Audit of a nationwide pathology-based cancer registry in Iran.

Background: Cancer registries are important infrastructure for cancer control programs. However most developing countries lack population based cancer registry. In Iran there cancer incidence is estimated based on pathology-based cancer registry. In this study we evaluated results of the nationwide pathology-based cancer registry in Iran. Materials and Methods: We compared age-standardized incidence rate (ASRs) of all cancers combined among male and female from 2004 to 2006 for the entire country and stratified by 30 provinces. In addition, we compared ASRs of all cancer combined and six common cancers from pathology-based cancer registry with the results of population- based cancer registry conducted in five provinces including Tehran, Aradbil, Kerman, Golestan, and Semnan provinces. Ratio of pathology-based to population-based cancer registries in these provinces perceived as the completeness of pathology-based cancer registry. Results: We found that ASRs among men and women increased from 2004 to 2006. However, the increasing trend was not consistent for all 30 provinces; ASRs increased, decreased on remained stable in different provinces. Completeness of pathology-based cancer registry was about 58% and 64% for men and women, respectively. Among the other, the completeness was extremely low for lung (26%) and esophageal (53%), and stomach (54%) cancers among male and for stomach (54%) and ovary (0.68%) among female. Conclusion: Pathology-based cancer registry underestimates the cancer incidence and cannot be a reliable source for policy making and research. Inclusion of other sources such as death registry and establishment of population-based cancer registry is necessary. We suggest promoting regional population-based registries using standard methods in Iran and other developing countries. [ABSTRACT FROM AUTHOR]