Cairo, 16 – 17 November 2008 The “Olive Tree” …...Cairo, 16 – 17 November 2008 Aims of the...

t h e O l i v e T r e e P r o j e c t

The The ““Olive TreeOlive Tree”” Project Project

Second Ministerial Euro-Mediterranean Conference on Health

Workshop on “Non-communicable disease”

Cairo, 16 – 17 November 2008

a cooperation across Mediterraneana cooperation across Mediterraneancountries for cancer registration andcountries for cancer registration andshared cancer control actions.shared cancer control actions.

The PartnersThe Partners

MODENA CANCER REGISTRYMODENA CANCER REGISTRYPopulation: 650.000 residents in yhe province of Modena

Established in 1988

Located in the Comprehensive Modena Cancer Center

2003: Benghazi Cancer Registry2003: Benghazi Cancer Registry

The Actors The Actors ……..

Dr. Mufid El MistiriDr. Mufid El Mistiri

1985 Medical Degree, Bologna

1990 Specialization in Medical Oncology, Modena

1990-1994 Post Doctoral position at the Department of

Medical Oncology, University of Modena

Current position: Assistant Professor of Medical

Oncology, Garyounis University, Benghazi, Director,

Benghazi Cancer Registry, Libyan International Medical

University

77

Spring, 2004 Garyounis University of

Benghazi decided to establish a

population based Cancer Registry in

Eastern Libya

The TwinningThe Twinning

March, 2004

99

Spring, 2004 Garyounis University of

Benghazi decided to establish a

population based Cancer Registry in

Eastern Libya

December, 2004 First Meeting in

Libya M Federico, I Rashid (Modena

Cancer Registry) and A Verdecchia (ISS

Roma)

Aims: to install a specific software

developed by MCR for BCR.

In 2005 meetings in Tripoli andIn 2005 meetings in Tripoli andBenghazi, with the aim ofBenghazi, with the aim ofpromoting the project (not onlypromoting the project (not only……))

1212

Second Meeting

Aims: To assess the quality of data

collected by the BCR, and to evaluate

the opportunity of publishing a formal

report with cancer incidence in Eastern

Libya.

CCancer Incidence in Eastern Libya, 2003ancer Incidence in Eastern Libya, 2003

1414

September, 2006 Third meeting,

involving M Federico, I Rashid, A

Verdecchia (ISS Roma) and P Pisani

(IARC Lyon)

Aims: to organize a training course for

cancer registration.

1515

January 2007

The International Journal of Cancer,

published an article on Cancer

incidence in Eastern Libya

Comparison of

age-specific rates

0100

200

300

400

0-4

5-9

10

-1

4

15

-1

9

20

-2

4

25

-2

9

30

-3

4

35

-3

9

40

-4

4

45

-4

9

50

-5

4

55

-5

9

60

-6

4

65

-6

9

70

-7

4

75

+

Modena F Benghazi F

What we know

about Breast Cancer

1717

January, 2007 L Cortesi organized a

course on DNA extraction for BRCA

testing in women with early onset breast

cancer

August, 2007 M Federico, I Rashid and

F Ricceri (CPO Torino), organize a

second course on cancer registration



African Regional MeetingAfrican Regional Meeting2828thth October 2007 October 2007

Cape Town, South AfricaCape Town, South Africa

Lack of support to cancer registries

in Africa

Need for more efficient technical

tools (e.g. software for cancer

registration)

Success of Benghazi and Modena

twinning arrangement

Importance of tapping global funds

Key points summary

(from IACR Newsletter, April 2008)

19

February, 2008

Second report, on cacner

incidence and mortality in

2004

The adventure continues ….

Maghreb ProjectMaghreb Project

AlgeriAlgeri

SetifSetif

SfaxSfaxRabatRabat

Cooperation among Cancer Registries lining on bothCooperation among Cancer Registries lining on both

Mediterranean Rims (starting with Italy and Maghrebian RegionMediterranean Rims (starting with Italy and Maghrebian Region

Countries)Countries)

21

October 2008, Sixt meeting, with the

participation of: M Federico, I Rashid,

R Zanetti (CPO Torino), M Fusco (RT

Napoli) and MP Curado (IARC Lione)



Proponents and adherentsProponents and adherents

Modena

Florence

Benghazi

Alger

Setif Sfax

Rabat

Tarragona

Turin

NaplesSalerno

Ragusa

Chair of Medical Oncology II and Modena Cancer Registry,

University of Modena and Reggio Emilia, Modena, Italy

Italian Association of Cancer Registries, Florence, Italy

Benghazi Cancer Registry, Benghazi, Libya

Registre des Tumeurs d’Alger, Algeria

Registre du Cancer de Sétif, Algeria

Registre du Cancer du Sud Tunisien, Sfax, Tunisia

Direction de l’Epidemiologie et Lutte contre les Maladies,

Ministère de la Santé, Rabat, Morocco

Tarragona Cancer Registry, Tarragona, Spain

Piedmont Cancer Registry, CPO, Turin, Italy

Registro Tumori di Salerno, Salerno, Italy

Naples Cancer Registry, Naples, Italy

Ragusa Cancer Registry, Ragusa, Italy



Aims of the projectAims of the project

t h e O l i v e T r e e P r o j e c t

Improving performances of eachCancer Registry

Expanding cooperation with otherCancer Registries in the EuroMedRegion

Sharing different experiences andmerging data for pooled analyses

Promoting prospective cooperativestudies



Why we propose a cooperation in EuroMed?Why we propose a cooperation in EuroMed?

Tlemcem

Sidi Bel Abbes

Oran Setif

Batna

Alger

Costantine Annaba

Tunis

Sousse

Sfax

Garbiah

JordanRabat,

Casablanca

Benghazi

Israel

CyprusAntalya

Izmir



Covered populationCovered population

CyprusCyprus 850.000850.000 100%100%

IsraelIsrael 6.800.0006.800.000 100%100%

TunisiaTunisia 5.500.0005.500.000 59%59%

LibyaLibya 1.500.0001.500.000 28%28%

ItalyItaly 14.800.00014.800.000 26%26%

SpainSpain 7.900.0007.900.000 22%22%

AlgeriaAlgeria 5.300.0005.300.000 18%18%

FranceFrance 6.300.0006.300.000 13%13%

MoroccoMorocco 3.600.0003.600.000 12%12%

TurkeyTurkey 4.800.0004.800.000 7%7%

EgyptEgypt 3.600.0003.600.000 5%5%

population %



Background:Background:why we need a cooperation in EuroMed Regions?why we need a cooperation in EuroMed Regions?

population aged 60+ years population aged 60+ years (percentage)(percentage)

World Health Organization, 2002 estimates

<7% 7-12% 12-18% 18-22% >22%




average fertility rate average fertility rate (children/woman)(children/woman)


<1.5 1.5-2 2-2.5 2.5-3 >3




life expectancy at birth life expectancy at birth (years)(years)


<70 70-73 73-76 76-79 >79




prevalence of smokers prevalence of smokers (%)(%)

WHO Report on Tobacco Epidemic, 2008

60%60%

50%50%

40%40%

30%30%

20%20%

10%10%

0%0%

Egypt (26%)Lebanon (29%)

Morocco (30%)

Syria (42%)

Tunisia (51%)

Italy (31%)France (34%)

Greece (62%)

Spain (36%)

60%60%

50%50%

40%40%

30%30%

20%20%

10%10%

0%0%Egypt (4%)

Lebanon (7%)

Morocco (<1%)Tunisia (2%)

Italy (16%)

France (23%)

Greece (33%)

Spain (28%)

Turkey (53%)

Turkey (21%)

MalesMales FemalesFemales



Background:Background:why we need a cooperation in EuroMed?why we need a cooperation in EuroMed?

per capita Food Consumptionper capita Food Consumption

Meat

SpainCyprusIsrael, France, Italy

Greece

Lebanon

Libya, TunisiaSyria, EgyptTurkey, Morocco, Algeria

GreeceLebanonTurkey, Libya, Israel

TunisiaEgypt, ItalyCyprus

Spain, FranceSyria, Morocco

Algeria

Vegetables

SpainFrance

Italy

Cyprus, Greece

Israel, Turkey, Lebanon

Morocco, AlgeriaTunisia, EgyptLibya, Syria

Alcohol

estimates, 12 november 2008

Food c

onsum

ption q

uantity

(kg/c

apita/y

r)



Cancer Incidence in EuroMed regionCancer Incidence in EuroMed regionWorld Age Standardized rates (per 100,000)World Age Standardized rates (per 100,000)

0 50 100 150 200 250 300 350 400

Turin (IT)

Modena (IT)

Isère (FR)

Naples (IT)

Tarragona (ES)

Murcia (ES)

Israel

Salerno (IT)

Ragusa (IT)

Izmir (TR)

Cyprus

Antalya (TR)

Gharbiah (EG)

Sousse (TN)

Benghazi (LY)

Casablanca (MO)

Setif (DZ)

Males

Females

Source:

Curado et al. CI5 vol.IX (2007)

Cancer Incidence and Mortality in

Eastern Libya, 2004. Benghazi

Cancer Registry (2007)

Registre des Cancers de la Region

du grand Casablanca, Année 2004,

(2007)



Specific actions Specific actions #1#1

Meetings and training courses for improving cancerregistration

Adoption of a common data-set

Development of ad hoc software for cancerregistration and analysis in countries with differentlanguages and alphabet

Pooled analysis of years 2003-2005 data, mainlyfocused on pattern of incidence in different areas



Technical requirements: efficient softwareTechnical requirements: efficient software

CanReg4 (released in 2001) MCRdb (released in 2005)




Design and management of prospective studies on:

Public Health System performances in differentcountries

The role of diet, physical activity and cancer

Genetic predisposition to cancer




Creating specific task forces on:

Childhood cancers

Virus-associated cancers

Early onset breast and ovarian cancers

Tobacco-related cancers

Provider delay between diagnosis and treatment




Spreading the Olive Tree message:

…and

“working together andgrowing together.”

next stepsnext steps…………

Adequate financial

support from the

Barcelona

Secretariat

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