The Nairobi Cancer Registry, KEMRI

OVER VIEW

ABOUT US

Nairobi Cancer Registry was established in 2001 as a research project and transitioned to be a department within the Kenya Medical Research Institute (KEMRI) since the year 2012. The cancer registry has continuously availed cancer data on incidence, mortality and survival to stakeholders with the aim of guiding data-driven decision making in Kenya and beyond. The data from the registry has been instrumental in informing research, estimating cancer burden in Kenya through the Globoccan estimates, and evidence-based decisions on cancer control and programming. Nairobi cancer registry is a founding member of the East Africa Cancer Registry Network that grew to become the Africa Cancer Registry Network (AFCRN) (http://afcrn.org/) in 2012.

Since inception, the cancer registry has achieved some significant milestones key among them, publication of data in two successive volumes of the prestigious cancer incidence in five continents (CI5 volume XI and XII) (https://ci5.iarc.fr/) and designation as the Center of Expertise for sub-Saharan Africa mandated to  conduct trainings, mentorship, and offer technical support to cancer registries in the region — a responsibility implemented from November, 2022.

In collaboration with other stakeholders, the cancer registry implements several research activities to provide evidence-based decision making. In addition, the cancer registry is involved in cancer advocacy in efforts to ensure early diagnosis, access to care and education to the community on all aspects of cancer.

ROLES OF CANCER REGISTRY

  1. Avail data on cancer incidence, mortality and survival in Nairobi County.
  2. Offer capacity building programs (trainings, mentorship) and technical support to cancer registries in Kenya and in sub-Saharan Africa
  3. Conduct cancer research to provide evidence-based interventions
  4. Conduct cancer advocacy in the populace
  5. Disseminate data from cancer surveillance in Nairobi and research findings from studies implemented in the department.

MISSION/VISION

MISSION

Quality Data for Research and Better Health

VISION

To be an internationally recognized Centre of Excellence committed to Advancing Cancer Research for Better Health

MANDATES

  1. Establish the Kenya National Cancer Registry program which will collate and compile National data on cancer in Kenya
  2. Establish and maintain a centralized data centre that assist collate cancer data in Kenya
  3. Develop and implement trainings of heath personnel on cancer registration in the selected counties and hospitals interested in setting hospital based cancer registries in Kenya
  4. Establish additional cancer registries in selected counties and hospitals in Kenya
  5. Develop and implement a cancer registry awareness programme for clinical and hospital staff
  6. Collect, collate, analyze and interpret data on cancer (incidence, mortality, survival).
  7. Monitor and evaluate cancer registry activities in Kenya
  8. Develop proposals and source for research funds for cancer registration and data analysis.
  9. Conduct studies in epidemiological, trends and incidences for cancer.
  10. Inform policy and provide national trends in cancer
  11. Disseminate research findings to stakeholders through local and international forums and prepare publications to various journals.
  12. Forge partnerships with both international and national research collaborators.
  13. Establish other disease specific registries in the country in order to have baseline epidemiologic data
  14. Participate in Non-Communicable Diseases Research, advocacy, capacity building and Knowledge sharing and establish networks with other stakeholders.

ONGOING PROGRAMMES

ONGOING PROGRAMMES

Cancer (and Tobacco Control) Training and Research Across the Lifespan in Kenya (D43 TW009333). Funded by Forgaty; National Institute of Health. The grant awarded to Kenya through a sub-award from Dr. Scott Remick of West Virginia University covered three major aims with KEMRI responsible for one aim as follows:

  1. Strengthen and expand capacity at KEMRI for cancer and other NCD registration:
  2. Train additional staff for both cancer and other NCD registration – piloting a stroke registry (first time ever done)
  3. Build capacity for both cancer and other NCD registration given successful partnership with WVUH Tumor Registry
  4. Explore EMR system for NCD registration that can serve as a model for sub-Saharan Africa
  5. Build capacity in Nairobi, Eldoret and Kisumu to expand reach of NCR to provide more meaningful epidemiological data for national reporting and frame healthcare policy, and drive research agendas

PRODUCTS AND SERVICES OFFERED

PRODUCTS AND SERVICES OFFERED

  1. Trainings: We offer basic and advanced courses on cancer surveillance, data management and reporting. Calendar for next year’s courses will be posted on this site.  
  2. Technical support: We offer technical support by arranging a site visit to address any challenges with canreg5 or data analysis.
  3. Mentorship: We host trainees from Kenya and Africa region for mentorship programs at our registry. 
  4. Internships: We offer opportunities for interns who have an interest in surveillance and epidemiological research.
  5. Data: We welcome partnerships and collaborations for research. We have an experienced team of registrars who are versed with the health system in Kenya. Our data has been presented in several formats. National estimates for Kenya is accessed at http://gco.iarc.fr/today/data/factsheets/populations/404-kenya-fact-sheets.pdf

THE ROLE OF CANCER REGISTRY

The role of the National Cancer Registry at KEMRI in Universal Health Coverage

Introduction

Cancer remains a major public health problem globally and it is predicted that more than 20 million new cases will occur worldwide by 2025 with 80% of the burden occurring in low- and middle- income countries.

Cancer surveillance is the ongoing, timely, and systematic collection and analysis of information on cancer risk factors (such as lifestyle factors, behavioral influences, genetic predispositions, or environmental exposures). It identifying new cancer cases, cancer deaths, the extent of disease at diagnosis, treatment, clinical management, and survival.

Cancer registration is an important component of cancer surveillance. Cancer registration is the fundamental method by which information is systematically collected about the occurrence of cancer (incidence), about the types of cancer that occur (histology, morphology, and behavior), the anatomic location (topography), the extent of disease at the time of diagnosis (stage), the kinds of treatment received by cancer patients, and the outcomes of treatment and clinical management (mortality and survival).

KEMRI established a population-based registry in 2001 covering one geographical region – Nairobi County then referred to as Nairobi province.

In 2016, KEMRI launched the national cancer registry to collate cancer data and establish the incidence, mortality and survival rates in various counties in Kenya.

Uses of Cancer registry data
  1. Cancer registry is used as a tool for epidemiological research
  2. Registry data enables us to establish the disease burden, geographic distribution and the patient care pathways
  3. It can also help us identify and track the impact of different clinical, systemic and policy initiatives and measures to improve cancer care. 

Utility of cancer registry data for research:

  1. Cohorts of specific cancers or grouping
  2. Risk factors including environmental exposures
  3. Patterns of care : Time lags between diagnosis and treatment
  4. Undertake outcome of care studies: enables us to study patient outcomes, patients treatment choices which helps us identify and address gaps and problems in cancer care, therefore data is critical to improving cancer care
  5. Occurrence of cancer in specific groups (childhood cancers, Head and Neck, Gastrointestinal, HIV-associated malignancies etc).  
  6. Use the Geographic Information systems (GIS) mapping to establish possible cancer clusters that may provide information on cancer risk factors. 
  7. Survival studies: Conduct Follow-up studies to understand survival of different cancer types, looking at diagnostics, access to treatment, geographical distances etc
  8. Generate research hypothesis and conduct epidemiologic and clinical research using cancer registry data to contribute to scientific knowledge regarding cancer in Kenya.  Some of the linkages to be set up for research include:
    1. Linkage of the cancer registry to the comprehensive care clinics or existing HIV databases and study the occurrence of cancer amongst people living with HIV/AIDS.
    2. Linkage to NHIF system for completeness of registry data and to undertake studies on utility and impact of NHIF on access to care
    3. Linkage to existing DHIS database to ensure more comprehensive and complete data for patients
    4. Linking with HDSS (Health Demographic Surveillance Systems) data to study variations in relation to social and environmental factors; 
    5. Linkage to Civil registration of deaths for vital status to describe mortality

The national cancer registry at KEMRI however needs to be strengthened with adequate resources including personnel. A robust registry could enable different types of questions to be answered and the data can be utilized by researchers and other stakeholders. For example: 

  • How big is the cancer burden in the country and how is cancer distributed across different regions? 
  • What are the outcomes of the diagnostic and treatment initiatives already in place in the country? 
  • How efficient are the screening initiatives implemented in the communities in terms of final diagnostic, treatment and outcomes/survival for the patients? 
  • Is pharmacogenomics in African populations being assessed? 
  • Why do certain products show lower efficacy in the Kenyan population/ certain Kenyan populations vs. what is observed in international clinical trials? 
  • What is the underlying biomarker makeup of the Kenyan population affected with key types of tumors – and how could these impact therapy guidelines in the country? 
  • Are there enough patients matching specific inclusion criteria to launch a local clinical trial? 

SELECTED PUBLICATIONS

  1. Nairobi Cancer Registry Report –  (2009 – 2013)
  2. Korir A, Okerosi N, Ronoh V, Mutuma G, Parkin M. Incidence of cancer in Nairobi, Kenya (2004-2008). Int J Cancer. 2015 Nov 1;137(9):2053-9. doi:10.1002/ijc.29674. PubMed PMID: 26139540.
  3. Korir A, Yu Wang E, Sasieni P, Okerosi N, Ronoh V, Maxwell Parkin D. Cancer risks in Nairobi (2000-2014) by ethnic group. Int J Cancer. 2017 Feb 15;140(4):788-797. doi: 10.1002/ijc.30502. Epub 2016 Nov 27. PubMed PMID: 27813082.
  4. Korir A, Mauti N, Moats P, Gurka MJ, Mutuma G, Metheny C, Mwamba PM, Oyiro PO, Fisher M, Ayers LW, Rochford R, Mwanda WO, Remick SC. Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya. PLoS One. 2014 Jan 23;9(1):e85881. doi: 10.1371/journal.pone.0085881. eCollection 2014. PubMed PMID: 24465764; PubMed Central PMCID: PMC3900436.
  5. Korir A, Gakunga R, Subramanian S, Okerosi N, Chesumbai G, Edwards P, Tangka F, Joseph R, Buziba N, Rono V, Parkin DM, Saraiya M. Economic analysis of the Nairobi Cancer Registry: Implications for expanding and enhancing cancer registration in Kenya. Cancer Epidemiol. 2016 Dec;45 Suppl 1:S20-S29. doi: 10.1016/j.canep.2016.11.006. Epub 2016 Nov 30. PubMed PMID: 27915004; PubMed Central PMCID: PMC5840871.
  6. Gakunga R, Korir A, Oduor JO, Muniu E, Njeru M and Kaduka L. Exploring integration of education and screening for cancer and other non-communicable diseases into HIV testing and counseling services in Nairobi, Kenya: Results from a Swot Analysis. Submitted to AORTIC conference 2015, Marrakech, Morocco from 18-22 November 2015. 
  7. Gakunga R, Kinyanjui A, Ali Z, Ochieng’ E, Gikaara N, Maluni F, Wata D, Kyeng’ M, Korir A, Subramanian S. Identifying Barriers and Facilitators to Breast Cancer. Early Detection and Subsequent Treatment Engagement in Kenya: A Qualitative. Approach. Oncologist. 2019 Oct 10. pii: theoncologist.2019-0257. doi: 10.1634/theoncologist.2019-0257. [Epub ahead of print] PubMed PMID: 31601730.
  8. Subramanian S, Gakunga R, Jones MD, Kinyanjui A, Ochieng’ E, Gikaara N, Maluni F, Wata D, Korir A, Mutebi M, Ali Z. Establishing Cohorts to Generate the Evidence Base to Reduce the Burden of Breast Cancer in Sub-Saharan Africa: Results From a Feasibility Study in Kenya. J Glob Oncol. 2019 Mar;5:1-10. doi: 10.1200/JGO.18.00225. PubMed PMID: 30908145; PubMed Central PMCID: PMC6449073.

EVENTS

Training opportunities
  • Are you interested in joining the next cohort of cancer registration training, and mentorship? Please fill your details on this link: https://bit.ly/4llhk0r OR contact us through cancerregistry@kemri.go.ke and cc: akorir@kemri.go.ke
  • Interested in learning cancer registration virtually in self-phased modules for free and get a globally recognized certificate? Kindly click on this link to take the course: https://gicr.iarc.fr/e-learning/ – Should you experience any difficulty navigating the platform, do not hesitate to contact us.
Trainings Conducted:
  1. 20th -24, August 2012, Basic Cancer registration course in KEMRI and practical course on case abstraction in various hospitals within Nairobi.  Participants from Ethiopia, Uganda, Zimbabwe Tanzania, Kenya and Malawi, Funded by AFCRN.
  2. 3rd-14th February 2014, Basic Cancer registration course in KEMRI and mentorship program for Kisumu cancer registry staff funded by D43 HIV malignancy study.
  3. 21st -26th April 2014, Basic Cancer registration course to new cancer registry staff in Nairobi population based cancer registry (NPBCR). Sponsored by NPBCR
  4. 21st of January 2015, one-day training for the stroke study research assistants and KNH facility staff, carried out at the Centre for Public Health Research-KEMRI, sponsored by stroke study D43 grant- USA
  5. 24th Aug–1st Sept 2015, Basic course on cancer registration, conducted in KEMRI. participants from Kenya, Zimbabwe and Malawi Sponsored by Union of International Cancer Control (UICC) KEMRI and AFCRN with 
  6. 25th Feb-3rd Mar 2019, Basic course in cancer registration; setting up Bujumbura population Cancer Registry. Participants from Non –Communicable diseases MoH Burundi. Sponsored by Eastern Central and Southern Africa Health Community (ECSA-HC) 
  7. 20th -23rd May 2019, Cancer registration and sensitization activity in Kitui County, participants from all sub counties.  sponsored by Catholic Medical Mission Board (CMMB) 
  8. 6th -17th May 2019, KNCR-KEMRI conducted advanced course in cancer registration in Nairobi –funded by different counties in Kenya. 
  9. 18th -22nd February cancer registry staff trained together with the ministry of Health-Kenya, participants from various counties in Kenya. Sponsored by the East, Central and Southern African (ECSA) Health Community.
  10. 7th -11th October 2019 Mentorship program for BPBCR offered by Nathan KEMRI. Sponsored by the East, Central and Southern African (ECSA) Health Community

STAFF PROFILES

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Ms. Anne Rugutt Korir

Research Officer

Anne Korir is an accomplished senior research scientist with expertise in cancer epidemiology. She has been instrumental in the establishment of cancer registries in Kenya and in sub-Saharan Africa region. Under her leadership, she has propelled the Nairobi cancer registry to be a leader in cancer registration in the region notably, the designation as the IARC Center of Expertise for the sub-Saharan Africa and positioning it as a research resource. Mrs. Korir is a PI of several research studies focusing on cancer epidemiology and disparities among patients of black populations. Previously, she served in technical working groups for the Ministry of Health, International Network for Cancer Treatment and Research (INCTR)/Africa Cancer Registries Network, the International Agency for Research on Cancer (IARC), Vital Strategies, USA and the National Cancer Institute of Kenya. She currently serves in the technical working group of the City Cancer Challenge, National Cancer Control Strategy Pillar 5 and KESHO (Kenya Society for Hematology and Oncology) Research Committee. Mrs. Anne is also a co-leader in the Women Cancer Group of the Africa Caribbean Cancer Consortium (AC3). She is a global trainer and mentor to many cancer surveillance officers both locally and internationally.
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Evans Kiptanui

Biostatistician

Evans Kiptanui is a research scientist with expertise in biostatistics and cancer surveillance. He is instrumental in offering biostatistics support to several collaborative research projects. Mr. Evans is a GICRNet trainer on CanReg5 and serves as the administrator of the IARC GICR Center of Expertise for sub-Saharan Africa, based at KEMRI.
In addition, he has hands-on experience, and in-depth knowledge of statistical methods as well as communicating statistical concepts and research findings, experience on statistical software’s, broad experience with practical application of biostatistical methodologies. He is a co-leader in the African Caribbean Cancer Consortium — colorectal cancer working group. His passion is to implement strategies of ensure high quality data is availed for decision making in the region that ultimately informs the national cancer control programming.
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Melvin Obuya

Research Scientist

Melvine is a Research Scientist at the Cancer Registry unit, Center for Clinical Research –KEMRI. She is currently pursuing her PhD in Public Health at the KEMRI Graduate School and has extensive experience in Health Research spanning from Applied to Implementation Research. Her focus is on prevention and control of Non-Communicable Disease (NCDs). She has worked in several NCD studies, some of which have informed policies and practice. Melvine is an active member of the Cancer Thematic Group (KEMRI NCD Program) and of the African-Caribbean Cancer Consortium. Melvine has a keen interest in Research Ethics as a fundamental aspect in Human Health research. Her goal is to build her research capacity with integrity, transparency and accountability. Through her work, she aspires to continuously provide credible evidence that will contribute to the reduction of NCDs through evidence-based policy formulations.
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Joseph Anyona

Research Scientist

Anyona Ongeri Joseph is a Research Scientist at the Centre for Clinical Research, KEMRI, with a strong focus on non-communicable diseases research. Currently pursuing a Master of Public Health (MPH) in Epidemiology & Biostatistics at the University of Nairobi. He is currently coordinating high-impact research studies including: PRH- Prostate cancer research, POLB and HPV prevalence in Head & Neck Cancer Studies, Telehealth innovations in healthcare delivery, Diabetes and Hypertension population studies and ACGR-Breast Cancer Study. He ensures seamless study implementation, adherence to objectives, and timely execution. He possesses expertise in data collection, advanced data analysis, and scientific manuscript development, driving evidence-based decision-making in public health. He is a Member of Childhood Cancers Technical Working Group and Non-Communicable Diseases (NCD) Program. He is a Liaison Officer, Partnership to Strengthen Cancer Surveillance Data Quality and Accessibility in Sub-Saharan Africa – a strategic collaboration with the National Cancer Institute (NCI-US). His work underscores a commitment to advancing cancer surveillance, strengthening health systems, and contributing to peer-reviewed research that informs policy and practice.
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Dr. Regina Wachuka Mbugua

Research Scientist

Dr. Regina Wachuka Mbugua is a research scientist with expertise in molecular oncology, biomarker discovery, translational oncology and precision oncology. She holds a PhD in Medical Sciences (Medical Oncology) and has conducted extensive research on cancer biomarkers, including breast cancer, hepatocellular carcinoma (HCC) and gastrointestinal (GI) cancer.
Her research interests focus on identifying novel therapeutic targets, understanding cancer biology and in particular the study of the African cancer genome and molecular cancer epidemiology. She is particularly passionate about advancing cancer research in low- and middle-income countries to improve patient outcomes.
Dr. Mbugua has been involved in laboratory-based cancer research and translational oncology, trying to bridge the gap between basic research and clinical application. She has collaborated on several projects aimed at identifying the molecular drivers of cancer and developing targeted therapeutic approaches.
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Nathan Okerosi:

Health Records and Information Technician /Cancer Registrar

Nathan Okerosi is responsible for data management in the unit. He holds a Bachelor’s Degree in Health Systems management and a Diploma in Health Records and Information. He was trained in Cancer Registration, applications and Epidemiology by the International Agency for Research on Cancer WHO 2012, and 2015. Internship at West Virginia University Hospital Cancer Registry USA 2012. He has also conducted both international, local trainings and mentorship programs for cancer registry staff with AFCRN, IARC and East, Central and South African Health Community (ECSA-H). Mr. Okerosi has participated in various research projects and studies conducted in the unit that have led to publications.
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Patricia Ndambuki

Research Scientist

Patricia Kavuli Ndambuki is a dedicated research scientist with growing expertise in epidemiology and biostatistics. She earned her Bachelor of Science in Medical Biochemistry from JKUAT, graduating with Second Class – Upper Division honors, and is currently advancing her analytical and methodological skills through a Master of Science in Epidemiology and Biostatistics at the Institute of Tropical Medicine and Infectious Diseases (ITROMID), JKUAT. Her research and professional endeavors focus on the promotion of cancer awareness, early detection, and the implementation of community outreach initiatives that aim to reduce the burden of cancer. At the Nairobi Cancer Registry, where she serves as a Research Scientist, Patricia leads cancer awareness and advocacy. Her work emphasizes a holistic approach—integrating both qualitative and quantitative research methodologies—to drive targeted cancer prevention strategies. Patricia is particularly passionate about improving health outcomes by leveraging robust research, effective communication, and strategic public health interventions for the implementation of specific prevention strategies. Her commitment to advancing cancer prevention and research underscores her ongoing pursuit of excellence in the field of epidemiology and biostatistics.
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Maureen Lutomia

Health Records and Information Technician /Cancer Registrar

Maureen Lutomia is an experienced cancer registrar with over 10 years of expertise in cancer surveillance. Ms. Lutomia has contributed significantly to the expansion of cancer surveillance activities in Nairobi population-based cancer registry. Her duties encompass; case finding and abstraction in selected facilities, training and supervising junior cancer registrars, and data quality checks to ensure accurate, complete, and valid case reporting in the registry database. Ms. Lutomia remains dedicated to advancing public health through the continuous improvement of cancer surveillance practices and the implementation of data-driven solutions in oncology.
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Mary Nyanchama Abere

Health Records and Information Technician /Cancer Registrar

Mary Nyanchama is a senior health records and information technologist and cancer registry specialist. She is a dedicated professional specializing in case finding and data abstraction, coding and quality checks on data submitted to the cancer registry. Ms. Nyanchama has wealth of experience in coding and essential TNM (E-TNM) cancer staging and is a resource to cancer registries locally and in the sub-Saharan Africa region — faculty in the IARC GICR Center o Expertise for sub-Saharan Africa. She is passionate on continuously making a meaningful impact in cancer research and surveillance through quality data from the cancer registry

Nancy Karanja

Secretary

Ms. Nancy Karanja is dedicated secretary. She oversees all the administrative related tasks at the cancer registry.

RESOURCES

Cancer Registration Resources

  1. The Cancer Registry e-learning: https://gicr.iarc.fr/e-learning/
  2. Resources on Cancer Registration: https://gicr.iarc.fr/library-and-resources/
  3. Additional Cancer Registration Resources: https://bit.ly/4brf9DU

CONTACT US

contact us

CONTACT US

LOCATION

Kenya Medical Research Institute (KEMRI) HQ.

Center for Clinical Research

Off Raila Odinga Way, Nairobi

Tel: 0722 205 901 | 0709 295 300 | 020 272 254 1