No. 29 July 1999   News from Associations and Cancer Registries Honorary members   Obituary Activities of the Japanese Association of Cancer Registries Aya Hanai (Japanese Association of Cancer Registries) In 1992, all 30 population-based cancer registries operating in Japan held a meeting in Osaka City to set up the Japanese Association of Cancer Registries (JACR). A president (Dr. Fujimoto) and 11 executive committee members were elected. The Association has an office in the Osaka Medical Centre for Cancer and Cardiovascular Diseases. Since that time, five newly established population-based cancer registries have joined the JACR. Two research groups studying population-based cancer registration related subjects, helped by a grant from the Japanese Ministry of Health and Welfare (JMHW), have also joined the JACR as members. As of 1999, the membership included 35 population-based cancer registries, two research groups, and 26 supporting members. The JACR’s activities and budgets are proposed by the executive committee and decided on in a general meeting. The purpose of the JACR is to improve registration completeness and techniques at each registry, promote standardization of registration methods, promote utilization of registry data, and exchange knowledge and information. To achieve these purposes, the JACR holds an annual scientific meeting. On the day before the meeting, education programmes for registry workers are conducted. The 1998 annual meeting was held in Nagoya City; the 1999 meeting will be held in Kobe City. The JACR publishes the lecture papers presented in the annual meeting as a monograph series. A newsletter to facilitate exchange of knowledge and information between members is published semi-annually. Member registries are requested to send their annual incidence figures to the JACR. Each registry’s reporting completeness and incidence rates for major sites by sex are edited and published in the JACR annual report. JACR member research groups also present papers on their recent activities at the annual meeting. Moreover, recent study reports are constantly being sent to the JACR for distribution to other member registries. The president of the JACR organized a study group with the participation of several member registries in 1992-94 and 1996-97, with a one-year grant from the JMHW, to perform the following studies: 1) By using record linkage methods between the gastric cancer screenees’ file and the gastric cancer patients’ file at each registry, overlooked false negative incident cases were investigated and the rate and frequency of false negative cases in the area calculated. In addition, the biological characteristics of these patients were studied. 2) The study group tried to assess the effectiveness of early diagnosis and early treatment (the second prevention program) for cancer in each registry area, by comparing the time trends for cancer incidence and mortality according to site. 3) In 1998, the study group surveyed the activities of population-based cancer registries throughout Japan, and consequently proposed that a nationwide population-based cancer registration system be set up in Japan. Originally, each prefecture implemented its own prefecture-wide cancer registration program based on voluntary compliance. In 1983, the national government decided to subsidize these regional cancer registration programs as a way to assess cancer screening programs in each area. However, the national government did not propose or initiate steps towards a national cancer registration scheme. Recently, due to massive national budget cuts, the Japanese government stopped subsidizing all prefectural cancer screening and cancer registry programs. Therefore, prefectural governments are now forced, once again, to entirely fund their registration programmes. On the other hand, the JMHW has been providing financial support to the Research Group for Population-based Cancer Registration in Japan since 1975. This research group, organized around 10-15 qualified registries, has continued to play a leading role as a technical centre for registries in Japan. Dr. A. Oshima, director of the Department of Cancer Prevention and Statistics, Osaka Medical Centre for Cancer and Cardiovascular Diseases, has chaired the research group since 1996. He was also elected as president of the JACR last year. Presently, the JACR and the research group are jointly cooperating in an effort to establish a national cancer registration system for Japan. Honorary members   Obituary Cancer incidence in Lithuania, 1988-92 Juozas Kurtinaitis, Lithuanian Cancer Registry Regina Winkelmann, International Agency for Research on Cancer Lithuania is the Southern-most of the Baltic countries, which for more than fifty years were part of the Soviet Union. With the dissolution of the latter, Lithuania gained independence in 1990. The country covers a surface of 64,000 km2 and its population at the last census in 1989 was 3,689,800, 23% of whom were children under age 15. The population is composed to a large extent of 80% Lithuanians, 15% Russians, and 4% Polish. In 1990 the primary sectors of employment were industry 40%, agriculture 25%, construction 15%, and transport and communication 5%. Lithuania is administratively subdivided into 44 districts, with Vilnius as the capital. Compulsory cancer registration was introduced throughout the territory of Lithuania in 1957. The network of oncological services and the cancer registration methods stem from the Soviet model of specialised oncological services, responsible for diagnoses, treatment and registration of cancer patients, complemented by follow-up through the general health care network at the district level (Winkelmann et al., 1998). The Department of Epidemiology of the Institute of Oncology in Vilnius was responsible for the data collection and the preparation of annual statistical reports for submission to the Ministry of Health. Population-based statistics by site, sex and age groups are available since 1964. For a long time, however, the cancer registration operations and the statistical reporting remained an entirely manual process, although an attempt was made in 1975 to establish a computerised database (Glinskiene, 1975). In 1990, the Lithuanian Cancer Registry was established as a separate department of the Oncology Centre. The main purpose of the Cancer Registry is to collect data about all new cancer cases and deaths from cancers in Lithuania, to describe cancer occurrence by age, sex, and territorial subdivision, to assess cancer patient survival, and to serve the national cancer control program. In 1993, the Lithuanian Cancer Registry became a member of the International Association of Cancer Registries. The registration of cancer is based on compulsory reporting of all new cases of cancer in the population of Lithuania. The Cancer Registry receives approximately 14,000 notifications of new cases each year from the Oncological Centre and the local oncological services as one of the two primary information sources. About 100 new cases of cancer per year occur in children under age 15. The notifications include identifying information (surname, name, sex, year of birth, nationality, occupation, and place of residence), information on cancer diagnosis (date of diagnosis, site, stage, TNM code, clinical group, and method of diagnosis). Cancer topography has always been coded according to the International Classification of Diseases (ICD), and at present the 9th Revision (ICD-9) is in use. Coding of tumour morphology according to ICD-O, however, only started in 1993. Before, only a local one-digit code for morphology was recorded. The second main information source for the Cancer Registry is the death certificate. The death certificate in use in Lithuania corresponds to the international standards and contains name, date of birth, sex, place of residence, date of death and causes of death (immediate, underlying and associated). In 1993, approximately 39,000 deaths from all causes were registered in Lithuania, 7,500 of which had cancer as the underlying cause of death. Today, the Lithuanian Cancer Registry is fully computerised and contains data on 206,912 cancer cases diagnosed since 1978. The feasibility of retrospective computerisation of the individual cancer patient data since 1964 is currently being investigated. The Cancer Registry reports the official cancer incidence figures to the Ministry of Health annually, and cancer registry reports are published regularly. Cancer incidence rates for Lithuania for the period 1988-92 are presented in Table 1. When compared to the rates from selected registries in Cancer Incidence in Five Continents, for all malignant neoplasms combined, overall cancer incidence in Lithuania is slightly lower than that of most Western European cancer registries, particularly in females, but similar to that of registries from the New Independent States (Figure 1). An analysis of conventional data quality indicators showed the same tendency (details not provided here). Figure 2 shows the relative frequency of the major cancer sites in Lithuania during the period 1988-92. In men, one in four newly diagnosed cancers is a lung cancer, whereas this cancer ranks low in females. In the latter, one in five cases is breast cancer. Stomach cancer is second in both sexes, representing 14% of all newly diagnosed cancer cases in males and 10% in females. The proportion of prostate cancers, the third most frequent cancer diagnosed in men, appears rather low (9%). Similarly, the proportion of breast cancer in females is relatively low (19%). Conversely, the proportion of each of the major female genital tumours is between 7 and 8% (cervix uteri 8.1%, corpus uteri 7.4%, ovary 8.2%). These patterns, although somewhat different from most Western European cancer registries, tend to agree with those previously reported from other New Independent States (Parkin et al., 1997). In conclusion, the results presented here show that, in spite of a low level of histological verification indicating a certain lack of validity, the cancer incidence data from the Lithuanian Cancer Registry during the period 1988-92 are compatible with international cancer registration standards, as assessed on the basis of the criteria employed for publication of cancer registry data in the series Cancer Incidence in Five Continents. References Winkelmann RA, Okeanov A, Gulak L, Remennik L, Rahu M, Storm HH.     Cancer registrationtechniques in the New Independent States of the     former Soviet Union. IARC TechnicalReport No. 35. Lyon: IARC; 1998. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young L. Cancer Incidence     in Five Continents,Vol. VII.     IARC Scientific Publication No. 143. Lyon: IARC; 1997. Glinskiene V. [Sozdanie centra registracii zlokacentvennich novoobrazovanij      i avtomatizirovannogo banka dannych ob onkologicenskich bolnych     "Kancerregistr" vLitovskoj SSR.]. In: [Organizacija protivorakovoj borby,     diagnostika i lecenijezlokacestvennich novoobrazovanij], Vilnius, 1975, p. 8-9. Table 1: Cancer incidence in Lithuania, 1988-92. ASR (W) = Age-standardised rate (World population). Figure 1: Cancer incidence in selected parts of Europe, 1988-92.                All sites, excluding non-melanoma skin cancers. Figure 2: Relative frequency of main cancer sites in Lithuania, 1988-92. Honorary members   Obituary