Improving Quality of Cancer Registration in Iran. Part1: Evaluation and Comparison of Cancer Registration Results in the Country

Control of cancer as the third cause of death is a health priority in Iran. In the last decade, different cancer registries launched to estimate the incidence of cancer in Iran. In this study, we evaluated quality of the results of cancer registries. First we used data from national pathology based cancer registration program and compared Age-Standardized Incidence Rates (ASRs) of all cancer types from 2004 to 2006 for the entire country and stratified them by provinces. Subsequently, we compared ASRs of eight common cancers in Tehran, Ardabil, Isfahan, Lorestan, Kerman, Golestan, and Semnan provinces. ASRs of all cancers in the national pathology based cancer registry for the entire country increased from 2004 to 2006, although the increasing trend was not observed for all provinces. ASR was considerably higher in the population-based cancer registries compared with the pathology-based ones. The completeness of pathology based cancer registry was 53 to 63 percent in men and 61 to 70 percent in women. The coverage was even lower in the cancers with high case-fatality rates including stomach (44% in male and 48% in female) and lung (19% in male) cancers. National cancer registration does not provide consistent and reliable results. ASRs in the pathology-based cancer registries are underestimated. In order to use the cancer registry data for policy making and research, national cancer registration program in Iran needs a major revision.