnosis
Mortality to incidence ratio the mortality to incidence ratio (MIR)

7. Materials and Methods MNCR
RADIOTHERAPY UNIT PATIENT REGISTER
LABORATORY
ARCHIVES
CIVIL STATUS OFFICE
PRIVATE
PATHOLOGISTS
OVERSEAS TREATMENT UNIT
HOSPITAL HEALTH RECORDS
All cancer patients registered in the Republic of Mauritius from 1st January to 31st December 2015

8. Results 36 901 observations (¼ males and ¾ females ) Males
ASR = 95 per 105 ( ) to 133 per 105 ( )
AAPC = 1.4% (95% CI: 0.8 to 2.0)
Females
ASR = 116 per 105 ( ) to 151 per 105 ( )
AAPC = 1.4% (95% CI: -0.6 to 2.2)

9. TRENDS IN incidence rate in FIVE MOST FREQUENT CANCER AMONG FEMALES
AAPC
+3,4%*
+4.4%*
-3.6%*
5.2%
-0.1%

10. TRENDS IN INCIDENCE RATE IN FIVE MOST FREQUENT CANCER AMONG MALES
AAPC
+3.9%*
+4.2%*
+0.5%
-0.1%
-1.3%*

11. Pediatric Tumors Children (0 to 14 years)
803 cases, 57% occurred in males and 43% in females
Leukemia = 34%
Mean age 6 years old
Brain-nervous-system = 11%
Mean age 7 years old

12. Morphologically Verified diagnosis
Quality Indicators
Quality Indicators
Age Unknown
2.9%
2.5%
Primary Sites Unknown
6.2%
7.1%
Morphologically Verified diagnosis
90.9%
89.5%
MIR
Males
liver
1.8
1.1
pancreas
1.5
1.4
lung
1.3
1.2
Females
2.2
Introduction of Death Certificates Only (DCO) in 2013

13. East Africa - Females Breast cancer Age (Post menopause) Hereditary
Smoking
Obesity
Type 2 diabetes
Use of Oral Contraception Pills
Decrease fertility rate
HPV vaccine 2016

14. East Africa - Males Colon-rectum cancer - obesity, inactivity, diet
Prostate cancer - Age
Obesity
Increasing awareness for prostatectomy and biopsies

15. In Summary Cancers related to the “westernisation” of lifestyle
The most common sites and feature the most dramatic increase
Contrast with other Sub-Saharan African countries
HIV and other infection related cancers are most predominant
Prevention by stronger public health action
Tobacco and alcohol control, immunisation and better nutrition and weight control

16. Next Steps Accreditation for MNCR in the next CI5 manual
Introduction of survival studies
Submission for publication – peer reviewed
Conversion of MPhil to PhD degree

17. THANK YOU Co-authors: Dr MANRAJ Meera Dr FAUZEE Jasmine
Dr SEWSURN Sashi
Dr PARKIN Maxwell Donald
Dr MANRAJ Shyam
Financial support Tertiary Education Commission of Mauritius