Annual Report 2017
Center for Cancer Registries
Takahiro Higashi, Naoyuki Sato, Tomohiro Matsuda, Akiko Shibata, Kumiko Saika, Mariko Niino, Ayako Okuyama, Yoichiro Tsukada, Yoshiko Emori, Kaori Nakano, Rika Nabata, Mika Mizuochi, Saya Maruyama, Seiya Kondo, Hiroko Takamatsu, Asako Umeda, Tokiko Iguchi, Hiroko Okazaki, Masako Hoshikawa, Masayo Kato, Emiko Enjoji
Introduction
The Center for Cancer Registries is in charge of providing precise cancer statistics for patients and their families, the public, healthcare professionals, policy makers, and researchers. Our center promotes nationwide cancer control programs based on the newly enacted Act on Promotion of Cancer Registries, as well as standardization of hospital-based cancer registries in designated cancer care hospitals.
Our team and what we do
1. Population-Based Cancer Registries
On the basis of the Act on Promotion of Cancer Registries, we collect cancer information from 47 prefectures by using the online National Cancer Registry System (NCRS). We have continuously exerted efforts to develop a reliable cancer surveillance system in Japan, which is stated as a key element in the Cancer Control Act. We support all 47 prefectures through various measures such as disseminating up-to-date information via websites and mailing lists; by setting up a Q&A service; and by holding 2-day educational workshops for cancer registrars and administrative officers in charge of cancer control in May (141 participants) and December (133 participants). We also developed an online cancer reporting system. Of 12,712 medical institutions, 5,268 (41.4%) are under process of connection, and of this number, 3,452 (27.2%) had submitted data to prefectures. The Population-Based Cancer Registry Database System (PBCRDS), developed by our center, allows prefectures to maintain cancer registry data in the past years, and to link them with the current data in the NCRS. Forty-five registries have introduced the PBCRDS as of March 2018. An external audit on security control in cancer registration was performed in collaboration with the professional agency. Our regular activities include a consulting service for the Ministry of Health, Labour and Welfare, and for the related boards.
2. Hospital-Based Cancer Registries
Hospital-Based Cancer Registry (HBCR) is essential to evaluate cancer care in each hospital and also to achieve high quality data for PBCR. As of 2015, the HBCR is operated at 427 designated cancer care hospitals (DCCHs) and 324 other hospitals, including 15 designated hospitals for childhood cancer. These data are submitted to the Center and analyzed to produce clinical cancer statistics nationwide. We play an important role in the standardization and quality improvement of HBCR. In 2015, records for 702,866 cancer cases diagnosed in 2015 were collected from 427 DCCHs. In collaboration with clinical experts, we continuously updated the standards for HBCR and distributed them continuously to the DCCHs and other hospitals. We introduced the eighth edition of the UICC TNM classification of malignant tumors and the latest edition of SEER multiple primary rules to HBCR. To facilitate the work of cancer registrars, we distributed the standardized software "Hos-CanR Next" for those that operates hospital-based cancer registries, and the simplified version, "Hos-CanR Lite" to hospitals that submit date only to the National Cancer Registry. To ensure data quality, we organized a series of education programs for cancer registrars, consisting of 13 one-day continuous education session for 1,526 participants and four one-week programs for new applicants for intermediate-level registrars. After the qualification exam 371 beginner level and 186 intermediate level cancer registrars were newly certified.
Research activities
The national cancer incidences in 2014 were calculated on the basis of the data from all 47 cancer registries, as 867,408. Owing to good quality data, we obtained a total number of cancer incidence of 47 prefectures for the first time. The incidence data were then analyzed in detail by cancer site and age group, and published in international academic journals, presented at conferences both in Japan and abroad, on the website, and in the book titled "Cancer Statistics in Japan".
As a routine activity, international comparisons of cancer burden and survival rate were conducted based on the WHO mortality, GLOBOCAN, and cancer registry database. Updated trend analysis of cancer incidence and mortality in Japan was conducted.
Hospital-based cancer registries are compiled at the national level in the Center. To improve the quality of cancer care nationwide, we produce an annual report for cases diagnosed in 2015 with a focused analysis on the first-course treatment for older patients. The reports are frequently cited in media and academia in discussion about care for older patients.
Education
Our activities of extramural education were provided as mentioned in the strand of "Our team and what we do".
Future prospects
We intend to set the activities of the National Cancer Registry (NCR) on a better track through continuous restructuring of the organization, and building a new relationship with the International Agency of Research on Cancer (IARC) and other overseas institutions based on the bi-institutional memorandum of understanding (MOU).
The hospital-based cancer registries continue to evolve to closely monitor the care provided to cancer patients in Japan. The training of cancer registrars enables the collection of detailed information including the International Union against Cancer (UICC) TNM classifications. Other clinically useful information is planned as research studies for a closer look at the clinical practices nationwide.
Table 1. Estimated number of patients
