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| No. 29 | July 1999 |
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| News from the Regions 1997-1998 |
  ObituaryProjects and Publications 
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The IACR Regional Representatives prepare reports on activities within their regions for the annual meeting of the Executive Board. It is not always easy for these Representatives to know what is going on in countries other than their own, and members are encouraged to send news about what they are doing to their Representative. As you know, the IACR is a strictly non-political association and the regions are defined by geography alone. In case you wonder which region you belong to, the countries covered in each are listed at the end of this Newsletter. |
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AFRICA Mokhtar Hamdi-Cherif (Regional Representative for Africa) Population-based cancer registration is developing fairly rapidly in some areas of Africa, and there are now at least 30 population-based registries in the Continent. Five of these have data published in Volume VII of Cancer Incidence in Five Continents (CI5), and nine in the International Incidence of Childhood Cancer, Vol. II (IICC). |
| In Algeria, the Sétif registry (for which data are published in CI5 for the years 1990-93) has been expanded to areas in the East, including the wilayas of Constantine and Annaba, thanks to support from WHO. The principal investigators from the Annaba and Constantine Cancer Registries spent two weeks at IARC, Lyon for training in cancer registration methodology. Data for the years 1993-1996 are now available for Alger, Oran and Constantine. |
| The Harare Registry in Zimbabwe has published the 1990-92 results for the African and European populations in the International Journal of Cancer (Bassett et al., 1995) and appears in CI5. The other registries in CI5 are Bamako (Mali), La Réunion (France) and Kampala (Uganda). La Réunion is too small and too recent to have sufficient childhood cases to appear in IICC, but the other CI5 contributors also appear in the Childhood publication, along with the registries of Alexandria (Egypt), Malawi, Namibia, Ibadan (Nigeria) and South Africa. |
| Data from Conakry (Guinea), Kampala (Uganda), Rwanda, Gabon, Malawi and South Africa have been published in scientific journals during the last three years. First results are now available for the cancer registries of Abidjan (Ivory Coast), Niamey (Niger) and Ife-Ijesha (Nigeria). |
| New registries have been established in Moshi (Tanzania), Addis Ababa (Ethiopia), Ouagadougou (Burkina Faso), Botswana, and Eldoret (Kenya). The Directors of the new Tanzanian and Ethiopian registries participated in the 1998 IARC Summer School on Cancer Registration and Applications in Epidemiology, as did the Director and Registrar of the Ibadan (Nigeria) Cancer Registry. |
| An IARC course on cancer epidemiology (in French) was held in October 1997, just prior to the IACR annual meeting in Abidjan. A course on cancer registration techniques for registrars was held in Johannesburg in March 1998, organised by IARC in collaboration with the South African Institute of Medical Research with additional sponsorship from the US National Cancer Institute and the WHO African Regional Office. Twenty-seven students from 11 countries in sub-Saharan Africa attended the course. |
| A meeting on the epidemiology of childhood cancer in Africa was held in Rabat, Morocco in May 1998. |
| An international conference, ‘Hepatitis B, Immunization and Prevention of Cirrhosis and Hepatocellular Carcinoma in Sub-Saharan Africa’ took place in The Gambia in March 1998. The main objective of the meeting was to discuss the results of the Gambia Hepatitis Intervention Study and to prepare the basis of the introduction of HBV vaccination elsewhere in Africa. |
| The African Association of Cancer Registries held a meeting on 5 November 1997 in Abidjan. The main objectives of the Association are to develop cancer registration in Africa, to establish coordination between African cancer registries, and to disseminate information. |
| The US National Cancer Institute has offered to finance Internet connections for cancer registries in Africa, and also supported several African members of IACR to participate in the 1998 annual meeting in Atlanta. |
| In accordance with the recommendations of the Executive Board, made during the Abidjan meeting, the IACR was represented at the WHO/AFRO meeting of NGOs held in February 1998 in Dakar, Senegal. This meeting identified specific opportunities to promote health in the African region, as well as collaboration between governments, NGOs and the WHO Regional Office for Africa. The opportunity was taken to express the role of IACR in the development of cancer registration and strengthening collaboration between registries in Africa, in order to progress together in the fight against cancer to reach the goal of ‘Health for All’. WHO was urged to participate actively in the promotion and development of cancer registries in sub-Saharan Africa and to support the African Association of Cancer Registries. |
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References: Bassett MT, Chokunonga E, Mauchaza B, Levy L, Ferlay J, Parkin DM Cancer in the African population of Harare, Zimbabwe, 1990-1992 Int J Cancer 1995 Sep 27; 63(1):24-8 Bassett MT, Levy L, Chokunonga E, Mauchaza B, Ferlay J, Parkin DM Cancer in the European population of Harare, Zimbabwe, 1990-1992 Int J Cancer 1995 Sep 27; 63(1):29-36 |
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LATIN AMERICA |
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Edwin Carrascal (Regional Representative for South America) There is news from the cancer registries in Brazil, Colombia, Ecuador, Peru and Puerto Rico. |
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Trujillo, Peru Dr Pedro Albujar is Director of the Trujillo Cancer Registry in Peru, which covers a population of 511 062 inhabitants, and is located in the Pathology Department of Belen Hospital. He is helped in his work by one system technician. The registry operates with one 286 and one 386 PC and a printer. |
| Data are made available for research purposes. An application form and a research project have to be submitted. The registry prepares reports for Health Authorities, university libraries and hospitals. Information for the general public is released through local and national newspapers. |
| A major use of the registry data is for the design and assessment of a Cervix Uteri Cancer Control Programme. Research projects include morphological and colposcopic correlation in dysplastic lesions of the cervix uteri; clinical and pathological features of gastric cancer; dysplastic changes in gallbladder epithelium, and the Nottingham index in breast cancer. |
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Puerto Rico The Puerto Rico Central Cancer Registry (PRCCR), covering a population of 3 700 000, is headed by Dr Diego E. Zavala. The registry was created in March 1950 and depends on the Health Department. PRCCR obtained funds from the NIH National Program of Cancer which permitted improvement of the computer resources, and a donation was received from Bristol Myers Pharmaceutical, including computer equipment and the payment of professional services in ORACLE, the operational language used by the Registry. |
| Cancer notification is compulsory in Puerto Rico. A supervisor and five record clerks collect the information from data sources (hospitals, pathology laboratories, clinics, radiotherapy departments, physicians’ offices and demographic registries throughout the island) and check for quality control for the first time. A supervisor and four technicians in epidemiology check for errors, inconsistencies and duplicates, classify the primary site, the incidence date and assign the code. A second check for quality control is performed. There is one record clerk to check death certificates and match the data with those of the Registry. Data management and output are performed by one further supervisor. |
| PRCCR is financed by state funds and recently from federal funds. State funds cover staff salaries and operational expenses. The federal funds come from the National Project of Cancer Registries and are destined for computer resources. |
| Information is requested by researchers, health administrators and Government Agencies. The Registry Director has prepared a draft policy document for users of the registry data to observe. PRCCR is included in Trends in Cancer Incidence and Mortality, Cancer Incidence in Five Continents and the International Incidence of Childhood Cancer. It is also included in the North American Association of Cancer Registries’ Annual Reports. |
| The registry plays a role in a cancer epidemiology surveillance programme organized by the Health Department and other Agencies. The data are also used for early detection programmes, to improve professional and public education and to generate hypotheses and research. PRCCR has initiated a project on oropharyngeal cancer early detection in Lares Municipality. A study on cancer incidence in Vieques Municipality, 1960-1989, was finished recently. |
| A project to introduce electronic reporting from all sources of information to the PRCCR is ongoing. Several workshops on cancer registration are in progress, aimed at hospital and pathology laboratory personnel, updating and use of software. The 1992 data have been published and data on 1993 are now being collected. Recent efforts focus on updating the data for the last five years. The registry needs 12 additional officers to complete the 1994-1996 information. Of these 12 vacancies, only five have been occupied. |
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Quito, Ecuador This national population-based registry was created in July 1984, and has since been directed by Dr Fabian Corral. Although it is called a national registry, so far it covers only the capital of Quito, with a population of 1 444 363 inhabitants. Financial support is provided by the National Society of Fight against Cancer (SOLCA), a private institution supported by Government funds. Five registrars and two MD epidemiologists work in the registry, which uses its own computer program. |
| Researchers and Health Managers in the whole country have access to the information in the registry as required, while respecting the confidentiality criteria. Annual Reports are distributed nationally and internationally. The data are used to assess cancer patterns in Quito, for planning cancer control and to develop and, in particular, to evaluate the Cervix Uteri Cancer Prevention Programme. The Registry Staff is involved in encouraging the massive use of data by researchers and National Health Agencies. Research projects on gastric, colon, breast, penis and cervix cancer are on-going. |
| The Registry has encouraged the creation of several cancer registries in the country: Portoviejo City (1994), Cuenca City 1996), Loja City (1997) and Tungurahua Province registry for gastric cancer (1996). The SOLCA national network sponsors these all registries. The main objective is to extend the registry coverage through the most representative and populated region in the country. The next report will include data from Portoviejo and Tungurahua. |
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Brazil Lucilia Reis Pinheiro, Head of the Cancer Registry Services at the National Cancer Institute of Brazil |
| The National Cancer Institute of Brazil has been working with the population-based cancer registries since 1990. New hardware and software are being installed in all the registries, so there will be a national database. Data from the whole country will be available at the same time. |
| A Brazilian Association of Cancer Registries holds an annual meeting, that for 1998 taking place in October in Curitiba, Parana. The National Cancer Institute organizes an annual course for registrars and directors of cancer institutions and also local courses in some registry facilities. |
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Cali, Colombia The registry, created in 1962, is directed by Dr Edwin Carrascal and covers a population of 1 800 000 inhabitants. It is located in the Department of Pathology of the School of Health Sciences, University of Valle. |
| A network of three PCs, one 586, two 486 and a DbaseIV database are used in the registry. The permanent personnel consist of a coordinator, 4 registrars and a secretary. 30 medical students are recruited to work two months a year. |
| The basic personal salaries are paid by the University of Valle. Every year, the Registry applies for donations from non-profit organizations, mostly with success. In the last two years, research projects for government health agencies brought some financial support, which was used to cover operational expenses. |
| Researchers and Health Managers throughout the country have access to the information via a written form, according to their requirements, and taking confidentiality into account. The CCR data have appeared in all seven volumes of Cancer Incidence in Five Continents. Data are also included in Trends in Cancer Incidence and Mortality and the International Incidence of Childhood Cancer. It is planned to produce a comprehensive publication for 1962-1996 towards the end of 1999. Efforts will be made to produce a periodical report. |
| The data are used to monitor the trends of cancer in Cali, to assess the early detection program for cervical cancer, and to serve as a database for research and teaching proposals. The registry encourages the use of data by researchers and under- and postgraduate students. |
| Research projects carried out include, in 1996, "Cancer in ISS users, 1962-1991", a research project for the Colombian Social Security Institute (ISS) the results of which were published as a book. In 1998, a new project was undertaken for ISS: "Lung, urinary bladder, stomach and haematological cancers: an ecological and occupational study". The Registry is now participating in the research "Epstein-Barr virus-associated gastric cancer", an international study headed by Kagoshima University in Japan. |
| Since 1996, a group on cancer epidemiology has emerged from CCR activities. The group is about to be recognized by Colciencias, the Colombian System for Science and Technology. The following six research projects sent to this organization for funding are under evaluation: (1) Cancer and socioeconomic status in Cali, (2) Present state of cancer in Colombia, (3) Helicobacter pylori: pathology and prevalence in gastric biopsy material in Colombia, (4) Wilms' tumour: pathoepidemiology in Colombia, (5) Epidemiology of papillomavirus infection in Cali, (6) Smoking-associated cancers in Cali. A new project, "HTLV-1 virus-associated Lymphoid Malignancies in Cali" has been presented to Japan Agencies through Kagoshima University School of Public Health (Professor Suminori Akiba, Head). |
| A workshop for all Registry members supported by the University of Valle Research Office was conducted in 1997, to train them in carrying out the work of the registry while conforming to the new statements of the Health System in Colombia. |
| CCR participated in the creation of a new population-based cancer registry in Pasto, a city of 350 000 inhabitants in southern Colombia. The Pasto Cancer Registry started activities in 1998. This is the second population-based registry in Colombia. |
| The National Network of Hospital-based Cancer Registries, created by the Ministry of Health twelve years ago, failed to continue. It is expected that further efforts will renew this programme. |
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| Obituary Projects and Publications
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Dee W. West and Eric J. Holowaty (Regional Representative for North America) The major funding agencies of population-based cancer registries in the US are the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC). The NCI funds the Surveillance, Epidemiology and End Results Program (SEER) which includes five states (Connecticut, Hawaii, Iowa, New Mexico, Utah) and six metropolitan areas (Atlanta, Georgia; Detroit, Michigan; Los Angeles, California; Seattle, Washington; San Francisco, California; San Jose, California). Together these registries cover 14% of the US population. The CDC funds the National Program of Cancer Registries and has contracts with all 50 States; the District of Columbia; and the Virgin Islands and Puerto Rico. Four new contracts were awarded this past year. These CDC funded registries are in various stages of development. |
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| The North American Association of Central Cancer Registries (NAACCR) is the professional organization for population-based registries in the US and Canada. There are 81 US and 12 Canada member organizations. Last year a new category for single membership was created, and one member was approved. During the past year, NAACCR has been involved in the following activities: | ||||||||||||
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Vanchai Vatanasapt (Regional Representative for Asia) Korea Registries in Seoul, Kangwha and Pusan are now functioning. Data from Kangwha were published in Cancer Incidence in Five Continents. Registry staff from Seoul went to Lyon for training in 1998. |
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Philippines A breast cancer screening project is being carried out by the two registries in greater Manila. Both play an active role in the follow-up of cases, and extra staff in Rizal ensure careful staging and follow-up of all breast cancer cases. The data of the Manila registry are being used for studies of survival. |
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Singapore An analysis of survival of cases registered during 1968-92 is being carried out. |
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Thailand The results from four population-based registries (Lampang, Chiang Mai, Khon Kaen and Songkla) have been included in a combined analysis of ‘Cancer in Thailand’, Vol. II. The results will be published in 1999. |
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Vietnam The first results from the Ho Chi Minh City Cancer Registry were published (Nguyen et al., 1998) as well as a separate analysis of childhood cancer. |
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Reference Nguyen MQ, Nguyen CH, Parkin DM Cancer incidence in Ho Chi Minh City, Viet Nam, 1995-1996 Int J Cancer 1998 May 18;76(4):472-9 |
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SOUTH AND WEST ASIA
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A. Nandakumar (Regional Representative for Asia) India News from the individual registries: |
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Ambilikkai (J. Cherian and R. Rajkumar) Dr Sankaranarayanan from IARC visited Ambillikai and conducted a training programme. Cancer registration began in this rural area, with a population of 400 000, in 1995. The first results, for 1995-96, are now available. |
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Barshi (B. Nene and K. Jayant) Registration activities and analysis of data in this innovative registry serving a rural population in the State of Maharashtra have continued, and an analysis of survival has been carried out. |
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Bombay (D.J. Jussawalla (deceased) and B.B. Yeole) An analysis of survival data has been made. The registry assists in follow-up of a cohort study of tobacco-related cancer. |
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Madras (V. Shanta and C.K. Gajalakshmi) The registry continues to focus particularly on methods of follow-up and survival studies. |
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Trivandrum (K. Nair and C. Varghese) The registry continues to provide valuable information related to the various research projects in the Kerala population, particularly to the oral cancer screening trial. |
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Bangalore Population-based survival studies on breast, cervix, lymphomas and leukaemias have been carried out. |
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National Cancer Registry Programme of India The network of cancer registries under the National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR) continues to collect information on cancer. |
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Under its auspices a three-day workshop was held in the Cancer Institute, Chennai on 2-4 April 1998. The agenda for the workshop included discussions and exercises in ICD-O-2, exercises in data quality and lectures in clinical staging and recording diagnostic and treatment details. Some of the recommendations that came up during the workshop for consideration and implementation included: |
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As one of the specific quality control exercises, a population-based cancer cum tobacco survey has been undertaken by three older registries at Mumbai, Chennai and Bangalore, mainly to assess the completeness of coverage. Preliminary results were completed in 1998. A multicentric case-control study to determine the possible risk of vasectomy as a method of family planning and the occurrence of cancer of
the prostate has also been initiated in these three registries. Another case-control study, on gallbladder cancer in Delhi - which has some of the highest incidence rates in the world - has also been initiated. Both studies are funded by ICMR and coordinated by the unit in Bangalore. |
Middle Eastern Cancer Consortium Project (MECC)
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Dr John Young and Steven D. Roffers have been consulting and working with the MECC in the area of cancer registration training, quality control and consultation. In 1997-98 they performed a quality control audit study of the Jordan Cancer Registry, and carried out a training programme in Bethlehem, Palestine that was attended by 51 physicians and tumour registrars. They both participated in planning meetings
in Jerusalem and Haifa and accompanied a team of site visitors to each of the participating MECC countries.
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Pakistan A population-based cancer registry, directed by Dr Yasmin Bhurgri, and covering the population of the southern part of Karachi was established in March 1995. The population covered by the registry is 1 724 915 (census 1998). Muslims constitute 97% with the remaining being Hindus, Christians and Parsis. The sources of cases include 27 hospitals and 4 laboratories. Results for 1995-97 give all sites age-standardized rates of 138.8 in males and 169.2 in females. Lung cancer was the leading site among males (ASR 20.9), and breast in females (ASR 53). |
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Saudi Arabia (N. Al Hamdan and A. Al Zahrani) The Saudi National Cancer Registry (NCR) is a population-based registry covering the entire kingdom of Saudi Arabia, and was set up in 1992. It started reporting cancer cases from 1 January 1994. For comprehensive data collection, a Ministerial decree has rendered cancer a notifiable disease, with accessibility to all government and private hospitals, clinics and laboratories throughout the kingdom. The estimated total population of Saudi Arabia in 1994 was 17.89 million, 13.23 million Saudi and 4.6 million non-Saudi. The total number of cases reported in 1994 to the NCR was 7028 with 96.1% microscopic confirmation of diagnosis. A total of 5044 (71.8%) cases were reported among the Saudi population. The preliminary results indicate an overall age standardized rate (both sexes, Saudi) of 80.9. The most common sites of cancer among males were lung and liver, and breast cancer was the most common among females. During the first year of operation coverage was estimated at 70%, and it is expected that this will improve. |
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NORTH AND WEST EUROPE
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Leo Schouten (Regional Representative for Europe) In Germany cancer registries have started in all states, their existence having been made obligatory by federal law. However, because of confidentiality legislation, the cancer registries are restricted in their operations. Most state registries have divided their operations into a ‘Vertrauensstelle’ (Confidential office) and a ‘Registerstelle’ (Registration office). The Vertrauensstelle encrypts identifying information and codes the tumour information. The Registerstelle handles and checks the notifications of the Vertrauensstelle and makes the information available for research. Whether this will result in complete and valid registration has to be proven. |
| The European Network of Cancer Registries (ENCR) organised a German-language course in Saarbrücken in March 1998 to support the German registries. |
| Confidentiality issues are interfering with cancer registration in other countries as well, including Belgium, the Netherlands and the United Kingdom. In the Belgian province of Limburg a new regional cancer registry has started. This registry will operate completely automatically. At the moment only pathology information is available, but other sources will be used in the future. A first report has been published. This regional registry collaborates with the national Belgian registry. |
| The Netherlands Cancer Registry published its 1994 report in December 1997. Specific reports on head and neck cancer, urological tumours and haematological malignancies are in preparation. |
| The United Kingdom Association of Cancer Registries (UKACR) unites registries from England, Wales, Scotland, Northern Ireland and Ireland. In November 1997 a meeting was organised in Liverpool. Special attention was given to Contract Performance Issues. UK registries have a contract with the National Health Service, that forces them to meet certain quality standards (completeness, validity, timeliness). |
| In November 1998 the UKACR meeting was organised on the Isle of Wight. A course on survival and a workshop on geographic information (GIS) were also organised by the UKACR in 1998. |
| The present chairman of the UKACR, Dr Tom Davies, reports that: |
| ‘There have been no major single events that have affected the registries in the UK as a whole in the past year, but there is a great amount of change on the way. The Government has published a number of papers outlining new strategies, which cover the organisation of services, underlying causes of disease and quality of treatment, and these are clearly going to increase the need for high quality information. One of the major changes to come is the alteration of health service boundaries again, and while this will only affect the regions around London to begin with, the rest of the country will probably be affected in the near future. How registry catchment populations will change, if at all, and how registries will be paid for is not yet clear. Coping with change clearly occupies much of the time of registry senior staff, but there is still steady progress towards improving the quality of data, their usefulness and timeliness and compatibility. In addition there are up to three meetings per year to consider the epidemiological interpretation of the data to which all staff from registries outside the UK are welcome.’ |
| The president of the Association of Nordic Cancer Registries (ANCR), Dr Hrafn Tulinius, reported that the most newsworthy happening was the change in operations of the Danish Cancer Registry. Since 1 January 1997 the Danish Cancer Registry has been split into two. The actual data collection has been merged with other health registries at the National Board of Health. The other half - research and ad hoc quality control, as well as the physical registry - resides with the Danish Cancer Society, which also provides professional support to users. A joint body (advisory board) including both parties, the National Research Council and Danish Pathologists and Oncologist Organisation, follows operations to secure a smooth transition to the new data capture method. Due to delays in the establishment of the National Pathology Register new procedures including quality control measures cannot be expected to be in place before year 2001, and the registry operations continue unchanged. Both the National Board of Health and the Danish Cancer Society represent the "Cancer Registry" at the ANCR and share international obligations (as reported by Hans Storm). |
| Secretary of the Italian Association of Cancer registries (AIRT) is Dr Eva Buiatti. In Italy the AIRT organised a cancer registry course in Italian (and English) in collaboration with the ENCR (Macerata, September 1998). The Italian registries published a joint report in December 1997 on cancer incidence in Italy (1988-1992). |
| The Spanish registries do not have an association. The former European representative in the IACR board, Dr Isabel Izarzugaza, reported some news. The Spanish Autonomous Communities have decided to develop a breast cancer screening programme. In the areas with a cancer registry, the registries are involved in the planning and the evaluation of the programme. Several Spanish registries have participated in the activities of Eurocare and the Latin Language Group of Registries. |
| The general secretary of the Latin Language Group of Cancer Registries, Dr Roberto Zanetti, reported: ‘The group is nicknamed "Ascension Group" because, since 1976, it has held a scientific meeting annually in May, starting on the Thursday of Ascension. A scientific Board, with representatives from France, Spain, Portugal, Switzerland and Italy, coordinates the activities of the Group. The 1998 meeting took place in Madeira, Portugal, last May, at the invitation of Eduard Limbert and Ana Miranda of the Registo Oncologico Regional do Sul. |
| The scientific programme included genetic epidemiology, second primaries, evaluation of primary prevention interventions and clinical epidemiology. A satellite workshop was dedicated to the problem of measuring quality of life from a population-based perspective.’ |
| Dr François Ménégoz and Professor R. Schaerer from the Isère Cancer Registry were the organisers of the 1999 meeting, which took place in Grenoble on 13 and 14 May 1999. |
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SOUTH AND EAST EUROPE
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Vera Pompe-Kirn (Regional Representative for Europe) During the period October 1997 to August 1998 there were no new IACR members from the non-EC states. |
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| On 29-30 November 1997 an ESO Conference on Cancer Control in the Balkans and Middle East was held in Athens. This included a Panel Discussion on Present and Future Perspectives in Cancer Registration in the region. A book of papers presented at this conference was published in spring 1998. Papers from cancer registries in Crete, Belgrade, Izmir and Alexandria were presented. An overview on cancer in the Mediterranean countries was given by Dr Kogevinas from the University in Barcelona. | ||||||||||
| Already in 1997, 25 registries were invited to establish an association of cancer registries in Central Europe. The first meeting should have been organized in May 1998 during the Conference Health Development in Central and Eastern Europe after Transition, but it was not. | ||||||||||
| Regular annual reports on cancer incidence were published in Bulgaria for 1994, the Czech Republic for 1995, Croatia for 1992, Malta for 1995, Norway for 1995, Poland for 1995 (all registries together) and for the Cracow Region separately (Epidemiology of Cancer in Cracow and Rural Areas of Cracow Region, 1995 and Cancer Incidence and mortality in Cracow Region 1996), Slovakia for 1994, and in Slovenia for 1995 (data on prevalence and official mortality were added for the first time). In Geneva a quadrennial report on incidence in the period 1991-1994, including data on survival and mortality, and in Belarus a ten-year report, were published. The quality of the cancer registry reports continues to improve everywhere. The report from Norway is particularly attractive and could serve as a golden standard for all of us. | ||||||||||
| Registries in Voivodina (Yugoslavia), Hungary and Latvia have reported problems. In Voivodina there are problems with staff and money, in Hungary with legislation (Dr Peter is working hard and it was planned to re-start cancer registration on 1 January) and in Latvia (Dr Stengrevics needs a good trained young doctor in statistics and epidemiology). | ||||||||||
| Two registries from Switzerland, and five from Central Europe (Estonia, Cracow and Warsaw from Poland, Slovakia and Slovenia) have been included in the EUROCARE 2 (cancer registry based study on survival and care of cancer patients) study group, and they are further collaborating in EUROCARE 3 (understanding the reasons for cancer patient survival differences in Europe) as well as in the EUROPREVAL (Cancer Prevalence in Europe) study. | ||||||||||
| The ECLIS study is continuing, registries from six regions in Belarus, Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Norway, Rumania, four regions in Russia, Slovakia, Slovenia, and six registries from Switzerland are included, and a new paper focusing on in-utero exposure has been prepared (Black et al., in preparation). | ||||||||||
| Cancer registration activities in the NIS (Belarus, Ukraine, and Russia) are being supported through the European Commission INCO-COPERNICUS Program. The project, called Improvement and Use of Epidemiological Tools in the New Independent States of the former Soviet Union (NIS) with a view to the consequences related to mastering the Chernobyl late-effects, is continuing successfully, with Dr Regina Winkelmann coordinating all the activities. According to her report the following activities and studies were undertaken: | ||||||||||
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| In Izmir (Turkey), the Ege University Cancer Research Centre and 20 other hospitals have been participating in the Izmir Cancer Incidence and Data Collection Project since 1992. In Albania the National Cancer Register has been functioning since 1984. It covers about 70% of the population, and is supposed to be 80% complete. There was no news from Romania. |
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OCEANIA
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David Roder (Regional Representative for Oceania) The Oceania Region covers cancer registries in Australia, New Zealand, New Caledonia, Fiji, French Polynesia, and other Pacific Islands. A comprehensive report of cancer registration and related activities across the Region for the 1996-97 period was published in the IARC July 1998 Newsletter. The present report for 1997-98 does not repeat the background detail provided in that Newsletter. Cancer registration continued across the Region during 1997-98 as in the earlier period, with some specific developments that are worthy of comment. |
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| The Australian National Cancer Clearing House of the Australian Institute of Health and Welfare, which compiles data from state/territorial cancer registries, collaborated with the Australasian Association of Cancer Registries in completing a report of cancer incidence data for 1995, published in December 1998. Also published in that month were data on breast cancer case survival in Australia for 1982-94, classified by year of diagnosis, age at diagnosis, state/territory of residence, and urban/rural place of residence, and including international comparisons. The survival report was a collaborative effort of the Australian Institute of Health and Welfare, the Australasian Association of Cancer Registries, and the National Breast Cancer Centre. Also published were data on aspects of screening in relation to cancer of the breast and cervix, including: screening participation; the detection of small breast tumours and low/high grade cervical dysplasias; and cancer incidence and mortality. The Australasian Association of Cancer Registries endorsed a common protocol for coding breast cancer size and nodal status, and ductal carcinoma in-situ. Plans for promoting a further standardization of coding by state/territorial cancer registries were developed to enhance the quality of national data. | ||||||||
| The New Zealand Cancer Registry, which was established in 1948, completed its collection of 1995 data and continued with processing data for 1996-98. The volume of registrations had increased markedly following the introduction in July 1994, of the Cancer Registry Act, which had mandated cancer reporting by laboratories. The Registry uses ICD-9 topography and ICD-O-2 morphology coding. Special fast-tracking is undertaken for melanomas and cancers of the female breast, cervix and prostate, to support: the planning and monitoring of local services; and allied research activities. The Waikato Registry, which covers the Waikato/Bay of Plenty population, completed its report of 1996 data. The Registry acts as a regional data-collection agency for the National Registry, and collects additional data on tumour stage, grade, treatment, and case survival. This is considered to be a valuable adjunct to the national data set for service monitoring and research. The future viability of the Registry has been in some doubt due to funding uncertainties. | ||||||||
| From 20-29 July 1998, a meeting was held in Noumea of cancer registrars from Pacific Island countries. It was organised by the South Pacific Commission, IARC, and the WHO Western Pacific Regional Office. There are 22 Pacific Island countries and territories with an aggregate population of approximately 6.5 million. At the meeting, the desirability of a unifying system of Pacific-wide cancer registration was discussed and endorsed. Such a system would facilitate the pooling and analysis of data for the region as a whole and comparative analyses of trends within the region. It also was apparent that a number of operational efficiencies would result. Outcomes of the meeting included: | ||||||||
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| Participants expressed their gratitude to the New Zealand Government for funding support for training and the operation of the Pacific Islands Registry. |
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