The role of cancer registries in cancer control

Cancer control aims to reduce the incidence, morbidity, and mortality of cancer and to improve the quality of life of cancer patients through the systematic implementation of evidence-based interventions in prevention, early diagnosis, treatment, and palliative care. In the context of a national cancer control program (NCCP), a cancer surveillance program (CSP), built around a population-based cancer registry, is an essential element. Data on the size and evolution of the cancer burden in the population are essential to evaluation of the current situation, to setting objectives for cancer control, and defining priorities. Cancer data are essential in monitoring the progress of the implementation of an NCCP, as well as providing an evaluation of the many individual cancer control activities. In the context of an NCCP, the CSP should provide a focus of epidemiological expertise, not only for providing statistical data on incidence, mortality, stage distribution, treatment patterns, and survival but also for conducting studies into the important causes of cancer in the local situation, and for providing information about the prevalence of exposure to these factors in the population. Cancer surveillance via the population-based registry therefore plays a crucial role in formulating cancer control plans, as well as in monitoring their success.     

Cancer patterns in eastern India: the first report of the Kolkata cancer registry

There are no population-based data available for the cancer patterns in Eastern India. This is the first report of cancer incidence in the region from the population-based cancer registry in Kolkata (Calcutta), the capital city of the state of West Bengal, India, for the period 1998-1999. The cancer registry collects data on all new cases of cancer diagnosed in the resident population of Kolkata. Since cancer is not a notifiable disease in India, registration is carried out by active data collection by the registry staff. The cancer registry staff visits 50 data sources comprising cancer hospitals, secondary and tertiary care hospitals, nursing homes, diagnostic laboratories and death registration offices; scrutinizes medical records and collects details on incident cancer cases. A customized version of CanReg-3 software was used for data entry and analysis. A total of 11,700 cases were registered during the 2-year period from 1 January 1998 to 31 December 1999. The overall age-adjusted (world population) incidence rates were 102.1 per 100,000 males and 114.6 per 100,000 females. The most frequently reported malignancies in males were lung cancer (16.3%), followed by cancers of the oral cavity (7.1%), pharynx (5.7%) and larynx (5.7%). In females, the most frequently reported malignancies were breast (22.7%) followed by uterine cervix (17.5%), gallbladder (6.4%) and ovary (5.8%). The data reported by the Kolkata cancer registry provide information on the cancer profile in Eastern India for the first time. The highest incidence rate of lung cancer in males in India is reported from Calcutta. A high risk of gallbladder cancer is observed in women. The observed cancer patterns indicate that tobacco-control measures and early detection of head and neck, breast and cervical cancers are of importance for cancer control in this population.     

Completeness in an African cancer registry

Objective: A high level of completeness of case-finding is essential if data from cancer registries are to be useful for comparative studies. A large case series, collected independently of the cancer registry case-finding mechanisms, as part of a study of the influence of HIV infection on cancer risk, was used to evaluate the completeness of the registry in Kampala, Uganda, for the years 1994–1996. Results: For adults aged 15 or more, the completeness of registration of diagnosed cancer cases was 89.6% (95% CI 87.0–91.7) overall. It varied with age (better ascertainment of younger cases, aged under 30) and cancer site (with Kaposi sarcoma cases significantly better identified), and cases with a histology report were more likely to be registered than those without (though the difference was not significant). Completeness declined with time, as in most registries, which continue to identify late cases some time after the initial diagnosis. Conclusion: This is the first objective measurement of completeness of cancer registration in Africa, and it gives reassurance that published incidence rates are reasonably accurate (provided that there is not an insistence on the very latest results).     

Survival analysis of cancer cases from Qidong cancer registry

Thispaperdescribesthesurvivalexperiencefrom15selectedsitesofcancersaccordingtodatafromapopulation--basedcancerregistryduringtheperiodof1982--1991forevaluationofcancersurvivalaswellasdifferentcancercontrolmeasures.MATERIALSANDMETHODSDataCollectionCanc...     

Survival of children with cancer in Italy, 1989-98. A report from the hospital based registry of the Italian Association of Paediatric Haematology and Oncology (AIEOP)

We describe the survival patterns of 10,791 Italian children (age 0–14) diagnosed with cancer during 1989–1998 and who were included in the hospital-based registry of the Italian Association of Paediatric Haematology and Oncology. Five-year cumulative survival percentages were 76% for lymphoproliferative disorders and 68% for solid tumours. Survival rates in 1994–1998 significantly improved for acute lymphocytic leukaemia (ALL), acute non-lymphocytic leukaemia, Hodgkin’s lymphoma and Wilms’ tumour. Gender and age were determinants of survival for some specific types of cancer. Girls with ALL and neuroblastoma exhibited a significant advantage (hazard ratio HR 0.72, 0.62–0.83) and disadvantage (HR 0.73, 0.59–0.90) over boys, respectively. Children with a Wilms’ tumour diagnosed above age 3 had a worse prognosis than younger children (HR 2.3, 1.4–4.1). The persisting gender-related difference in survival rate for ALL requires understanding as to whether it is attributable to delays in the adoption of more recent therapeutic protocols, while the corresponding findings for Wilms’ tumour and neuroblastoma deserve further biological interpretation.     

The prioritisation of paediatrics and palliative care in cancer control plans in Africa

Background:

Given the burden of childhood cancer and palliative care need in Africa, this paper investigated the paediatric and palliative care elements in cancer control plans.

Methods:

We conducted a comparative content analysis of accessible national cancer control plans in Africa, using a health systems perspective attentive to context, development, scope, and monitoring/evaluation. Burden estimates were derived from World Bank, World Health Organisation, and Worldwide Palliative Care Alliance.

Results:

Eighteen national plans and one Africa-wide plan (10 English, 9 French) were accessible, representing 9 low-, 4 lower-middle-, and 5 upper-middle-income settings. Ten plans discussed cancer control in the context of noncommunicable diseases. Paediatric cancer was mentioned in 7 national plans, representing 5127 children, or 13% of the estimated continental burden for children aged 0–14 years. Palliative care needs were recognised in 11 national plans, representing 157 490 children, or 24% of the estimated Africa-wide burden for children aged 0–14 years; four plans specified paediatric palliative needs. Palliative care was itemised in four budgets. Sample indicators and equity measures were identified, including those highlighting contextual needs for treatment access and completion.

Conclusions:

Recognising explicit strategies and funding for paediatric and palliative services may guide prioritised cancer control efforts in resource-limited settings.     

2016年海南省肿瘤登记地区恶性肿瘤发病与死亡分析

目的 对2016年海南省肿瘤登记地区的癌症发病率和死亡率进行分析,为癌症的预防和控制提供了基础依据.方法 通过中国肿瘤登记平台收集符合质量控制要求的6个肿瘤登记地区发病死亡数据及人口数据.按城乡、性别、年龄别划分,分别计算发病(死亡)率、中标率、世标率、构成比、0～74岁累积发病(死亡)率和前10位癌症发病死亡情况.结...     

The state of the art of cancer control in 30 European countries in 2008

Inequalities in cancer incidence, mortality and survival represent a major challenge for public health. Addressing this challenge requires complex and multidisciplinary approaches. Sharing successful experiences from across Europe may therefore be of benefit. We describe the state of the art of cancer control structures in the 27 European Union countries, plus Iceland, Norway and Switzerland, at the beginning of 2008. Information on cancer plans, cancer registries, cancer screening, Human Papillomavirus (HPV) vaccination and smoking restrictions in each country was identified through PubMed, the official websites of national and international organizations and Google™ searches. Experts and/or health authorities from each country completed and validated the information. Sixteen countries had implemented national cancer plans in 2008. Twenty four countries had population‐based cancer registries with 100% coverage. The exceptions were Greece and Luxembourg (no population‐based registry yet), France, Italy and Spain (<50%), and Switzerland (62%). In 9 countries, population coverage of breast cancer screening was 100% with participation ranging from 26 to 87%; 8 countries did not have organized programmes. Seven countries had cervical cancer screening programmes with 100% coverage with participation ranging from 10 to 80%; 8 countries had no organized programme. Nine countries had announced national HPV vaccination policies by early 2008. Six countries had organized colorectal cancer screening programmes. Five countries had complete bans on smoking in public places. There is wide international heterogeneity in cancer control structures in Europe. This provides considerable scope and motivation for cooperation and sharing of experience.     

Improving cancer control in the European Union: conclusions from the Lisbon round-table under the Portuguese EU Presidency, 2007

Cancer is a major cause of morbidity and mortality in the European Union (EU), and a public health burden. Improving cancer control in the EU will require implementation of efficient strategies within Member States and better policy coordination between them. In cooperation between the rotating EU Presidencies of Germany (2007), Portugal (2007) and Slovenia (2008), special attention was devoted to an integrated approach to cancer control in EU policies and programmes. A round-table focussed on national cancer plans, population-based cancer registries and cancer screening programmes was held during the Health Strategies in Europe meeting in Lisbon in July 2007, under the Portuguese Presidency. These three topics were selected as critical for improving cancer control at both national and European levels. The round-table was designed to produce a set of recommendations to inform EU cancer policy. This paper provides a résumé of the conclusions and recommendations, to stimulate wider discussion and policy development.The conclusions of the meeting were presented at the Employment, Social Policy, Health and Consumer Affairs Council in December 2007 and cancer was included in the Council Conclusions for the new European Health Strategy. Success in cancer control will require consistent attention from future EU Presidencies, such as the initiative of the Slovenian EU Presidency in early 2008.     

2010—2016年广西肿瘤登记地区肝癌发病和死亡分析及变化趋势

目的 分析2010—2016年广西肿瘤登记地区肝癌发病和死亡特征及其变化趋势,为广西制定肝癌防控措施提供依据.方法 收集2010—2016年广西肿瘤登记地区上报的恶性肿瘤发病与死亡资料,计算肝癌发病率、死亡率、构成比、0～74岁累积率、35～64岁截缩率,按地区(城市/农村)、性别和年龄分层.采用2000年中国人口普查...     

2017年福建省肿瘤登记地区肝癌发病和死亡分析

目的 分析2017年福建省肿瘤登记地区肝癌发病和死亡数据,为肝癌防治策略制定和评估提供科学依据.方法 根据全国肿瘤登记中心制定的数据审核和评价方法,对福建省12个肿瘤登记处上报的2017年数据进行评价,将符合要求的10个登记处数据合并分析.按城乡、性别和年龄组分别计算肝癌发病和死亡粗率、标化率、累积率(0～74岁).中...     

大型单中心医院登记的7753例肺癌手术患者生存报告:基于第8版国际肺癌TNM分期标准

背景与目的:通过基于医院登记为基础的肺癌手术患者的随访资料,分析其1、3和5年观察生存率,为了解中国肺癌患者长期生存情况提供真实世界证据。方法:研究纳入2008年1月1日-2017年12月31日在复旦大学附属肿瘤医院接受手术的肺癌患者共7 753例,通过查阅患者复诊病史、电话随访和死因数据链接等方式收集患者的生存随访资料,随访统计时间截至2019年11月30日。采用Kaplan-Meier法估计患者1、3和5年总生存率(overall survival,OS),分性别根据年龄组、吸烟情况、诊断时间、肿瘤分期等特征分别描述。结果:男性肺癌手术患者经中位随访49.7个月后,5年OS为69.0%;女性患者经中位随访43.0个月后,5年OS为82.9%,显著优于男性。0、ⅠA、ⅠB、ⅡA、ⅡB、ⅢA和ⅢB期男性患者5年OS分别为100.0%、86.0%、74.6%、66.9%、55.2%、42.5%和41.8%,女性患者5年OS分别为100.0%、93.7%、78.5%、78.2%、62.9%、49.3%和33.0%。ⅠA、ⅠB、ⅢA期组女性患者OS优于男性。结论:本研究是目前国内最大规模的单中心肺癌患者的5年长期生存结果报告,经规范治疗后的肺癌患者的生存情况有显著改善,女性肺癌手术患者生存优于男性。肿瘤分期是影响肺癌患者生存的重要因素,应加强早诊早治,进一步提升患者生存率。     

Accelerating knowledge to action: the pan-Canadian cancer control strategy

Background

In 2006, the federal government committed funding of $250 million over 5 years for the Canadian Partnership Against Cancer Corporation to begin implementation of the Canadian Strategy for Cancer Control (cscc). The Partnership was established as a not-for-profit corporation designed to work actively with a broad range of stakeholders and organizations that had been engaged in the development of the cscc and with the public more broadly. A policy experiment unto itself, the Partnership was the first disease-based organization funded at the federal level outside of government. It was charged with a mandate to enable transfer of knowledge and to catalyze coordinated and accelerated action across the country to reduce the burden of cancer.

Implementation

Implementation has involved establishing shared goals, objectives, and plans with participating partners. Knowledge management—incorporating pan-Canadian approaches to the identification of content, processes, technology, and culture change—was used to enable that work across the federated health care delivery system. Evaluation of the organization through independent review, the ability to achieve initiative-level targets by 2012, and progress measured using indicators of system performance was used to examine the effectiveness of the strategy and approach overall.

Discussion and Conclusions

Evaluation findings support the conclusions that Canada has made progress in achieving immediate outcomes (achievable in <5 years) associated with advancing its cancer control goals and that there is evidence that, with sustained effort, those goals will translate into a long-term (>25 years) impact on cancer. The mechanism of funding the Partnership to develop collaboration among stakeholders in cancer control to achieve coordinated action has been possible and has been enabled through the Partnership’s knowledge-to-action mandate. Opportunities are available to further engage and clarify the roles of stakeholders in action, to clearly define outcomes, and to further quantify the economic benefits that have resulted from a coordinated approach. With the ongoing funding commitment to support coordinated action within a federated environment of health care delivery, there is opportunity to reduce the impact that cancer may have in the long term in Canada.     

Healthcare costs in the Danish randomised controlled lung cancer CT-screening trial: A registry study

Objectives

Low dose computerised tomography (CT) screening for lung cancer can reduce lung-cancer-specific mortality. The objective of this study was to analyse healthcare costs and healthcare utilisation of participants in the Danish lung cancer CT-screening trial (DLCST).

Materials and methods

This registry study was nested in a randomised controlled trial (DLCST). 4104 participants, current or former heavy smokers, aged 50–70 years were randomised to five annual low dose CT scans or usual care during 2004–2010. Total healthcare costs and healthcare utilisation data for both the primary and the secondary healthcare sector were retrieved from public registries from randomisation – September 2011 and compared between (1) the CT-screening group and the control group and, (2) the control group and each of the true-positive, false-positive and true-negative groups.

Results

The median annual costs per participant were significantly higher in the CT-screening group (Euros [EUR] 1342, interquartile range [IQR] 750–2980) compared with the control group (EUR 1190, IQR 590–2692) (p < 0.0001). When the cost of the CT-screening programme was excluded, there was no longer a statistically significant difference between the CT-screening group (EUR 1155, IQR 567–2798) and the control group (p = 0.52). Analyses according to the diagnostic groups showed that annual costs were 10.57 (95% CI 7.09–15.75) times higher for the true-positive and 1.67 (95% CI 1.20–2.32) times higher for the false-positive group compared with the control group.

Conclusion

Low dose lung cancer CT screening increases healthcare costs compared with no screening; this difference was attributable to the costs of the CT-screening programme. Overall healthcare costs were higher for the true-positive and false-positive groups than for the control group, also when excluding the cost of the CT-screening programme. This increase was outweighed by the larger true-negative group showing no significant differences in costs compared with the control group.     

2013—2017年黑龙江省肿瘤登记地区肝癌发病与死亡分析及变化趋

目的 分析黑龙江省肿瘤登记地区肝癌发病死亡情况及时间变化趋势。方法 收集2013—2017 年黑龙江省肿瘤登记地区上报的肝癌发病与死亡资料,计算发病（死亡）率、标化发病（死亡）率、累积率（0~74岁）等,标化率采用2000 年全国人口普查标准人口构成和 Segi's 世界标准人口构成作为标准。年度变化百分比（APC）使用Joinpoint软件计算。结果 2013—2017年黑龙江省肿瘤登记地区肝癌发病率为29.13/10万,中标率为17.18/10万,累积率（0~74岁）为1.96%。 其中男性肝癌发病率（42.59/10万）高于女性（15.90/10万）,农村地区肝癌发病率（35.05/10万）高于城市地区（26.75/10万）。2013—2017年黑龙江省肿瘤登记地区肝癌死亡率为26.53/10万,中标率为15.90/10万,累积率（0~74岁）为1.78%。其中男性肝癌死亡率（38.33/10万）高于女性（14.93/10万）,农村地区肝癌死亡率（30.65/10万）高于城市地区（24.88/10万）。2013—2017年发病中标率呈下降趋势,死亡中标率无明显变化趋势（P>0.05）,男性发病中标率呈下降趋势（P<0.05）。结论 黑龙江省肝癌负担较重,发病率整体呈下降趋势,死亡趋势较平稳。防治工作中应重点关注男性及农村地区,采取综合措施进行有效预防与控制。     

A central role for TRPS1 in the control of cell cycle and cancer development

The eukaryotic cell cycle is controlled by a complex regulatory network, which is still poorly understood. Here we demonstrate that TRPS1, an atypical GATA factor, modulates cell proliferation and controls cell cycle progression. Silencing TRPS1 had a differential effect on the expression of nine key cell cycle-related genes. Eight of these genes are known to be involved in the regulation of the G2 phase and the G2/M transition of the cell cycle. Using cell synchronization studies, we confirmed that TRPS1 plays an important role in the control of cells in these phases of the cell cycle. We also show that silencing TRPS1 controls the expression of 53BP1, but not TP53. TRPS1 silencing also decreases the expression of two histone deacetylases, HDAC2 and HDAC4, as well as the overall HDAC activity in the cells, and leads to the subsequent increase in the acetylation of histone4 K16 but not of histone3 K9 or K18. Finally, we demonstrate that TRPS1 expression is elevated in luminal breast cancer cells and luminal breast cancer tissues as compared with other breast cancer subtypes. Overall, our study proposes that TRPS1 acts as a central hub in the control of cell cycle and proliferation during cancer development.     

2009—2015年甘肃省肿瘤登记地区子宫体癌发病与死亡特征分析

目的 分析甘肃省肿瘤登记地区2009—2015年子宫体癌发病和死亡流行状况及变化趋势,为甘肃省子宫体癌的防治提供依据.方法 审核整理2009—2015年甘肃省肿瘤登记地区子宫体癌发病(死亡)率、构成比、中国人口标化率(中标率)和世界人口标化率(世标率)等,分析年龄别发病及死亡情况,并通过Joinpoint回归模型计算年...     

启东市1972-2011年膀胱癌生存率长期趋势分析

背景与目的：我国鲜见有以人群为基础的超过40年的膀胱癌生存率的报道。该研究对启东1972—2011年全人群膀胱癌登记病例进行生存率分析,为预后评价及防治提供依据。方法：1619例登记病例的生存(死亡)情况随访截止于2012年4月。用SURV 3.01软件计算观察生存率(observed survival rate,OS)和相对生存率(relative survival rate,RS)。结果：膀胱癌1、3、5、10、15、20及30年OS分别为59.91%、43.49%、35.98%、26.91%、21.30%、18.37%及12.24%,1、3、5、10、15、20及30年RS分别为64.07%、53.02%、50.06%、52.42%、59.59%、76.39%及115.75%。其中男性1、3、5、10、15、20及30年OS分别为60.84%、43.91%、36.95%、27.31%、21.49%、18.29%及12.59%,1、3、5、10、15、20及30年RS分别为65.23%、53.95%、52.02%、54.57%、62.59%、79.12%及117.07%;女性1、3、5、10、15、20及30年OS分别为56.61%、42.03%、32.44%、25.65%、20.78%、18.80%及0%,1、3、5、10、15、20及30年RS分别为59.99%、49.91%、43.37%、45.86%、51.21%、69.02%及0%,男性、女性生存率差异无统计学意义(P=0.256)。15~34岁、35~44岁、45~54岁、55~64岁、65~74岁及大于75岁各年龄组的5年RS分别为49.10%、67.53%、62.77%、53.92%、46.59%和39.85%;10年RS分别为49.79%、61.23%、52.99%、48.21%、54.94%和51.21%。20世纪80年代以来,膀胱癌5、10和15年RS均有上升趋势。结论：启东市全人群膀胱癌登记病例总体生存率在逐步提高,早期诊断和治疗方法的进步可能是膀胱癌生存率提高的影响因素。与发达国家相比,膀胱癌生存率的差距正在缩小,但仍有提高的空间。