Background
Cancer outcomes vary significantly based on geography, leading to preventable deaths and societal loss. While Population-based cancer registries (PBCRs) are essential for guiding decision-making and monitoring cancer control efforts, data collection remains a challenge in lower-resource settings. However, the rising prevalence of electronic medical records (EMRs) offers an opportunity for these regions to "leapfrog" cumbersome paper-based methods and move directly to digital systems.

Objectives
The E-NNOVATE Project, a collaboration of international partners including the International Agency for Research on Cancer (IARC), the University of Oslo, and Vital Strategies, aims to develop a global tool connecting PBCRs to DHIS2, a health information system widely used in low- and middle-income countries. The goal is to create a robust, free, and open-source solution that facilitates the seamless transfer of data from health facilities to registries.

Methods
The project developed a Beta cancer module within DHIS2, led by the Rwanda National Cancer Registry, which contains necessary PBCR data fields and incorporates IARC edit checks to flag incompatible entries in real-time. This system interfaces with CanReg5, an open-source software for cancer registry management. Utilizing implementation science approaches, the module was then pilot-tested and customized for regional needs, a component led by the Caribbean Public Health Agency.

Outcomes
Integration of EMRs via E-NNOVATE standardizes data collection formats and definitions, eliminating record incompatibility. The system uses unique identifiers to reduce inconsistencies when linking records and employs built-in cross-checks to validate information. By automating data capture, the project reduces time spent on manual entry, avoids duplication, and frees registry staff to focus on high-value tasks.

Conclusion
Scheduled for a global release in 2026, the DHIS2 Oncology module provides a sustainable model for improving cancer data quality and usability. By empowering countries with strong registries, E-NNOVATE enables policymakers to implement and monitor cancer strategies that effectively lessen the cancer burden.