Feasibility of Household Surveys for Population Risk Assessment of Cancer and Cancer Registration Support

Cancer is a major health problem in the Arab region including Iraq. An adequate database is essential for effective cancer control strategies. Such a database may be provided through cancer registration but supportive household surveys may be useful. This article reports selected results on the feasibility of household surveys to support and validate cancer registration in Basrah governorate - southern Iraq. A large scale multi-stage cluster sample household survey was carried out in Basrah during 2013. It covered 6,999 households and involved gathering data on demographic characteristics and both incident cancer cases and cancer-related deaths among members of these households during a three-year recall period (2010-2012). The data obtained yielded an average annual incidence rate of 91 per 100,000 population (age-standardized incidence rate of 148.8 /100,000) and cancer specific mortality rate of 68 per 100,000 population (age-standardized mortality rate of 126.3/100,000). The results showed an overall pattern of cancer similar to that reported according to cancer registration but the household survey results were consistently higher than those of the cancer registration by a margin of approximately 20-30% with respect to incident cancer and about 70 % with respect to cancer-specific mortality. Household surveys on cancer, while costly and time consuming, are a very useful additional source of information on cancer at the population level. They can be performed for specific purposes with effective resource mobilization.