Current activities and future directions of the cancer registration system in Japan.

Cancer surveillance is essential for implementing evidence-based cancer control programs, and cancer registries provide core information for cancer surveillance. In 2006, the Cancer Control Act was approved in Japan and it is clear that the national government will take the initiative in promoting cancer control programs, including cancer registries. There are three types of cancer registries: population-based, hospital-based, and site-specific cancer registries. Although each has its own aim and function, the population-based cancer registry is the only one that can provide cancer incidence data. Currently, 35 of the 47 prefectures in Japan, and one city (Hiroshima) have population-based cancer registries; however, there are two major issues with these registries, i.e., standardization of procedures and completeness of incidence data. In order to improve the level of standardization, the Japan Cancer Surveillance Research Group has developed a standard registry system in which standardized procedures are implemented; this system is currently being disseminated into several registries. To improve completeness of incidence data, it is planned, first, to establish hospital-based cancer registries at designated cancer-care hospitals (a newly developed hospital network to provide standardized high-quality cancer care). This strategy will be effective in rural areas, where most cancer patients are covered by designated cancer-care hospitals, but in urban areas additional action will be needed. In 2006, the Center for Cancer Control and Information Services (CIS) was launched at the National Cancer Center. It is expected that the CIS will play a central role in improving the quality of the cancer surveillance system in Japan.