Economic evaluation of Mumbai and its satellite cancer registries: Implications for expansion of data collection

Abstract

Background: The Mumbai Cancer Registry is a population-based cancer registry that has been in operation for more than five decades and has successfully initiated and integrated three satellite registries in Pune, Nagpur, and Aurangabad, each covering specific urban populations of the Indian state Maharashtra. Data collectors at the satellites perform data abstraction, but Mumbai carries out all other core registration activities such as data analysis and quality assurance. Each of the three satellite registries follows the same data collection methodology as the main Mumbai Cancer Registry. This study examines the cost of operating the Mumbai and its satellite cancer registries.

Methods: We modified and used the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool) to collect cost and resource use data for the Mumbai Cancer Registry and three satellites.

Results: Almost 60% of the registration expenditure was borne by the Indian Cancer Society, which hosts the Mumbai Cancer Registry, and more than half of the registry expenditure was related to data collection activities. Across the combined registries, 93% of the expenditure was spent on labor. Overall, registration activities had a low cost per case of 226.10 Indian rupees (or a little less than 4.00 US dollars in 2014 [used average exchange rate in 2014: 1 US $=60 Indian rupees]).

Conclusion: The centralization of fixed-cost activities in Mumbai likely resulted in economies of scale in operating the Mumbai and satellite registries, which, together, report on almost 20,000 cancer cases annually. In middle-income countries like India, where financial resources are limited, the operational framework provided by the Mumbai and satellite registries can serve as a model for other registries looking to expand data collection.

Keywords: Cancer registry; Cost; Economic evaluation; India; Mumbai.

Fig. 1

Top Three Age-Adjusted Incidence Rates per 100,000 Individuals by Registry. A. Males Notes: Incident rates for Greater Mumbai 2011, Aurangabad annual average 2005–2009, Nagpur annual average 2005–2009, and Pune annual average 2006–2010. Mouth includes the oral cavity and pharynx. B. Females Note: Incident rates for Greater Mumbai 2011, Aurangabad annual average 2005–2009, Nagpur annual average 2005–2009, and Pune annual average 2006–2010. Mouth includes the oral cavity and pharynx.

Fig. 2

Mumbai Cancer Registry and Satellite Registries’ Resources by Source, 2014–2015. Notes: In 2014, 1 US dollar = 60 Indian rupees. NCDIR-NCRP = National Center for Disease Informatics and Research-National Cancer Registry Program.

Fig. 3

Mumbai Cancer Registry and Satellite Registries’ Percent Resources by Budget Category, 2014–2015.

Fig. 4

Mumbai Cancer Registry and Satellite Registries’ Resources by Activity, 2014–2015. Notes: The bottom bars indicates activities performed by the Mumbai registry, and all other bars represent activities performed by the satellite registries. In 2014, 1 US dollar = 60 Indian rupees.