Accurate and timely cancer diagnosis offers those with cancer the best chance for a cure. However, today people from all geographical areas, ethnic groups and specific populations do not have an equal chance for cure. Not every physician in the U.S. and around the world has the training and resources to accurately diagnose cancer under microscope to offer appropriate treatment for these diverse populations.
The mission of the World Tumor Registry is to minimize diagnostic errors, eliminate inequality in cancer recognition, diagnosis, and treatment in diverse populations, and improve outcomes by increasing access to the diagnostic pathology expertise and knowledge of microscopic characteristics of cancers that occur in different geographic, environmental, cultural, and socio-economic settings.
The World Tumor RegistryTM, Inc (WTRTM) is a non-profit 501(c)(3) international organization headquartered in Pittsburgh, USA. It was founded in 2021 with the goal of establishing a comprehensive, searchable, open-access catalog of digital microscopic images of human cancer types and subtypes occurring in different geographic regions, populations, and environmental and socio-economic settings. It was created to serve as an educational and practical resource for individuals and public organizations involved in cancer care and research.
The WTR is envisioned as a collection of registries for individual cancer sites (e.g. cancer of thyroid, lung, breast). The work on each cancer site starts with selecting the Chairperson and Editorial Board that includes twenty pathologists who are experts in diagnosing these cancers, four editors from each of the five world regions: Africa and Middle East, Asia and Oceania, Central and South America, Europe and Northern Asia, and Northern America. During the initial phase, several thousands of de-identified microscopic whole-slide images (WSI) representing common and rare tumor types and subtypes from every geographic region are deposited by the editors and other contributors and carefully curated by the Editorial Board before posting them for public use. Every WTR cancer case is annotated with relevant demographic and clinical information and, when available, immunohistochemical and genetic data, and linked to the search engines allowing users to search the registry by cancer type and subtype, geographic region, and other characteristics. Upon completing this phase, the cancer site-specific registry remains open for submissions, capturing additional cancer cases and monitoring the emergence of new cancer types and subtypes. Physicians-in-training, practicing physicians, scientists, and patients can utilize the WTR to learn how human tumors look under the microscope and how to better diagnose cancer occurring in their own population.
In addition to the cancer site-specific Editorial Boards, the WTR has an Advisory Council comprised of a Chairperson and ten internationally renowned pathologists equally representing each region of the world. The Advisory Council guides the work of cancer site-specific Editorial Boards and provides additional expertise for diagnosing the most challenging cancer cases.
The WTR is governed by the Board of Directors which includes twelve highly accomplished and diverse individuals with experience in diagnostic pathology, digital pathology, clinical oncology, evolutionary genetics, large data storage and management, health care administration, and business law.
The WTR embraces the principles of equality, diversity, and inclusion in all of its activities, starting with equal representation of every geographic region of the world among its editors and advisors. The WTR does not collect information on ethnicity or socially defined race because we believe that, when taken outside of the geographical and environmental factors, it does not influence cancer characteristics. The WTR organization is centered on helping cancer patients around the world and has no political agendas or boundaries.
Comprehensive collection of tumors occurring in all geographic regions and different environmental settings
Open for submission of cases by any medical professional
Based on whole slide images annotated with clinical information, immunohistochemistry, and genetic data
Searchable by (i) pathology diagnosis, (ii) key morphologic features, and (iii) specific cohorts
Curated by expert pathologists
Open access; no registration required
Continuously updated
Comprehensive collection of tumors occurring in all geographic regions and different environmental settings
Based on whole slide images annotated with clinical information, immunohistochemistry, and genetic data
Curated by expert pathologists
Continuously updated
Open for submission of cases by any medical professional
Searchable by (i) pathology diagnosis, (ii) key morphologic features, and (iii) specific cohorts
Open access; no registration required
Modern humans first evolved in Africa ~300,000 years ago. Approximately 100,000 years ago, our species began to migrate around the globe. During this migration, genetic variation was lost and local adaptation occurred involving traits such as adaptation to cold environment, high fat diet, variability in food, levels of sun exposure, altitude, microbial resistance; and other environmental factors. Most of these adaptations were the result of single Mendelian genes. In addition, some modern humans mated with archaic humans. These events resulted in adaptive genetic variants being introduced into our species.
While there is clearly geographically-based biological variations in our species, human migration did not result in the formation of biological races. Any two humans chosen at random will share ~99.9% similarity in DNA sequence. Furthermore, if two African individuals were chosen at random, and an African and European were chosen at random; it would be the latter pair that shared the greatest similarity since the greatest amount of genetic variation within our species is found in Africa. The groups that are called “races” are socially defined groups that do not parallel human biological variations. Thus, while disparity in cancer rates and likely cancer microscopic appearance exist between socially defined racial and ethnic populations across the globe, most of this results from exposure or vulnerability to diverse environmental, behavioral, psychosocial, or material risk factors and resources.
Following these principles, the World Tumor Registry approaches the variability in cancer microscopic appearance and genetics on the basis of geographic regions where the affected individuals reside and of specific environmental factors they are exposed to. We do not collect information on ethnicity or socially defined race because we do not believe that, when taken outside of the geographical and environmental factors, it influences cancer appearance and diagnostic microscopic features.
Every cancer patient deserves the best possible outcome. This belief is rooted in the WTR’s mission to improve the diagnosis in each and every cancer patient to accelerate a cure. It also drives our deep commitment to diversity, equity, and inclusion, and a specific goal to eliminate the existing disparities in the cancer recognition and diagnosis affecting underserved patients around the globe. Our focus is on achieving equal representation of every geographic area throughout all WTR activities and educational and practical resources that we create and offer to the world community.
The WTR has accepted the registry of thyroid cancer as its first project, enabling us to construct and refine the WTR infrastructure, website, search engine, and overall user experience. The methodologies developed during the initial phase will be employed in the subsequent two cancer sites and further improved upon. Ultimately, the fully optimized workflow will be extended to the remaining 13 cancer sites.
PHASE 1
Thyroid cancerRegistry of thyroid cancers is the first project designated for execution by the WTR. Thyroid cancer is a diagnostically challenging cancer type with incidence related to environmental settings such as ionizing radiation and level of iodine consumption. This project allows us to build and optimize the WTR infrastructure, website, search engine, and end-user experience. It is scheduled to release to public at the end of March of 2024.
PHASE 2
Lung cancer and Breast cancerThe approach established during Phase 1 will be applied to two other cancer types: Lung cancer (the leading cause of cancer deaths in the world) and breast cancer (the most commonly diagnosed cancer in the world). AI-based search engine will be added. Anticipated completion by the third quarter of 2026.
PHASE 3
All Remaining Cancers: Brain, Soft Tissue And Bone, Colorectal, Head And Neck, Hematolymphoid, Female Genital, Liver, Pancreas, Prostate And Male Genital, Skin, Urinary System, Pediatric, Other Endocrine, Rare Cancers.Anticipated completion by the end of 2029.
