Cancer registry

A cancer registry is a systematic collection of information in the form of a database on cancer. The term cancer is used virtually interchangeably.

• 2.1 Clinical Cancer Registry in Lower Saxony

• 8.1 laws

Differentiation according main objective

A distinction epidemiological cancer registries and clinical cancer registries. In favorable cases, clinical and epidemiological cancer registry work together, so that the physician must report only to the clinical registries and this message is then forwarded to the epidemiological register. There will also be, as far as the law permits it, an exchange of data between epidemiological cancer registries instead, since a patient living in a state, but can be treated, for example, in another state.

Epidemiological Cancer Registry

Using population-based cancer registries, the cancer process, ie how often encounter certain tumor diseases in a region observed. About comparisons over time within a region or from comparisons of regions themselves will determine whether somewhere clusters of disease occur ( temporal and spatial monitoring). In the second step must be tried in the rule of targeted investigations to determine the causes for the accumulation, of course, with the aim to eliminate the cause if possible.

Clinical Cancer Registry

Clinical Cancer Registry aimed to improve the treatment of tumor diseases. These must first relatively detailed data on disease and therapy are collected. Improvements can be made by the following method:

• Comparison of therapies to each other: " What treatment is at what stage the most appropriate? "
• Comparison of therapists with each other: "Which therapist or hospital achieved with the same initial situation and the same treatment the better results and why " (so-called quality management)
• Optimization of individual supervision: About reminder procedure ensures that therapies and follow-up examinations take place at the optimum time. Of mutual information (register as an information hub ) will ensure that each party to the care has the best possible information available.

Funding for nationwide clinical cancer registry

For the construction of clinical cancer registries in Germany are from 2013, the first eight million euros ready, the German Cancer Aid takes over 90 percent of these costs. The states bear ten percent of the estimated financial requirements. The non-profit organization founded by Mildred Scheel assistance provided by the donations of citizens ready 7.2 million euros to further ensure patient care. In addition, the cancer early detection and register Act ( KFRG ) obliges the state health insurers to promote clinical cancer registry with a flat rate for each detected tab incidence of 119 euros. < § 65c paragraph 2 and 4 of Book V < The annual expenditure of the statutory health insurance for clinical cancer registries are estimated at 58.7 million euros. A basis for progress in the fight against cancer is the cancer screening and registries Act ( KFRG ) provides that that countries should establish comprehensive clinical cancer registry. The law passed by the German Bundestag Act came into force in April 2013 ..

Clinical cancer registry of Lower Saxony

The state of Lower Saxony in 2014 has determined that for a clinical cancer registries in the years to about 600,000 euro werden.Die invests German Cancer Aid involved in the establishment of the register with a total of 484,000 euros in donations of Bürger.Hinzu be added the support of health insurance, according to the official statistical data support the ongoing operation of the clinical cancer registration with a fee of 118 euros per incidence case. The clinical registers used in the future especially to raise the quality of tumor therapy. With the clinical cancer registry of Lower Saxony comes after 2013 came into force in early cancer detection and Register Act ( KFRG ).

Quality criteria

This epidemiological registers really can provide good results, more than 90 %, more preferably 95 % of all new cases need to be reported in the relevant register region ( so-called completeness ). This clinical registries really can provide good results, the diseases of the respective therapy device ( doctor / hospital) must be recorded complete. Moreover, it is important to capture also the entire course of the disease entirely ( relevant information ), and not about to stop after therapy.

Each population-based cancer registry gets to balance the data, the death certificates of the country. This will be calculated and tries to determine whether the cancer was causally involved in the death of a survival times. A certain proportion of disease ( DCO percentage, death certificate only) is alone, even after investigation, known on the death certificates. The problem with these cases is that the quality of information is usually poor and the year of occurrence of the disease can not be determined, which makes the figures on incidence rates unreliable. The DCO percentage should therefore be as low as possible ( less than five percent ).

In each tab, the newly created DCO rate is at the beginning naturally high because the case records of the past are not met. However, this percentage must fall in the course of a few years. Since the nationwide cancer registration in some states is relatively young, explains why long-term cancer registries such as the Saarland DCO lower rates than others.

Importance of age standardization

The risk of certain forms of cancer, is strongly age-dependent. The number of diseases in a population ( " crude " incidence) is thus dependent on the age distribution in the observed population. If you follow developments over time ( for example, " increasing the risk for a particular disease ?") Or spatial comparisons will perform (in terms of risk- polluted and unpolluted areas, international comparisons ) must be standardized such effects by the so-called age standardization. Common so-called reference populations for such comparisons are the Segi world population, FRG population in 1987 or European standard populations.

Distribution in Germany

In Germany the epidemiological cancer registration in the country is governed by laws. First, the Hamburg Cancer Registry was established in 1926 by the town physician of Hamburg as a tool for follow-up and monitoring. It was the first cancer registry in the world and also made in Germany for many years an exception as a long tradition also have some other German cancer registries, such as those of the states of Berlin, Brandenburg, Mecklenburg- Western Pomerania, Saxony, Saxony- Anhalt and Thuringia, the in continuation of the National cancer Registry of the GDR (1952 /53) are operated since 1992 as a Common cancer Registry ( GCC ) or the cancer registry of Saarland (1967). These different rules are a result of German federalism. Moreover, since 1980, there is a nationwide Cancer Registry, which is a combination of epidemiological and clinical cancer registry and is operated on a voluntary basis. The expansion of each tab is at different stages. Some countries have already achieved a full complement of register registration, some achieve this for specific diseases such as the health policy very significant breast cancer. Overall, it will take some years to nationwide numbers of good quality are to be expected, since the start-up time for new register is considerable.

The Centre for cancer registry data at the Robert Koch Institute evaluates the data nationwide. The periodical publication cancer in Germany shows the situation for each of the past few years. The Association of Population- Based Cancer Registries in Germany V. ( GEKID ) seeks nationwide to attain a high degree of methodological consistency through content standards despite different national legal regulations. On 29 May 2009, the Bundestag decided the federal Cancer Registry Data Act, which strengthens the Center for Cancer Registry Data and formal clinical cancer registries assigns an official role in the cancer registry.

Austrian Cancer Registry

In Austria, the mandatory reporting of tumors by the Cancer Statistics Act in 1969 and the Cancer Statistics Regulation 1978 is regulated. Statistics Austria receives from all around 270 reportable hospital morbidity and mortality data. In the states of Vorarlberg, Tyrol, Salzburg and Carinthia has its own nationwide cancer registry. In health reporting the epidemiology of cancer incidence ( new cases per calendar year) and the cancer mortality play a central role. The last publication on cancer incidence and cancer mortality in Austria is from the year 2010.