Current Status of Cancer Registration in the Federal Republic of Germany and Prospects for Further Development

Abstract

The present situation with regard to cancer registries in the Federal Republic of Germany arouses both hopes and fears. Hopes are raised as the conviction that cancer registries are necessary gradually gains ground. There are fears as restrictive data-protection laws considerably hinder the practical work of registries and make the founding of new registries more difficult. In this chapter, I have tried to realistically describe the situation with regard to the epidemiological cancer registries. Since our main topic is cancer mapping, I preferred to concentrate on the population-based cancer registries. Of course, a network of hospital registries has also developed at the tumor centers of the Federal Republic of Germany. Based on a uniform documentation method, data from a steadily increasing number of cancer patients are recorded. This number may have reached about 200000 by the end of 1985. The organizations which comprise the Working Group of German Tumor Centers are dedicated mainly to the better care of cancer patients, thus being treatment oriented. Strict population-based patient documentation is missing, and incidence calculation is therefore not possible. It is apparent, however, that data from the great number of patients on the registries could be used for analytic epidemiological studies. Inquiries at the German tumor centers in October 1984 revealed that there was theoretically a great willingness to cooperate in epidemiological studies (Dhom et al. 1987). All tumor centers, however, pointed out the impediments to epidemiological cancer research using hospital registries, the main one being shortage of personnel. The staffing of many tumor centers does not even assure the proper medical care of patients. These centers were financed by, Federal Government grants in the past, but the states have now taken on this responsibility.