Background:
Lebanon National Cancer Registry aims to monitor cancer incidence and provide guidance for better prevention, control and case management.
In 2023, 773 Non-Hodgkin Lymphoma (NHL) cancer were diagnosed with a crude incidence rate of 13,4/100,000 and age-standardized incidence rate of 11,1/100,000.
In order to evaluate the cancer activities, there is need to explore mechanisms to measure survival rates.
 
Objectives:
The objective is to measure 3-year survival rates of Non-Hodgkin Lymphoma in Lebanon via active follow-up.
 
Methods:
The national cancer registry is hosted at Ministry of Public Health (MOPH). It operates by collection of data from health facilities, from both public and private sectors, on annual basis. One of the sources is the MOPH program to provide cancer chemical treatment. To benefit from that program, the clinician completes online request form providing information on patient identification, tumour characteristics and treatment protocol.
To measure the survival rates, the active follow up is adopted. The target patients were the patients diagnosed in 2023 and who benefited from the MOPH program. An official MOPH circular was issued including specific follow-up form to collect data on patient satisfaction, delay on treatment, patient vital status, cause of death if death, and date of interview.
The interview is done via phone call from the MOPH call center. The agent introduces him/herself, and ask if the patient/family accepts to participate to the study. If approved, non-nominative data is collected and entered on DHIS2 form.
Later, the data is cleaned, analyzed to get the survival for 3-year using various methods: actuarial, net, relative, and the Kaplan-Meier survivals.
 
Results:
116 patients of Non-Hodgkin Lymphoma were identified in the database and who benefitted from the MOPH program. The response rate was 78%.
Using the actuarial methods, the cumulative survival was 92% by end of first year, 89% by second year and 87% by third year. By age group, the 3-year survival was 100% for 15-54y, 96% for 55-64y, 86% for 65-74y and 47% for 75+ years.
The net survival for all ages was 94% by end of first year, 91.4% by second year and 89.5% by third year.
The relative survival was 103%.
The Kaplan-Meier survival was 92% by end of first year, 90% by second year and 86% by third year.
 
Discussion:
The study represents new step for the national cancer registry in conducting survival studies for priority sites. Such analysis is requested in the national cancer plan 2023-2028.
Among the observations, the following were noted:
-High (78%) response rate of the patients and families to participate to the study. The non-response (22%) was due to patient/family refusal (2%) and no-answer or wrong numbers (20%).
-Low (116/773) proportion of MOPH patients among the all NHL patients.
-Similarity of the 3-year survival rates with published articles.
The study was an opportunity to build the capacity of the MOPH team in conducting and integrating survival analysis.
 
Conclusion:
As further steps, there is need to repeat such studies for priority sites including information on cancer stage and treatment protocol.
 

Actuarial and Kaplan-Meier survival for NHL