Cancer registration in Germany: current status, perspectives and trends in cancer incidence 1973-93.

Abstract

Background: A federal law effective in 1995 makes it mandatory for all German States to build up population-based cancer registries. Although the law provides a model of cancer registration, each State may modify this by State-specific regulations, as long as they ensure data exchange between the registries and between registries and scientific institutions. The 'Network of German Population-Based Cancer Registries' constitutes the basis for cooperation among the German cancer registries. In order to improve the cooperation between physicians and epidemiologists, and to demonstrate the benefits of cancer registration, the network published a booklet containing facts on time-trends in cancer incidence during the last two decades.

Methods: Information on cancer incidence and mortality was derived from the population-based cancer registries of Saarland, the former German Democratic Republic (until 1989), the City of Hamburg and the region of Münster. Altogether these registries cover a population of about 23 million. Sixteen types of cancer were selected for the analyses.

Results: Major increases in cancer incidence were observed for female lung cancer, testicular cancer, cancer of the oral cavity, malignant melanoma of the skin and non-Hodgkin's lymphoma. Incidence rates also increased for cancer of the female breast, prostate cancer and colorectal cancer. A decrease was observed for stomach and cervical cancer.

Discussion: In 1998, only a small fraction of all German adults were monitored by a population-based cancer registry, making it impossible to work out accurate incidence rates for the whole of Germany. Several new cancer registries have been built up recently. Data summaries of existing German population-based cancer registries assist in enhancing the completeness of new cancer registries.