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The Hong Kong Cancer Registry is population-based. It is a member of the International Association of Cancer Registries (IACR). Our basic concern is the incidence and mortality rates of cancer in the Territory. We collect basic demographic date, information on the anatomical site (topography) and histopathology (morphology). Staging and survival information has also been starting to collect in recent years. Analyses of this information illustrate the change in cancer distribution patterns in Hong Kong over time. It provides a framework for comparative geographical, epidemiological and clinical research.
The pursuit for excellence is always our goal. Quality control measures are established to check the accuracy and validity of the data. These are done through a series of computer programmes. The percentage of histologically verified cases (MV%), death certificate only cases (DCO%) and mortality/incidence ratio (M/I) are used to estimate the completeness. We have reasonably good figures in these quality indices (Figure). The data will not be published until case reporting is estimated to be almost complete. Very often the last few percent are the hardest to finish.
Ideally the MV% should be 100% and DCO% zero. In our case the MV% improved significantly from 55% in 1983 to 85% in 2004. The DCO% was 13.3% in 1983. It was 1.2% in 2004. This is already up to the standard in developed countries.
The Hong Kong Cancer Registry provides cancer incidence and mortality data in the Territory. Yearly report was first published in 1989 and electronic publications were available for download since 1998. Earlier data from 1973 to 1988 are available in table form. These reports are available on request and also our web site in the Publications area.
Cancer has emerged as a major health problem in most developed countries. In Hong Kong, the total number of new cancer patients was more than doubled from 8,900 in mid-70's to over 22,000 in 2004. The crude incidence rate rose substantially over the same period from 198 to 327 per 100,000 persons. It is projected that new cases will further increase due to aging and increasing population.
The ten leading sites in descending order are cancers of the lung, colorectum, female breast, liver, stomach, prostate, nasopharynx, non-melanomatous skin, non-Hodgkin's lymphoma and bladder. Together they account for over 70% of all registered new cases.
The incidence trends of nasopharyngeal cancer, oesophageal cancer, stomach cancer and cervix cancer showed significant decreases. Typical cancers in developed countries, like female breast cancer, colorectal cancer, prostate cancer and corpus cancer are on the rise. Changes in the trend of the following sites are also significant in recent years: laryngeal cancer in male is decreasing, prostate cancer is increasing and so is ovarian cancer. These trends may be attributable to economic upturn and lifestyle influences in the past twenty years.
As the Hong Kong Cancer Registry is population-based, we have to collect information on patient's demographics, anatomical site, histopathology and stage of every cancer case in Hong Kong. Each year we collect about 200,000 separate entries of raw cancer data and notifications from all sources. Most of these entries are duplicates as information on a particular case may continue to emerge over several months or a year after its initial appearance, and the same patient may be reported from multiple sources simultaneously. Thus all these entries must be consolidated and sifted manually in order to come up with the most reasonable diagnosis for individual patient. In view of the wide variety of information like clinical notes, operative records, pathological or radiological reports; as well as the huge volume of raw data, there is inherently a time lag of three years before the release of the incident figures. This is actually a common phenomenon in cancer registries all over the world. Epidemiologically, cancer is a chronic disease, hence both the incidence and mortality rates should evolve steadily over a long time period. Over the past years, with the aid of computer technology, we have been able to shorten the reporting lag time to 24 months, given the strict adherence to the quality control procedures depicted by the International Agency of Cancer Registries (IACR) of WHO, of which the Hong Kong Cancer Registry is a full Member since 1974. In considering the present given resources, and the lack of a compulsory notification mechanism by law, our output is indeed very cost-effective. After all, data quality is our goal.
Other cancer support institutions in Hong Kong can be found in the Related Links area of this web site.
If you have further queries, or your questions are not fully addressed in the FAQs, please contact us via e-mail to cancereg@ha.org.hk or call us at the hotline (852) 2958-6021.
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