cancer registry

cancer registry, surveillance system that allows for the collection, storage, and analysis of information on cancer patients. A cancer registry is the chief means by which information is systematically collected about persons diagnosed with cancer.

Depending on the resources available, the information in a cancer registry may include basic demographic data, such as age, sex, ethnicity, race, residence, and place of birth; date of diagnosis; date and cause of death; the type of cancer and its anatomical location; the extent of disease at the time of diagnosis; the types of treatment received; and the outcomes of treatment and clinical management. The information collected is then used to monitor cancer trends over time; to determine cancer patterns in various populations; to guide the planning and evaluation of cancer-control programs; to help set priorities for allocating health resources; and to advance clinical, epidemiological, and health services research. Cancer registries generally are of two types: hospital-based, in which information is recorded on cancer patients who receive care at a specific care facility, or population-based, in which information is recorded on cancer cases within a given population.

The first cancer registries

The first modern hospital-based cancer registry was created in 1926 in the U.S. state of Connecticut, where in 1935 one of the first population-based cancer registries also was established. In Europe, registries were started in Germany (1929), Denmark (1942), Belgium (1943), and the United Kingdom (1945). In 1940, New York passed the first law that required reporting of cancer cases diagnosed in the state (except in New York City) to the state health department; the law was amended in 1972 to include cancer cases in New York City.

Cancer reporting

Most modern state-based cancer registries in the United States require reporting of cancer cases by law. Regulatory requirements for cancer registries in other countries, such as those in Europe, vary considerably. In general, information reported to cancer registries is considered confidential, and many places have strict procedures in place to protect the privacy of cancer patients.

Most registries include reports of all malignant cancers. Many also require certain benign neoplasms, namely those located in the brain, the meninges, the pineal gland, or the pituitary gland, to be reported as well. Other types of benign tumours, especially those that are rarely fatal, may not be reported. Data that is reported can come from various medical facilities, including hospitals, physicians’ offices, and pathology laboratories.

National cancer registries

Within the United States, there are multiple national organizations and programs that actively collect and report cancer data. These include the Centers for Disease Control’s (CDC’s) National Program of Cancer Registries (NPCR); the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program; the Commission on Cancer of the American College of Surgeons’ National Cancer Data Base (NCDB); and the Central Brain Tumor Registry of the United States. Other countries have similar programs; examples include the National Central Cancer Registry of China, the National Cancer Registry Programme (NCRP) in India, and the Australasian Association of Cancer Registries (AACR) of Australia and New Zealand. In Europe, collaboration between national cancer registries is promoted by the European Network of Cancer Registries (ENCR), which also establishes standards for data collection.

One of the most heavily used cancer registries is the SEER registry, which was established in 1971. Its goals include assembling and reporting estimates of cancer incidence and mortality in the United States, monitoring annual cancer incidence trends to identify unusual changes in specific forms of cancer occurring in population subgroups, providing recent information on changes over time in diseases, and promoting studies designed to identify factors susceptible to cancer-control interventions.

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Role in cancer epidemiology

Cancer registries often are used to conduct epidemiological studies, typically those that are either retrospective (examining past events) or cross-sectional (involving a representative data subset). In such studies, data contained in cancer registries may be used to assess cancer trends, to monitor the impact of cancer on the general population or a subpopulation, to identify environmental carcinogens (cancer-causing agents), to monitor cancer-related effects of specific carcinogens (e.g., tobacco), to identify geographic areas with higher than average cancer rates, to study patterns and outcomes of cancer care, and to identify risk groups for research and public health interventions.