The role of the cancer registry in cancer control

It has been accepted generally that the cancer registry has more of a 'back room' than a 'front line' role in cancer control, its particular responsibilities lying in description of cancer patterns, care, and outcome, in monitoring these variables in relation to control activities, and in providing a research database--often, for others to utilize. While readily justifiable, this prevailing concept of the cancer registry's role may not be sustainable in times of economic restraint. A survey of members of the International Association of Cancer Registries showed that most registries fit the accepted mold. Some, however, extend beyond it, particularly in the direct conduct of epidemiologic research and in the implementation of control programs, particularly screening. Sixteen percent appeared only to be collecting incidence statistics and may be at risk of economic rationalization. It would be consonant with their basic role and skills, and promote more rational cancer control, if cancer registries were to take on an expanded role, including direct participation in epidemiologic research, evaluation of interventions against cancer at the population level, situation analysis and cancer control planning, and implementation of aspects of cancer control--particularly coordination of screening--and monitoring the performance of cancer control programs. This expanded role could become the responsibility of specialized cancer control units of which cancer registration would be the central function.