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...     

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.     

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...     

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.     

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.     

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。     

A review of methionine dependency and the role of methionine restriction in cancer growth control and life-span extension

Methionine is an essential amino acid with many key roles in mammalian metabolism such as protein synthesis, methylation of DNA and polyamine synthesis. Restriction of methionine may be an important strategy in cancer growth control particularly in cancers that exhibit dependence on methionine for survival and proliferation. Methionine dependence in cancer may be due to one or a combination of deletions, polymorphisms or alterations in expression of genes in the methionine de novo and salvage pathways. Cancer cells with these defects are unable to regenerate methionine via these pathways. Defects in the metabolism of folate may also contribute to the methionine dependence phenotype in cancer. Selective killing of methionine dependent cancer cells in co-culture with normal cells has been demonstrated using culture media deficient in methionine. Several animal studies utilizing a methionine restricted diet have reported inhibition of cancer growth and extension of a healthy life-span. In humans, vegan diets, which can be low in methionine, may prove to be a useful nutritional strategy in cancer growth control. The development of methioninase which depletes circulating levels of methionine may be another useful strategy in limiting cancer growth. The application of nutritional methionine restriction and methioninase in combination with chemotherapeutic regimens is the current focus of clinical studies.     

Rapid reporting of cancer incidence in a population-based study of breast cancer: one constructive use of a central cancer registry

Summary To support a study of genetic risk factors for breast cancer, the North Carolina Central Cancer Registry has implemented a rapid reporting procedure for hospitals in the study area. This system permits the identification of newly diagnosed breast cancer cases within a very short time period (less than one month). The procedures are straightforward, cost-effective, and greatly benefit the objectives of tissue collection and interviews with the cases. This article describes the rapid reporting procedures and their potential impact for population-based research. For the objective of making generalizable risk statements, the necessity of population-based research is stressed; participation with central cancer registries is endorsed for this and other molecular epidemiologic applications.     

The accuracy of prostate cancer staging in a population-based tumor registry and its impact on the Black-White stage difference (Connecticut,United States)

Stage at diagnosis of prostate cancer is a major determinant of survival. Among Blacks, prostate cancer is diagnosed at a later stage of disease than among Whites. This study examined the accuracy of routine coding of prostate cancer stage in the Connecticut (United States) Tumor Registry (CTR) and its effect on the Black/White stage difference. Medical records were collected for 115 Black and 136 White men with prostate cancer diagnosed between 1987 and 1990. Stage at diagnosis was determined by a panel of two of the study members and compared with the stage in the CTR file. According to the panel, 32 percent of Blacks, but only 15 percent of Whites, were diagnosed with distant stage disease. Fifty-eight cases (26 percent of Whites and 20 percent of Blacks) were staged incorrectly by the CTR. Two-fifths of the errors were due to incomplete medical records at the CTR and three-fifths were due to CTR coding or data management errors. The more accurate staging did not have an appreciable impact on the Black/White stage difference. Further work is needed to characterize the accuracy of routinely coded cancer registry stage data for different cancer sites, to devise ways of improving accuracy, and to determine the impact of staging inaccuracies on research that utilizes these data.This study was supported by grant 5-PO1-CA42101 from the US National Cancer Institute. Dr Dubrow received support from an NCI Preventive Oncology Academic Award, K07-CA01463.     

Characteristics of synchronous- and metachronous-type multiple primary neoplasms: a study of hospital-based cancer registry in Turkey

PURPOSE: The aim of this study was to evaluate the demographic, histologic, and topographic characteristics, and the association of synchronous and metachronous multiple primary neoplasms. PATIENTS AND METHODS: Five hundred seventy-two multiple primary tumors (n = 286) of 20,895 tumors recorded from 1993 to 2005 by the office of Izmir Cancer Registry at the Izmir Ataturk Training and Research Hospital were analyzed. chi(2) and Student t test were performed. RESULTS: One hundred fifty-eight patients had synchronous tumors whereas 128 had metachronous tumors. Both groups were more frequent among men and among patients aged > 50 years. The distribution of synchronous and metachronous tumors between sex and age groups was similar (P = .462 and P = .479, respectively). Carcinomas were more frequent and histologic compositions of both of the groups were significantly different (P = .009). Pairs of the same topographic origin were significantly more frequent in synchronous tumors (P = .019). The urogenital system was the most frequent location in all groups. The leading tumoral association was between urogenital-urogenital tumors, also. Detailed evaluation of the metachronous group revealed that the most frequent organ associations were of breast-ovary (n = 7) and bladder-larynx (n = 5). CONCLUSION: Field cancerization in the epithelium, theory of a common clonal origin, or the screening effect might account for the relatively frequent association of urogenital tumors. The association of the tumors of breast-ovary might be related to the endocrine effect. Further studies complying with international rules and using data from different population-based tumor registries are necessary to elucidate site correlation.     

Age-related variations in progression of cancer at diagnosis and completeness of cancer registry data

There is some evidence that stage and grade at diagnosis of cancer decreases with age and that the availability of data on stage and grade of cancer decreases with age. This may be because older people tend to receive less intensive investigation of cancer but this has not been confirmed. We investigated the relationship between age at diagnosis of cancer and both stage and grade at diagnosis, and the chances of data on stage or grade at diagnosis being unavailable, in people with colorectal cancer (n=12,419) and women with breast cancer (n=12,793) using 2 years of cancer registry data from the north of England. Stage and grade decreased with increasing age in colorectal cancer. Grade decreased but stage increased with increasing age in women with breast cancer. The chances of data on stage and grade at diagnosis being unavailable increased with age in all cases.     

2009—2015年甘肃省肿瘤登记地区肝癌流行特征及变化趋势分析

目的 分析甘肃省肿瘤登记地区2009—2015年肝癌发病和死亡流行特征,为制定肝癌防治策略提供依据.方法 按照全国肿瘤登记中心制定的审核方法收集甘肃省10个肿瘤登记点上报的数据作为样本数据,描述甘肃省肝癌发病和死亡分布情况,按地区(城市/农村)、性别、年龄进行分层,计算肝癌发病与死亡粗率、中国人口标化率(简称中标率)、...