Population-based cancer registration in Indonesia.

Cancer is a major public health problem in Indonesia, becoming the 7th largest cause of death based on a national survey in 2007, accounting for 5.7 of all mortality. A cancer registry was started in 1970, but it was partial and was stopped mainly because no government body was responsible. Realizing the above situation, the Indonesian government established the Sub Directorate of Cancer Control within the Ministry of Health, with responsibility for developing a national cancer control program, including a cancer registry. A sustainable cancer registry was then started in 2007 within Jakarta Province, first hospital-based but then expanded to be population-based. Steps of cancer registration in Jakarta are data collection, data verification, data validation, data management and analysis, and data publication. Data collection is conducted by health facilities (hospitals, laboratories, primary health centers) at the district/municipal level, with reports to the provincial level. Data are collected passively by holding meetings every three months in the district/municipality. Verification of data is the responsibility of the medical doctor or pathologist in each data source. Data validation is conducted by a team in the cancer registry, consisting of district/municipal/province health officers, pathologists, and registrars. Data management and analyses are conducted by a cancer registry team at the provincial level, assisted by the national team. We use software named Indonesian Cancer Registry System (SRIKANDI) which is adopted from CanReg4 IARC. Data from the population-based cancer registry in Jakarta Province showed the leading cancers among females in 2005-2007 to be breast cancer, cervical cancer, ovarian cancer, colorectal cancer and among males are bronchus and lung cancer, colorectal cancer, liver cancer, pharyngeal cancer, and prostate cancer. The leading childhood cancers are leukaemia and retinoblastoma.