• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6189-6193
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• 2013

In December 2011, the Cancer Research Centre of the Cancer Institute of Iran sponsored a 3-day workshop on "Cancer Registration Principle and Challenges in Iran", which convened cancer registry experts. The objectives of the workshop were: to introduce standard cancer registration, to review the policy and procedure of cancer registration in Iran, and to review the best practices in the cancer registries in Iran. Challenges to cancer registration were discussed and recommendations were developed. The workshop was evaluated by participants for better organization of subsequent workshops. The objective of publication of this report is that based on Cancer in 5 Continents, many low- or middle-income countries do not meet the criteria for a standard population-based cancer registry (PBCR); on the other hand cancer is the most important cause of mortality and the essential part of any cancer control program is the cancer registry. Therefore this report focuses on problems and challenges of PBCR and provides recommendations which might help other developing countries to decrease their PBCR defects.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4613-4617
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• 2012

National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in order to provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophageal cancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008. Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent change estimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer was found to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardized incidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 in all areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annual decrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreased with 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is still a big issue and efforts for control should be continuously enhanced. Cancer registration is playing an important role in cancer control with the number of registries increasing and data quality improving in China.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5839-5843
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• 2014

Objective: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. Methods: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. Results: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was $271.5/10^5$ during 2000 to 2009 (male $305.41/10^5$, female $236.58/10^5$), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were $147.1/10^5$ and $188.2/10^5$, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was $209.6/10^5$ in 2000, and it increased to $320.20/10^5$ in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. Conclusions: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.693-698
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• 2012

Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of $47{\pm}12$ years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5817-5823
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• 2013

Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.257-264
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• 2010

Objectives: An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. Methods: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. Results: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. Conclusions: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5367-5370
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• 2013

Background: Having knowledge or estimation of cancer incidence is necessary for planning and implementation of any cancer prevention and control programs. Population-based registries provide valuable information to achieve these objectives but require extra techniques to estimate the incidence rate. The present study aimed to estimate the esophageal cancer incidence using a log-linear method based on Tehran population-based cancer registry data. Materials and Methods: New cases of esophageal cancer reported by three sources of pathology reports, medical records, and death certificates to Tehran Metropolitan Area Cancer Registry Center during 2002-2006 were entered into the study and the incidence rate was estimated based on log-linear models. We used Akaike statistics to select the best-fit model. Results: During 2002-2006, 1,458 new cases of esophageal cancer were reported by the mentioned sources to the population-based cancer registry. Based on the reported cases, cancer incidence was 4.5 per 100,000 population and this was estimated to be 10.5 per 100,000 by the log-linear method. Conclusions: Based on the obtained results, it can be concluded that an estimated incidence for 2004 of 8.3 per 100,000 population could be a good benchmark for the incidence of esophageal cancer in the population of Tehran metropolis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2107-2111
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• 2013

Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional, descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist. Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care quality was also computed and the relationship with data agreement was investigated through chi-square test. Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%, and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned services assessed in the breast cancer prevention center and the corresponding medical records. A significant relationship was found between data agreement and quality assessment. Conclusion: Although the results showed good data agreement, more agreement regarding the cancer stage data elements and the type of the received treatment is required to better assess cancer care quality. Therefore, more structured medical records and stronger cancer registry systems are recommended.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2595-2598
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• 2013

Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9411-9416
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• 2014

Background: Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Materials and Methods: Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. Results: This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. Conclusions: The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.