Cancer Registration — Aims, Achievements, Prospects

Summary

The main routine activity of a population-based cancer registry is to produce annual statistics on the occurrence of cancer (numbers of cases and incidence rates) by sex, primary site, age, region, and possibly by other relevant parameters. This data base can be applied in descriptive epidemiology, e.g., in construction of maps, trend curves and age-incidence curves. These can the be used in different kinds of comparisons (national and international) and creating hypotheses. — An important characteristic of a cancer registry is a file of cancer patients identifiable through the names, personal identification numbers, etc. These patient files can be used in prospective cohort studies in which the cancer experience of a group of individuals exposed to a suspected carcinogen is assessed and compared with that of the general population or a suitable reference population. Cancer registry is also able to provide material for case-control studies and to assist in clinical trials. Different rules and restrictions (data protection) cause difficulties in the execution of analytical epidemiological studies. — Cancer registry data are often useful for administrative purposes. In addition to routine statistics, these include future forecasts of the occurrence of cancer, estimates of the diagnostic and treatment resources needed, and survival studies in unselected patient materials. Cancer registries may prove useful also in the evaluation of preventive measures directed to the general population (mass screenings, prevention of occupational cancer, measures undertaken to reduce smoking, etc.). Monitoring health hazards is becoming an important function of many cancer registries. — Proper staffing is important for a cancer registry. This means medical, epidemiological, statistical and computer experience. Research should always be an essential part of the cancer registry activities, and cancer registries should consider themselves as research institutes.

Cancer registration has been practised for many years in several areas in the world. There are a number of hospital-based registries but, on the other hand, several population-based systems also exist aiming at production of incidence rates. Depending on the prevailing conditions, economical and other resources, and nature of the data collection, different registries have different aims, and their achievements are also different. In this paper I am going to review the aims and achievements of population-based cancer registries, mainly on the basis of the experience obtained at the Finnish Cancer Registry which I know best (8). Some essential aspects of the future prospects will also be outlined.