{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:46:37Z","timestamp":1780393597594,"version":"3.54.1"},"reference-count":111,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Rev Gastroenterol Hepatol"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1038\/s41575-025-01138-9","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T11:03:06Z","timestamp":1763377386000},"page":"189-200","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishing cancer registries in Africa \u2014 focus on hepatopancreatobiliary cancers"],"prefix":"10.1038","volume":"23","author":[{"given":"Akwi W.","family":"Asombang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-9489","authenticated-orcid":false,"given":"Samuel O.","family":"Antwi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abidemi","family":"Omonisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Cooley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2891-3082","authenticated-orcid":false,"given":"Yvonne A.","family":"Nartey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin J.","family":"VanLith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailemichael","family":"Desalegn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Okeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-5714","authenticated-orcid":false,"given":"Fidel","family":"Rubagumya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Africa HepatoPancreatoBiliary Cancer Consortium (AHPBCC)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert T.","family":"Yonli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El-Kassas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Chipaila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolni Marius","family":"Nagalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-8574","authenticated-orcid":false,"given":"Lewis R.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"1138_CR1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1038\/s41572-020-00240-3","volume":"7","author":"JM Llovet","year":"2021","unstructured":"Llovet, J. M. et al. Hepatocellular carcinoma. Nat. Rev. Dis. Prim. 7, 6 (2021).","journal-title":"Nat. Rev. Dis. Prim."},{"key":"1138_CR2","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1016\/j.cell.2023.02.014","volume":"186","author":"CJ Halbrook","year":"2023","unstructured":"Halbrook, C. J., Lyssiotis, C. A., Pasca di Magliano, M. & Maitra, A. Pancreatic cancer: advances and challenges. Cell 186, 1729\u20131754 (2023).","journal-title":"Cell"},{"key":"1138_CR3","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1038\/s41572-021-00300-2","volume":"7","author":"PJ Brindley","year":"2021","unstructured":"Brindley, P. J. et al. Cholangiocarcinoma. Nat. Rev. Dis. Prim. 7, 65 (2021).","journal-title":"Nat. Rev. Dis. Prim."},{"key":"1138_CR4","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.annonc.2022.10.506","volume":"34","author":"A Vogel","year":"2023","unstructured":"Vogel, A. et al. Biliary tract cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann. Oncol. 34, 127\u2013140 (2023).","journal-title":"Ann. Oncol."},{"key":"1138_CR5","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1053\/j.gastro.2016.11.048","volume":"152","author":"D Sia","year":"2017","unstructured":"Sia, D., Villanueva, A., Friedman, S. L. & Llovet, J. M. Liver cancer cell of origin, molecular class, and effects on patient prognosis. Gastroenterology 152, 745\u2013761 (2017).","journal-title":"Gastroenterology"},{"key":"1138_CR6","first-page":"12","volume":"74","author":"RL Siegel","year":"2024","unstructured":"Siegel, R. L., Giaquinto, A. N. & Jemal, A. Cancer statistics, 2024. CA Cancer J. Clin. 74, 12\u201349 (2024).","journal-title":"CA Cancer J. Clin."},{"key":"1138_CR7","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-13605-3","volume":"12","author":"MJ Kang","year":"2022","unstructured":"Kang, M. J. et al. Distinct prognosis of biliary tract cancer according to tumor location, stage, and treatment: a population-based study. Sci. Rep. 12, 10206 (2022).","journal-title":"Sci. Rep."},{"key":"1138_CR8","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10286-z","volume":"22","author":"J Koshiol","year":"2022","unstructured":"Koshiol, J., Yu, B., Kabadi, S. M., Baria, K. & Shroff, R. T. Epidemiologic patterns of biliary tract cancer in the United States: 2001-2015. BMC Cancer 22, 1178 (2022).","journal-title":"BMC Cancer"},{"key":"1138_CR9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.hpb.2023.09.015","volume":"26","author":"S Sobnach","year":"2024","unstructured":"Sobnach, S. et al. The management and outcomes of hepatocellular carcinoma in sub-Saharan Africa: a systematic review. HPB 26, 21\u201333 (2024).","journal-title":"HPB"},{"issue":"Suppl. 1","key":"1138_CR10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/hep.31288","volume":"73","author":"KA McGlynn","year":"2021","unstructured":"McGlynn, K. A., Petrick, J. L. & El-Serag, H. B. Epidemiology of hepatocellular carcinoma. Hepatology 73(Suppl. 1), 4\u201313 (2021).","journal-title":"Hepatology"},{"key":"1138_CR11","first-page":"212","volume":"44","author":"AW Asombang","year":"2017","unstructured":"Asombang, A. W. et al. Pancreatic cancer: patterns in a low-to middle-income population, Zambia. Med. J. Zamb. 44, 212\u2013217 (2017).","journal-title":"Med. J. Zamb."},{"key":"1138_CR12","doi-asserted-by":"publisher","first-page":"6234","DOI":"10.3390\/cancers14246234","volume":"14","author":"SO Antwi","year":"2022","unstructured":"Antwi, S. O., Craver, E. C., Nartey, Y. A., Sartorius, K. & Patel, T. Metabolic risk factors for hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: a prospective study. Cancers 14, 6234 (2022).","journal-title":"Cancers"},{"key":"1138_CR13","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/j.dld.2021.12.002","volume":"54","author":"DS Nasereldin","year":"2022","unstructured":"Nasereldin, D. S. et al. Association of metabolic health phenotypes, obesity, and hepatocellular carcinoma risk. Dig. Liver Dis. 54, 964\u2013972 (2022).","journal-title":"Dig. Liver Dis."},{"key":"1138_CR14","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1053\/j.gastro.2018.08.065","volume":"156","author":"L Kulik","year":"2019","unstructured":"Kulik, L. & El-Serag, H. B. Epidemiology and management of hepatocellular carcinoma. Gastroenterology 156, 477\u2013491.e1 (2019).","journal-title":"Gastroenterology"},{"key":"1138_CR15","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1038\/s41571-023-00825-3","volume":"20","author":"AG Singal","year":"2023","unstructured":"Singal, A. G., Kanwal, F. & Llovet, J. M. Global trends in hepatocellular carcinoma epidemiology: implications for screening, prevention and therapy. Nat. Rev. Clin. Oncol. 20, 864\u2013884 (2023).","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"1138_CR16","unstructured":"Antwi S. O., Jansen R. J. & Petersen G. M. In Cancer Epidemiology and Prevention 4th edn (eds Thun, M., Linet, M. S., Cerhan, J. R., Haiman, C. A. & Schottenfeld, D.) 611\u2013634 (Oxford University Press, 2017)."},{"key":"1138_CR17","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/S0140-6736(10)62307-0","volume":"378","author":"A Vincent","year":"2011","unstructured":"Vincent, A., Herman, J., Schulick, R., Hruban, R. H. & Goggins, M. Pancreatic cancer. Lancet 378, 607\u2013620 (2011).","journal-title":"Lancet"},{"key":"1138_CR18","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1038\/s41575-021-00457-x","volume":"18","author":"AP Klein","year":"2021","unstructured":"Klein, A. P. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat. Rev. Gastroenterol. Hepatol. 18, 493\u2013502 (2021).","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"1138_CR19","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1093\/carcin\/bgw022","volume":"37","author":"SO Antwi","year":"2016","unstructured":"Antwi, S. O. et al. Pancreatic cancer: associations of inflammatory potential of diet, cigarette smoking and long-standing diabetes. Carcinogenesis 37, 481\u2013490 (2016).","journal-title":"Carcinogenesis"},{"key":"1138_CR20","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1053\/j.gastro.2023.02.012","volume":"164","author":"EM Stoffel","year":"2023","unstructured":"Stoffel, E. M., Brand, R. E. & Goggins, M. Pancreatic cancer: changing epidemiology and new approaches to risk assessment, early detection, and prevention. Gastroenterology 164, 752\u2013765 (2023).","journal-title":"Gastroenterology"},{"key":"1138_CR21","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S0140-6736(21)00153-7","volume":"397","author":"JW Valle","year":"2021","unstructured":"Valle, J. W., Kelley, R. K., Nervi, B., Oh, D.-Y. & Zhu, A. X. Biliary tract cancer. Lancet 397, 428\u2013444 (2021).","journal-title":"Lancet"},{"key":"1138_CR22","doi-asserted-by":"publisher","first-page":"3973","DOI":"10.1158\/0008-5472.CAN-19-0459","volume":"79","author":"SS Jackson","year":"2019","unstructured":"Jackson, S. S. et al. Anthropometric risk factors for cancers of the biliary tract in the biliary tract cancers pooling project. Cancer Res. 79, 3973\u20133982 (2019).","journal-title":"Cancer Res."},{"key":"1138_CR23","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1038\/s41416-018-0007-z","volume":"118","author":"JL Petrick","year":"2018","unstructured":"Petrick, J. L. et al. Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project. Br. J. Cancer 118, 1005\u20131012 (2018).","journal-title":"Br. J. Cancer"},{"key":"1138_CR24","unstructured":"International Agency for Research on Cancer. Cancer today. Liver and Intrahepatic Bile Ducts https:\/\/gco.iarc.fr\/today\/en\/dataviz\/tables?mode=population&cancers=11&types=0&populations=108_12_120_132_140_148 (2022)."},{"key":"1138_CR25","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/S2468-1253(22)00041-3","volume":"7","author":"CW Spearman","year":"2022","unstructured":"Spearman, C. W. et al. Hepatocellular carcinoma: measures to improve the outlook in sub-Saharan Africa. Lancet Gastroenterol. Hepatol. 7, 1036\u20131048 (2022).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"1138_CR26","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1002\/cam4.4530","volume":"11","author":"J Yang","year":"2022","unstructured":"Yang, J. et al. The burden of primary liver cancer caused by specific etiologies from 1990 to 2019 at the global, regional, and national levels. Cancer Med. 11, 1357\u20131370 (2022).","journal-title":"Cancer Med."},{"key":"1138_CR27","unstructured":"World Health Organization. Global Hepatitis Report 2024: Action For Access In Low-and Middle-income Countries (WHO, 2024)."},{"key":"1138_CR28","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-08426-y","volume":"21","author":"OB Dakurah","year":"2021","unstructured":"Dakurah, O. B., Tamandjou, C. R. T., Zunza, M., Preiser, W. & Maponga, T. G. Viral hepatitis associated hepatocellular carcinoma on the African continent, the past, present, and future: a systematic review. BMC Cancer 21, 715 (2021).","journal-title":"BMC Cancer"},{"key":"1138_CR29","first-page":"39","volume":"7","author":"D Mak","year":"2021","unstructured":"Mak, D. & Kramvis, A. Epidemiology and aetiology of hepatocellular carcinoma in sub-Saharan Africa. Hepatoma Res. 7, 39 (2021).","journal-title":"Hepatoma Res."},{"key":"1138_CR30","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/S2468-1253(16)30161-3","volume":"2","author":"JD Yang","year":"2017","unstructured":"Yang, J. D. et al. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol. Hepatol. 2, 103\u2013111 (2017).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"1138_CR31","doi-asserted-by":"publisher","first-page":"783","DOI":"10.4254\/wjh.v6.i11.783","volume":"6","author":"NG Ladep","year":"2014","unstructured":"Ladep, N. G. et al. Problem of hepatocellular carcinoma in West Africa. World J. Hepatol. 6, 783\u2013792 (2014).","journal-title":"World J. Hepatol."},{"key":"1138_CR32","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1186\/s12876-020-01581-9","volume":"20","author":"YA Nartey","year":"2020","unstructured":"Nartey, Y. A. et al. Ambulatory end-stage liver disease in Ghana; patient profile and utility of alpha fetoprotein and aspartate aminotransferase: platelet ratio index. BMC Gastroenterol. 20, 428 (2020).","journal-title":"BMC Gastroenterol."},{"key":"1138_CR33","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray, F. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 74, 229\u2013263 (2024).","journal-title":"CA Cancer J. Clin."},{"key":"1138_CR34","doi-asserted-by":"publisher","first-page":"9694","DOI":"10.3748\/wjg.v22.i44.9694","volume":"22","author":"M Ilic","year":"2016","unstructured":"Ilic, M. & Ilic, I. Epidemiology of pancreatic cancer. World J. Gastroenterol. 22, 9694\u20139705 (2016).","journal-title":"World J. Gastroenterol."},{"key":"1138_CR35","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1097\/JS9.0000000000001054","volume":"110","author":"Z Li","year":"2024","unstructured":"Li, Z. et al. Global, regional, and national burdens of early onset pancreatic cancer in adolescents and adults aged 15-49 years from 1990 to 2019 based on the Global Burden of Disease Study 2019: a cross-sectional study. Int. J. Surg. 110, 1929\u20131940 (2024).","journal-title":"Int. J. Surg."},{"key":"1138_CR36","unstructured":"IARC\u2013WHO. Database. Cancer Over Time https:\/\/gco.iarc.fr\/overtime\/en\/database (accessed 20 July 2024)."},{"key":"1138_CR37","first-page":"589","volume":"72","author":"OG Ajao","year":"1980","unstructured":"Ajao, O. G. & Abioye, A. A. Pancreatic carcinoma. J. Natl Med. Assoc. 72, 589\u2013590 (1980).","journal-title":"J. Natl Med. Assoc."},{"key":"1138_CR38","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1001\/jama.2021.13027","volume":"326","author":"W Park","year":"2021","unstructured":"Park, W., Chawla, A. & O\u2019Reilly, E. M. Pancreatic cancer: a review. Jama 326, 851\u2013862 (2021).","journal-title":"Jama"},{"key":"1138_CR39","doi-asserted-by":"publisher","first-page":"27","DOI":"10.7196\/SAMJ.2024.v114i1.1132","volume":"114","author":"ML Nhleko","year":"2023","unstructured":"Nhleko, M. L., Edoka, I. & Musenge, E. Pancreatic cancer mortality in South Africa: a case-control study. S. Afr. Med. J. 114, 27\u201332 (2023).","journal-title":"S. Afr. Med. J."},{"key":"1138_CR40","doi-asserted-by":"publisher","first-page":"14297","DOI":"10.1007\/s00432-023-05245-5","volume":"149","author":"F Amri","year":"2023","unstructured":"Amri, F. et al. Pancreatic cancer: experience from an emerging country in North Africa. J. Cancer Res. Clin. Oncol. 149, 14297\u201314302 (2023).","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"1138_CR41","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12876-023-02687-6","volume":"23","author":"AW Asombang","year":"2023","unstructured":"Asombang, A. W. et al. Systematic review of cholangiocarcinoma in Africa: epidemiology, management, and clinical outcomes. BMC Gastroenterol. 23, 66 (2023).","journal-title":"BMC Gastroenterol."},{"key":"1138_CR42","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1093\/annonc\/mdn533","volume":"20","author":"G Randi","year":"2009","unstructured":"Randi, G. et al. Epidemiology of biliary tract cancers: an update. Ann. Oncol. 20, 146\u2013159 (2009).","journal-title":"Ann. Oncol."},{"key":"1138_CR43","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1093\/oncolo\/oyac150","volume":"27","author":"M Javle","year":"2022","unstructured":"Javle, M. et al. Temporal changes in cholangiocarcinoma incidence and mortality in the United States from 2001 to 2017. Oncologist 27, 874\u2013883 (2022).","journal-title":"Oncologist"},{"issue":"Suppl. 1","key":"1138_CR44","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1111\/liv.14095","volume":"39","author":"SA Khan","year":"2019","unstructured":"Khan, S. A., Tavolari, S. & Brandi, G. Cholangiocarcinoma: epidemiology and risk factors. Liver Int. 39 (Suppl. 1), 19\u201331 (2019).","journal-title":"Liver Int."},{"key":"1138_CR45","first-page":"329","volume":"44","author":"TO Babatunde","year":"2015","unstructured":"Babatunde, T. O. & Ogunbiyi, J. O. Pattern of biliary tract carcinoma at the University College Hospital, Ibadan. Afr. J. Med. Med. Sci. 44, 329\u2013334 (2015).","journal-title":"Afr. J. Med. Med. Sci."},{"key":"1138_CR46","first-page":"1626","volume":"54","author":"M Abdel Wahab","year":"2007","unstructured":"Abdel Wahab, M. et al. Epidemiology of hilar cholangiocarcinoma in Egypt: single center study. Hepatogastroenterology 54, 1626\u20131631 (2007).","journal-title":"Hepatogastroenterology"},{"key":"1138_CR47","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.surg.2021.09.016","volume":"171","author":"ZA Khan","year":"2022","unstructured":"Khan, Z. A., Khan, M. U. & Brand, M. Gallbladder cancer in Africa: a higher than expected rate in a \u201clow-risk\u201d population. Surgery 171, 855\u2013858 (2022).","journal-title":"Surgery"},{"key":"1138_CR48","doi-asserted-by":"publisher","first-page":"S274","DOI":"10.1016\/j.hpb.2024.03.552","volume":"26","author":"M Cooley","year":"2024","unstructured":"Cooley, M. et al. Assessing capabilities of Africa hepatopancreatobiliary cancer consortium member institutions for research and the clinical management of hepato-pancreato-biliary cancers. HPB 26, S274\u2013S275 (2024).","journal-title":"HPB"},{"key":"1138_CR49","doi-asserted-by":"publisher","first-page":"46","DOI":"10.4291\/wjgp.v14.i3.46","volume":"14","author":"HB Choudhary","year":"2023","unstructured":"Choudhary, H. B., Mandlik, S. K. & Mandlik, D. S. Role of p53 suppression in the pathogenesis of hepatocellular carcinoma. World J. Gastrointest. Pathophysiol. 14, 46\u201370 (2023).","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"1138_CR50","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.606400","volume":"10","author":"SO Rotimi","year":"2020","unstructured":"Rotimi, S. O., Rotimi, O. A. & Salhia, B. A review of cancer genetics and genomics studies in Africa. Front. Oncol. 10, 606400 (2020).","journal-title":"Front. Oncol."},{"key":"1138_CR51","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1200\/GO.20.00425","volume":"7","author":"VVP Kedar Mukthinuthalapati","year":"2021","unstructured":"Kedar Mukthinuthalapati, V. V. P. et al. Hepatocellular carcinoma in sub-Saharan Africa. JCO Glob. Oncol. 7, 756\u2013766 (2021).","journal-title":"JCO Glob. Oncol."},{"key":"1138_CR52","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.899420","volume":"9","author":"M El-Kassas","year":"2022","unstructured":"El-Kassas, M. & Elbadry, M. Hepatocellular carcinoma in Africa: challenges and opportunities. Front. Med. 9, 899420 (2022).","journal-title":"Front. Med."},{"key":"1138_CR53","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1080\/17474124.2020.1802246","volume":"14","author":"A Sultan","year":"2020","unstructured":"Sultan, A. et al. Single center analysis of therapy and outcomes of hepatocellular carcinoma in sub-Saharan Africa. Expert. Rev. Gastroenterol. Hepatol. 14, 1007\u20131011 (2020).","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"1138_CR54","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1016\/S2468-1253(22)00042-5","volume":"7","author":"E Jonas","year":"2022","unstructured":"Jonas, E. et al. Treatment of hepatocellular carcinoma in sub-Saharan Africa: challenges and solutions. Lancet Gastroenterol. Hepatol. 7, 1049\u20131060 (2022).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"1138_CR55","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1038\/bjc.1950.16","volume":"4","author":"EL Kennaway","year":"1950","unstructured":"Kennaway, E. L. The data relating to cancer in the publications of the General Register Office. Br. J. Cancer 4, 158\u2013172 (1950).","journal-title":"Br. J. Cancer"},{"key":"1138_CR56","unstructured":"Wagner G. In: History of Cancer Registration (eds Jensen, O. M., Parkin, D. M., MacLennan, R., Muir, C. S. & Skeet, R. G.) 95, 3\u20136 (IARC Scientific Publications, 1991)."},{"key":"1138_CR57","doi-asserted-by":"publisher","first-page":"3934","DOI":"10.3390\/cancers15153934","volume":"15","author":"A Katalinic","year":"2023","unstructured":"Katalinic, A. et al. Population-based clinical cancer registration in Germany. Cancers 15, 3934 (2023).","journal-title":"Cancers"},{"key":"1138_CR58","first-page":"475","volume":"59","author":"W Haenszel","year":"1986","unstructured":"Haenszel, W. & Curnen, M. The first fifty years of the Connecticut Tumor Registry: reminiscences and prospects. Yale J. Biol. Med. 59, 475 (1986).","journal-title":"Yale J. Biol. Med."},{"issue":"Suppl. 7","key":"1138_CR59","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1177\/1403494810393562","volume":"39","author":"ML Gjerstorff","year":"2011","unstructured":"Gjerstorff, M. L. The Danish Cancer Registry. Scand. J. Public Health 39 (Suppl. 7), 42\u201345 (2011).","journal-title":"Scand. J. Public Health"},{"key":"1138_CR60","unstructured":"Parkin D. M. et al. Cancer in Africa: Epidemiology and Prevention (IARC Press, 2003)."},{"key":"1138_CR61","unstructured":"Bray, F. et al. (eds) Cancer Incidence in Five Continents Volume XI https:\/\/publications.iarc.fr\/597 (IARC, 2021)."},{"key":"1138_CR62","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1200\/GO.21.00065","volume":"7","author":"Z Abdul-Sater","year":"2021","unstructured":"Abdul-Sater, Z. et al. Cancer registration in the Middle East, North Africa, and Turkey: scope and challenges. JCO Glob. Oncol. 7, 1101\u20131109 (2021).","journal-title":"JCO Glob. Oncol."},{"key":"1138_CR63","unstructured":"IARC\u2013WHO. The Global Initiative for Cancer Registry Development. https:\/\/gicr.iarc.fr\/ (accessed 23 October 2025)."},{"key":"1138_CR64","doi-asserted-by":"publisher","first-page":"ed95","DOI":"10.3332\/ecancer.2020.ed95","volume":"14","author":"L Mery","year":"2020","unstructured":"Mery, L. & Bray, F. Population-based cancer registries: a gateway to improved surveillance of non-communicable diseases. Ecancermedicalscience 14, ed95 (2020).","journal-title":"Ecancermedicalscience"},{"key":"1138_CR65","unstructured":"Jensen, O. M., Parkin, D. M., MacLennan R., Muir C. S. & Skeet R. G. Cancer Registration: Principles and Methods (International Agency for Research on Cancer, 1991)."},{"key":"1138_CR66","first-page":"325","volume":"21","author":"MS Piver","year":"2000","unstructured":"Piver, M. S. The Gilda Radner Familial Ovarian Cancer Registry 1981-2000. Eur. J. Gynaecol. Oncol. 21, 325\u2013333 (2000).","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"1138_CR67","first-page":"22","volume":"95","author":"O Jensen","year":"1991","unstructured":"Jensen, O. et al. Planning a cancer registry. IARC Sci. Publ. 95, 22\u201328 (1991).","journal-title":"IARC Sci. Publ."},{"key":"1138_CR68","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1093\/ije\/29.2.197","volume":"29","author":"RM Merrill","year":"2000","unstructured":"Merrill, R. M., Capocaccia, R., Feuer, E. J. & Mariotto, A. Cancer prevalence estimates based on tumour registry data in the Surveillance, Epidemiology, and End Results (SEER) Program. Int. J. Epidemiol. 29, 197\u2013207 (2000).","journal-title":"Int. J. Epidemiol."},{"key":"1138_CR69","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003379","volume":"4","author":"DF Hordofa","year":"2024","unstructured":"Hordofa, D. F. et al. Childhood cancer presentation and initial outcomes in Ethiopia: Findings from a recently opened pediatric oncology unit. PLoS Glob. Public Health 4, e0003379 (2024).","journal-title":"PLoS Glob. Public Health"},{"key":"1138_CR70","doi-asserted-by":"publisher","first-page":"107","DOI":"10.7196\/SAMJ.8858","volume":"105","author":"E Singh","year":"2015","unstructured":"Singh, E. et al. South African National Cancer Registry: effect of withheld data from private health systems on cancer incidence estimates. S. Afr. Med. J. 105, 107\u2013109 (2015).","journal-title":"S. Afr. Med. J."},{"key":"1138_CR71","doi-asserted-by":"publisher","first-page":"47","DOI":"10.2147\/HMER.S193996","volume":"11","author":"M Alsaleh","year":"2019","unstructured":"Alsaleh, M. et al. Characterization of the urinary metabolic profile of cholangiocarcinoma in a United Kingdom population. Hepat. Med. 11, 47\u201367 (2019).","journal-title":"Hepat. Med."},{"key":"1138_CR72","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.744667","volume":"11","author":"Y Cao","year":"2021","unstructured":"Cao, Y. et al. Potential metabolite biomarkers for early detection of stage-I pancreatic ductal adenocarcinoma. Front. Oncol. 11, 744667 (2021).","journal-title":"Front. Oncol."},{"key":"1138_CR73","unstructured":"Gliklich R. D. N. & Leavy M. (eds) Registries for Evaluating Patient Outcomes: A User\u2019s Guide. 3rd edn Vol. 1 https:\/\/effectivehealthcare.ahrq.gov\/sites\/default\/files\/pdf\/registries-guide-3rd-edition_research.pdf (AHRQ, 2014)."},{"key":"1138_CR74","doi-asserted-by":"publisher","first-page":"191","DOI":"10.11604\/pamj.2014.17.191.3830","volume":"17","author":"DC Stefan","year":"2014","unstructured":"Stefan, D. C., Baadjes, B. & Kruger, M. Incidence of childhood cancer in Namibia: the need for registries in Africa. Pan Afr. Med. J. 17, 191 (2014).","journal-title":"Pan Afr. Med. J."},{"key":"1138_CR75","unstructured":"Ferlay J. et al. Planning and Developing a Population-based Cancer Registry https:\/\/publications.iarc.who.int\/_publications\/media\/download\/3825\/bc7196e57145aa392ed99caac790f0f9f3242807.pdf (IARC, 2014)."},{"key":"1138_CR76","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.1200\/GO.20.00294","volume":"6","author":"AE Omonisi","year":"2020","unstructured":"Omonisi, A. E., Liu, B. & Parkin, D. M. Population-based cancer registration in sub-Saharan Africa: its role in research and cancer control. JCO Glob. Oncol. 6, 1721\u20131728 (2020).","journal-title":"JCO Glob. Oncol."},{"key":"1138_CR77","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1002\/ijc.28661","volume":"135","author":"HR Wabinga","year":"2014","unstructured":"Wabinga, H. R. et al. Trends in the incidence of cancer in Kampala, Uganda 1991-2010. Int. J. Cancer 135, 432\u2013439 (2014).","journal-title":"Int. J. Cancer"},{"key":"1138_CR78","first-page":"128","volume":"9","author":"YC Wang","year":"2012","unstructured":"Wang, Y. C., Wei, L. J., Liu, J. T., Li, S. X. & Wang, Q. S. Comparison of cancer incidence between China and the USA. Cancer Biol. Med. 9, 128\u2013132 (2012).","journal-title":"Cancer Biol. Med."},{"key":"1138_CR79","first-page":"394","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray, F. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 68, 394\u2013424 (2018).","journal-title":"CA Cancer J. Clin."},{"key":"1138_CR80","first-page":"144","volume":"57","author":"G Shrestha","year":"2019","unstructured":"Shrestha, G., Pradhananga, K. K., Mulmi, R., Subedi, K. P. & Siwakoti, B. Cancer registration in Nepal: current status and way forward. JNMA J. Nepal. Med. Assoc. 57, 144\u2013148 (2019).","journal-title":"JNMA J. Nepal. Med. Assoc."},{"key":"1138_CR81","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.21.00149","volume":"6","author":"ME Charlton","year":"2022","unstructured":"Charlton, M. E. et al. Cancer registry data linkage of electronic health record data from ASCO\u2019s CancerLinQ: evaluation of advantages, limitations, and lessons learned. JCO Clin. Cancer Inform. 6, e2100149 (2022).","journal-title":"JCO Clin. Cancer Inform."},{"key":"1138_CR82","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-011338","volume":"8","author":"F Rubagumya","year":"2023","unstructured":"Rubagumya, F. et al. An analysis of the African cancer research ecosystem: tackling disparities. BMJ Glob. Health 8, e011338 (2023).","journal-title":"BMJ Glob. Health"},{"key":"1138_CR83","doi-asserted-by":"publisher","first-page":"e251","DOI":"10.1016\/S1470-2045(21)00720-8","volume":"23","author":"W Ngwa","year":"2022","unstructured":"Ngwa, W. et al. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. Lancet Oncol. 23, e251\u2013e312 (2022).","journal-title":"Lancet Oncol."},{"key":"1138_CR84","first-page":"751","volume":"20","author":"MP Curado","year":"2009","unstructured":"Curado, M. P., Voti, L. & Sortino-Rachou, A. M. Cancer registration data and quality indicators in low and middle income countries: their interpretation and potential use for the improvement of cancer care. Cancer Causes Control 20, 751\u2013756 (2009).","journal-title":"Cancer Causes Control"},{"key":"1138_CR85","volume":"26","author":"J de Castro","year":"2017","unstructured":"de Castro, J. et al. Systemic therapy treatment patterns in patients with advanced non-small cell lung cancer (NSCLC): PIvOTAL study. Eur. J. Cancer Care 26, e12734 (2017).","journal-title":"Eur. J. Cancer Care"},{"key":"1138_CR86","unstructured":"Bray F. et al. Planning and Developing Population-based Cancer Registration in Low- or Middle-income Settings (International Agency for Research on Cancer, 2014)."},{"key":"1138_CR87","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S1470-2045(08)70028-7","volume":"9","author":"MG Valsecchi","year":"2008","unstructured":"Valsecchi, M. G. & Steliarova-Foucher, E. Cancer registration in developing countries: luxury or necessity? Lancet Oncol. 9, 159\u2013167 (2008).","journal-title":"Lancet Oncol."},{"key":"1138_CR88","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-01962-y","volume":"22","author":"O Omotoso","year":"2023","unstructured":"Omotoso, O. et al. Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. Int. J. Equity Health 22, 189 (2023).","journal-title":"Int. J. Equity Health"},{"key":"1138_CR89","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.3332\/ecancer.2021.1308","volume":"15","author":"EO Akin-Odanye","year":"2021","unstructured":"Akin-Odanye, E. O. & Husman, A. J. Impact of stigma and stigma-focused interventions on screening and treatment outcomes in cancer patients. Ecancermedicalscience 15, 1308 (2021).","journal-title":"Ecancermedicalscience"},{"key":"1138_CR90","doi-asserted-by":"publisher","first-page":"iii66","DOI":"10.1093\/annonc\/mds091","volume":"23","author":"M Daher","year":"2012","unstructured":"Daher, M. Cultural beliefs and values in cancer patients. Ann. Oncol. 23, iii66\u2013iii69 (2012).","journal-title":"Ann. Oncol."},{"key":"1138_CR91","doi-asserted-by":"publisher","first-page":"23","DOI":"10.3348\/kjr.2019.0862","volume":"22","author":"H Rhee","year":"2021","unstructured":"Rhee, H. & Park, M. S. The role of imaging in current treatment strategies for pancreatic adenocarcinoma. Korean J. Radiol. 22, 23\u201340 (2021).","journal-title":"Korean J. Radiol."},{"key":"1138_CR92","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1002\/cncr.34541","volume":"129","author":"KC Ohaegbulam","year":"2023","unstructured":"Ohaegbulam, K. C. et al. The multidisciplinary management of cholangiocarcinoma. Cancer 129, 184\u2013214 (2023).","journal-title":"Cancer"},{"key":"1138_CR93","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s11864-023-01153-5","volume":"25","author":"M Wheless","year":"2024","unstructured":"Wheless, M. et al. Current standards, multidisciplinary approaches, and future directions in the management of extrahepatic cholangiocarcinoma. Curr. Treat. Options Oncol. 25, 127\u2013160 (2024).","journal-title":"Curr. Treat. Options Oncol."},{"key":"1138_CR94","doi-asserted-by":"publisher","DOI":"10.1177\/10732748211038735","volume":"28","author":"P Pi\u00f1a-S\u00e1nchez","year":"2021","unstructured":"Pi\u00f1a-S\u00e1nchez, P. et al. Cancer biology, epidemiology, and treatment in the 21st century: current status and future challenges from a biomedical perspective. Cancer Control. 28, 10732748211038735 (2021).","journal-title":"Cancer Control."},{"key":"1138_CR95","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.650117","volume":"11","author":"Y Hamdi","year":"2021","unstructured":"Hamdi, Y. et al. Cancer in Africa: the untold story. Front. Oncol. 11, 650117 (2021).","journal-title":"Front. Oncol."},{"key":"1138_CR96","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00428-024-03744-5","volume":"484","author":"T Longerich","year":"2024","unstructured":"Longerich, T., Stenzinger, A. & Schirmacher, P. Molecular diagnostics of hepatobiliary and pancreatic neoplasias. Virchows Arch. 484, 263\u2013272 (2024).","journal-title":"Virchows Arch."},{"key":"1138_CR97","doi-asserted-by":"publisher","first-page":"29","DOI":"10.21037\/hbsn-22-563","volume":"13","author":"EAK Warren","year":"2024","unstructured":"Warren, E. A. K. & Maithel, S. K. Molecular pathology for cholangiocarcinoma: a review of actionable genetic targets and their relevance to adjuvant & neoadjuvant therapy, staging, follow-up, and determination of minimal residual disease. Hepatobiliary Surg. Nutr. 13, 29\u201338 (2024).","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"1138_CR98","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1390560","volume":"11","author":"RJ Byers","year":"2024","unstructured":"Byers, R. J. et al. Development of an online teaching platform to improve access to postgraduate pathology training in sub-Saharan Africa. Front. Med. 11, 1390560 (2024).","journal-title":"Front. Med."},{"key":"1138_CR99","doi-asserted-by":"publisher","DOI":"10.1186\/1470-7330-14-14","volume":"14","author":"TP Hennedige","year":"2014","unstructured":"Hennedige, T. P., Neo, W. T. & Venkatesh, S. K. Imaging of malignancies of the biliary tract- an update. Cancer Imaging 14, 14 (2014).","journal-title":"Cancer Imaging"},{"key":"1138_CR100","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/s00534-002-0775-x","volume":"11","author":"D Delbeke","year":"2004","unstructured":"Delbeke, D. & Pinson, C. W. Pancreatic tumors: role of imaging in the diagnosis, staging, and treatment. J. Hepatobiliary Pancreat. Surg. 11, 4\u201310 (2004).","journal-title":"J. Hepatobiliary Pancreat. Surg."},{"key":"1138_CR101","doi-asserted-by":"publisher","first-page":"3800","DOI":"10.1007\/s00261-020-02587-3","volume":"45","author":"R Chung","year":"2020","unstructured":"Chung, R., Rosenkrantz, A. B. & Shanbhogue, K. P. Expert radiologist review at a hepatobiliary multidisciplinary tumor board: impact on patient management. Abdom. Radiol. 45, 3800\u20133808 (2020).","journal-title":"Abdom. Radiol."},{"key":"1138_CR102","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291897","volume":"19","author":"V Olago","year":"2024","unstructured":"Olago, V. et al. Cancer diagnostic service use in people living with HIV in South Africa: a cross-sectional study. PLoS One 19, e0291897 (2024).","journal-title":"PLoS One"},{"key":"1138_CR103","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(15)00755-2","volume":"387","author":"H Gelband","year":"2016","unstructured":"Gelband, H. et al. Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition. Lancet 387, 2133\u20132144 (2016).","journal-title":"Lancet"},{"key":"1138_CR104","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-12294-7","volume":"24","author":"J Trabitzsch","year":"2024","unstructured":"Trabitzsch, J. et al. Understanding referral of patients with cancer in rural Ethiopia: a qualitative study. BMC Cancer 24, 553 (2024).","journal-title":"BMC Cancer"},{"key":"1138_CR105","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1007\/s00534-009-0136-0","volume":"16","author":"H Isayama","year":"2009","unstructured":"Isayama, H. Current topics in pancreato-biliary endotherapy: what can we do? J. Hepatobiliary Pancreat. Surg. 16, 589\u2013591 (2009).","journal-title":"J. Hepatobiliary Pancreat. Surg."},{"key":"1138_CR106","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2023.2181920","volume":"16","author":"R Lee","year":"2023","unstructured":"Lee, R. & Holmes, D. Barriers and recommendations for colorectal cancer screening in Africa. Glob. Health Action. 16, 2181920 (2023).","journal-title":"Glob. Health Action."},{"key":"1138_CR107","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1002\/wjs.12097","volume":"48","author":"O Michael","year":"2024","unstructured":"Michael, O. et al. Advancing complex hepato-pancreato-biliary surgery in Uganda: challenges and outcomes. World J. Surg. 48, 924\u2013931 (2024).","journal-title":"World J. Surg."},{"key":"1138_CR108","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/S2468-1253(23)00396-5","volume":"9","author":"N Tazinkeng","year":"2024","unstructured":"Tazinkeng, N. et al. Gastroenterology training in Africa: an assessment of curriculum and perception. Lancet Gastroenterol. Hepatol. 9, 195\u2013197 (2024).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"1138_CR109","unstructured":"Gelband, H., Jha, P., Sankaranarayanan, R., Gauvreau, C. L. & Horton, S. In: Cancer: Disease Control Priorities 2nd edn, Vol. 3 (eds Gelband, H., Jha, P., Sankaranarayanan, R. & Horton, S.) (The International Bank for Reconstruction and Development\/The World Bank, 2015)."},{"key":"1138_CR110","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1016\/S0140-6736(17)32906-9","volume":"391","author":"DT Jamison","year":"2018","unstructured":"Jamison, D. T. et al. Universal health coverage and intersectoral action for health: key messages from disease control priorities, 3rd edition. Lancet 391, 1108\u20131120 (2018).","journal-title":"Lancet"},{"key":"1138_CR111","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_432104","volume":"44","author":"N Bogere","year":"2024","unstructured":"Bogere, N., Were, E., Asasira, J. & Orem, J. Enhancing cancer care through quality initiatives: the Uganda Cancer Institute experience with the Quality Oncology Practice Initiative. Am. Soc. Clin. Oncol. Educ. Book. 44, e432104 (2024).","journal-title":"Am. Soc. Clin. Oncol. Educ. Book."}],"container-title":["Nature Reviews Gastroenterology &amp; Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41575-025-01138-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41575-025-01138-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41575-025-01138-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T13:02:54Z","timestamp":1770037374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41575-025-01138-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":111,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["1138"],"URL":"https:\/\/doi.org\/10.1038\/s41575-025-01138-9","relation":{},"ISSN":["1759-5045","1759-5053"],"issn-type":[{"value":"1759-5045","type":"print"},{"value":"1759-5053","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"assertion":[{"value":"2 October 2025","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}