The HCR full text

Full text as it appears in pages 12-13 of the 1st Newsletter of the Hellenic Center of Disease Prevention & Control or HCDPC (issue No 1, year 1, April 6, 2011).

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The Hellenic Cancer Registry

Cancer remains a major public health problem and is one of the leading causes of death in Greece and worldwide. According to the most recent estimates from the Globocan Project of the International Agency for Research on Cancer, approximately 37,000 new cases are diagnosed in Greece each year and there are 27,000 cancer deaths annually [1]. It is estimated that 3.4 million new cancer cases will be diagnosed in Europe by 2020.

Considering the enormous toll that cancer still takes in Europe, systematic collection of accurate and reliable data through national (population-based) cancer registries in EU member states was considered an essential part of the health policy of each member state and was included in the Conclusions of the Council of the European Union on Reducing the Burden of Cancer [2].
It is worth noting that cancer registries are the only reliable way to assess the magnitude of the problem in a country and to monitor the effect of screening programmes, the effectiveness of treatment, and the duration and quality of patient survival on a population basis. Brewster et al. noted that population-based cancer registries are the invisible key to cancer control [3].

The Hellenic Cancer Registry (HRC) has been managed by the Hellenic Center for Disease Control and Prevention (HCDCP) according to Act No. 3370/2005 since June 2008. This followed the reporting mechanism that existed in the Department of Hygiene of the Ministry of Health during 1990–2005, when results were only published for 1990–1991. The data were considered incomplete and no electronic registration occurred between 1994 and 2008, when the HRC was moved to HCDCP. Thus, there has been retrospective registration of all new cancer cases reported from 1 January 2007 to gain an understanding of the reporting mechanism and identify any difficulties in the registration system.

During the two and a half years of HRC operation within HCDCP, there has been a significant increase in the number of hospitals that participate in the system and thus a substantial increase in cancer notifications. Nevertheless, despite the efforts made to improve registration and increase the percentage of reporting hospitals, the collected data remain incomplete and account for ~30% of the new cancer cases diagnosed in Greece every year. It is worth noting that the notification system is passive, whereby reporting is on a voluntary basis by physicians in pathology laboratories and clinics and departments.

Greece, in contrast to most westernised countries, showed a continuing upward trend in total cancer mortality between 1980 and 2004, as well as substantial geographical differences within the country, with a north-to-south pattern [4]. Thus, there is a great need for immediate implementation of a comprehensive national population-based cancer registry to help shape the national strategy against cancer. Development and implementation of the HCR is the first action of the fifth axis of intervention of the National Cancer Plan 2011–2015.

Development and comprehensive operation of the HCR remains a priority for the HCDCP. According to international standards and practice, this will include collection of the required data using two reporting mechanisms. These will work in parallel with a view to continuous availability of robust data for drawing reliable conclusions. However, for successful HCR operation, the support of health professionals involved in the diagnosis and treatment of cancer is essential.

Finally, as the HCR representative, I would like to express sincere thanks to the medical community who supported and still support our efforts thus far, the Secretary General of Public Health, Mr Antonis Dimopoulos, the president of the Oncology Committee of the Central Health Council, Professor Georgios Fountzilas, and the members of the Committee for their support of this ambitious task.

References:
– The GLOBOCAN Project. Fast stats for Greece (2008). Στο http://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=300 (accessed 20 March 2011).
– Council of the European Union. Council Conclusions on Reducing the Burden of Cancer, 2876th Employment, Social Policy Health and Consumers Affairs Council Meeting, Luxembourg, 10 June 2008.
– Brewster DH, Coebergh JW, Storm HH (2005). Population-based cancer registries: the invisible key to cancer control. Lancet Oncol 6:193–5.
– Tzala E, Best N (2008). Bayesian latent variable modelling of multivariate spatio-temporal variation in cancer mortality. Stat Methods Med Res 17:97–118.

Evangelia Tzala, Department of Education and Head of the Cancer Registry

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