APH 2000, 58, 295-306:

Registration of cancer in Flanders as a means of determining environmental health effects.

J. Van Herbruggen, A. Michielsen, K. Wouters, J. Droste, M. van Sprundel and J. Weyler

Keywords: cancer registration, environmental health, cluster analysis

Purpose of the study:  One of the objectives of the registration of cancer is to represent the geographical distribution of the incidence of cancer, which, in combination with other information, could be used to evaluate environmental health effects.  This study examines whether a cancer registry could be used to evaluate health effects of point sources, and if so, what the necessary requirements of registration are, and to what extent a (cancer)registry needs to contain geographical information in order to evaluate environmental health effects in a meaningful way.

Main findings:  To be useful for the investigation of a cancer (disease) cluster, a registry needs to fulfil several conditions, e.g. it should be as complete and as accurate as possible and duplicated data should be avoided.  The rapid availability of data is very important.  In Flanders, a network of existing cancer registries with linking of data can represent an important added value for the study of environmental health effects through cancer registration.  When a suspected cluster is reported, it often represents a very local increase in incidence of disease.  For this reason, the registry needs to contain detailed geographical information.  The most appropriate level of registration for the study of a cluster seems to be the statistical code.  The inventory of the incident cancer cases on the level of statistical units is possible, but very labour-intensive because of the current privacy-legislation.

Principal conclusions:  Cancer registration can be used to study the geographical distribution of cancer incidence in relation to environmental exposure to health risk factors.  If the authorities consider this to be an important objective of a cancer registry, then a legislation on the registration of cancer is necessary.  This legislation should lead to a more efficient organisation of cancer prevention by means of a well-structured cancer registry compiled in an ethically, economically, and scientifically acceptable manner.