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Short summary: Migration to and within Europe has increased and diversified in recent years. Individuals with a migration background often have health needs that differ from the general (host) population of a country. At the same time they can face important barriers to access the right health care. A unified quantification of current disparities of cancer by migration background in Europe does not exist impeding policy makers to act upon the health needs of migrants. To fill this knowledge gap Cancer RADAR’s aim is to develop an infrastructure that allows quantifying the risk of cancer by migration background across Europe. To establish this, Cancer RADAR will first focus on infection-related cancers (liver, stomach, and cervical cancer) and screening preventable cancers (breast, cervical, colorectal, and lung cancer).
Cancer RADAR is an infrastructure to systematically collect cancer data stratified by migration background from cancer registries. This data will be combined with other data sources to provide a harmonized Europe-wide perspective on the context-specific incidence and mortality risk and future (preventable) burden of stomach, liver, cervical, breast, colorectal and lung cancer among migrants in Europe.
The objective of this tool (package) is to facilitate data sharing between cancer registries in Europe and the International Association of Cancer Registries (IACR). The tool contains a set of functions that will generate aggregated indicators, for example totals, incidence rates, incidence rate ratios, incidence rate differences. These numbers will serve as input for the Cancer RADAR project. Please e-mail cancer.radar@iarc.who.int for the most up-to-date protocol.
The data shared are in the form of tables of aggregated frequencies (observed cases and population at risk) and/or indicators (Rates, SMRs, PIRs, standard errors, etc) and are thus considered anonymous. Data will be stored on a dedicated server at IARC-WHO according to the standard requirements for data security. Cancer RADAR was approved by the IARC Ethics Committee (IEC) under project number IEC 23-38.
Please install the package as explained below.
This package will provide you with an empty excel file in which the data can be entered.
This empty excel file contains different sheets in which the indicated data can be provided by country-of-birth of the individual in 5-year age-groups and as totals. Country-of-birth will serve as proxy for migration background.
Depending on the availability of the data at the cancer registry the excel file will provide the opportunity to complete a list of variables.
Type of data collected:
*Data on the population of the area covered by each registry are optional. If population at risk is not available we will use indirect methode Proportional Incidence Ratio (PIR).
Type of cancer for which data will be collected:
Depenidng on the availability, three input files may be requested for the following three time periods: - CI5-XII 2013-2017 - CI5-XI 2008-2012 - CI5-X 2003-2007
The package is hosted on gitlab.com and can be installed in R using the following commands:
## check if remotes package is installed and install remotes if not.
if(!('remotes' %in% rownames(installed.packages()))) install.packages('remotes', dep = TRUE)
## install cancerradarr package
remotes::install_gitlab("cancerradar/cancerradarr", dependencies = TRUE)The first step of the workflow is to create an input template file.
The create_registry_input_file() function has been designed
to create a template excel file that cancer registries should fill in
order to produce all cancer RADAR project summary statistics.
The function requires one parameter which is the path to the location
where the input file will be created. The following command will create
a file named cancerRADAR_input.xlsx in
/PATH_TO_INPUT_FILE/ a directory on the hard drive. This
file needs to be completed by the cancer registry.
library(cancerradarr)
create_registry_input_file('/PATH_TO_INPUT_FILE/cancerRADAR_input.xlsx')You can access a example of filled file
(i.e. ex_cancaerRADAR_input_filled.xlsx) typing:
file.copy(file.path(path.package('cancerradarr'), 'extdata/ex_cancerRADAR_input_filled.xlsx'), '/PATH_TO_INPUT_FILE/ex_cancaerRADAR_input_filled.xlsx')cancerRADAR_input_completed_xx_xx_vsxxxx2024.xlsx)Now that the data has been entered in the excel file you can create
summary statistics using the cancerradarr package. The
outputs of this package are the effect measures that will be shared with
International Association of Cancer Registries (IACR).
To do this run the create_canradar_summary_file()
function by copy-pasting it to the R console as shown below. This
function requires 2 files paths as parameters: 1. The path to the filled
template file from the previous step (e.g
/PATH_TO_INPUT_FILE/cancerRADAR_input_completed_xx_xx_vsxxxx2024_vsX.xlsx,
please replace PATH_TO_INPUT_FILE with the full path to the
directory where the input file is stored) and, 2. the path to an output
file where summary statistics will be stored
(e.g. /PATH_TO_INPUT_FILE/cancerRADAR_output_xx_xx_vsxxxx2024.xlsx).
To compute the summary statistics execute the following command in R (adapting the file name and path of the input and output files as appropriate)
create_canradar_summary_file('/PATH_TO_INPUT_FILE/cancerRADAR_input_completed_xx_xx_vsxxxx2024.xlsx', '/PATH_TO_OUTPUT_FILE/cancerRADAR_ouput_xx_xx_2023_vsX.xlsx')This will create 'cancerRADAR_ouput_xx_xx_2023_vsX.xlsx,
a multi-tabs excel file containing the summary statistics as listed in
the protocol.
It is possible to visualize the output created using the dynamic
report creation function (run_dynamic_report). This tool
can quickly give you an idea of the difference in risk in cancer between
individuals with a migration background and general population covered
by the registry. Here is an example showing how to build such a
report.
run_dynamic_report('/PATH_TO_OUTPUT_FILE/cancerRADAR_ouput_xx_xx_vsxxxx2024.xlsx')Note that a static report containing some key tables and figures can also be generated:
create_static_report('/PATH_TO_OUTPUT_FILE/cancerRADAR_ouput_xx_xx_vsxxxx2024.xlsx')When you have completed all steps please send the created file through the RedCap link created for this project.
These binaries (installable software) and packages are in development.
They may not be fully stable and should be used with caution. We make no claims about them.
Health stats visible at Monitor.