Renal cancer: First look at a potential South African urological cancer registry

Abstract

Purpose: The National Cancer Registry (NCR) of South Africa is the largest repository of cancer data in South Africa. While the NCR collects essential demographic data, vital clinical and tumour data are not captured. For these reasons, the authors propose the establishment of a prospective South African urological cancer registry. To spark interest in this proposal, we retrospectively analysed renal cancer histopathology reports submitted to the NCR.

Materials and methods: This was a retrospective audit of all renal cancer histopathological reports submitted to the NCR over two years. Descriptive statistics were explored and are presented as means and standard deviations for continuous variables and proportions for categorical variables.

Results: Eight hundred and one reports were submitted to the NCR from 22 laboratories. The mean age of the sample was 59 (± 4 years). Males accounted for 60% and females 40%. The population group for the majority of patients (50%) were classified as White, 28% were Black Africans, 14% were Coloured, and 6% were Asian/Indian. Clear cell renal cell carcinoma (ccRCC) accounted for the majority of cases (79%). Papillary RCC and chromophobe RCC accounted for 18% and 1.6%, respectively. American Joint Committee on Cancer pathological tumour staging showed more localised pT1 and pT2 tumours, 38.5% and 27.9%, respectively. Locally advanced, i.e. pT3 and pT4, formed 22.8% and 3.7% of all cases, respectively. Histological proof of metastatic disease was present in 7.1% of patients. World Health Organization/ International Society of Urological Pathology histological tumour grading for clear cell RCC showed 16.8%, 43.4%, 28.7% and 11.1% for grades 1, 2, 3 and 4, respectively.

Conclusion: Urological cancers may be well underdiagnosed and misrepresented by the statistics published by the NCR. Establishing a prospective South African urological cancer registry will help qualify the burden of urological cancers more accurately and improve national resource allocation.