Important tool to gain an understanding of cancer is cancer registration. But do not underestimate the expense and effort required to build the system and to maintain it. Registration is not perfect, does not mean anything.
Only a perfect system could form the basis of reliable epidemiological investigation. The requirements that must be met for a perfect cancer registration, first of all lies in the medical profession. The participation of private practitioners (private) can only be expected if they believe that the epidemiological investigation in order to have a large enough power.
In addition, the physician should be sure that the organization is different under good management, meaning not only trustworthy but also communicative and inventive. It requires leaders who are also capable of public relations, in order to explain that cancer registration is the base or reference frame or reference for any beginning research on human cancer.
Furthermore, the leadership of the registration should be easy to know the statistics of death, and this is a useful complement to statistical disease. In the Netherlands, the interest in this case so strongly protected by law, so the practical epidemiologists have not overcome the obstacles to run a massive investigation.
In other countries, especially in the countries around us material is arranged somewhat differently, so that the causes of death and patient identification data can be connected more easily. In the Netherlands from 1953 to 1974 there is a form of cancer registration which was originally built as an ambitious national systems, both for registration and for the incidence of clinical follow-up, then it is limited to the registration of incidence in the province of Friesland, the cities of Rotterdam and Den Haag and an area between Eindhoven and Venlo.
This registration does not give results comparable to the costs incurred. The fact that in the Netherlands in 1975 can not be met the requirements mentioned above, is a reason to abolish this system, though by various agencies realize that this can not continue for long.
Perhaps a way to penetrate this impasse is to educate experts in epidemiology are young, ambitious enough. In recent years the notion of prevention is only a mere byword. Perhaps '' lip-servisce '' This better be converted into concrete decisions.
From what is mentioned above looks possibilities and difficulties descriptive epidemiology. In the following chapters is given a brief overview of the data obtained from retrospective ddan prospective investigation with the conclusions that can be drawn therefrom.
Rapidly increasing knowledge and understanding so that the snapshot is nothing more than a basic knowledge that can be developed by any doctor with the research literature. At this time, in addition to statistics on causes of death around the world we also have cancer morbidity figures thanks to a variety of systems to regional and national cancer registration in Europe, North America, Africa, Asia, Latin America and the Pacific region.
Statistics published in 3 publications with the title '' Cancer incidence in five continents '' (1966, 1970, 1976) presents the incidence figures, classified by sex and age (5-year groups). By constituent material published is cultivated through certain quality requirements that can be taken several conclusions that can be accounted for.
These statistics once again teaches us that cancer is a complex notion. For example, it can not be said that cancer was rare in the tropics without mentioning specific localization. But looks are also some forms of cancer of various localization were more frequently found in Western countries also when it is considered that in Western countries the proportion of older people aged greater than in developing countries.
Presumably cancer frequency difference between the countries is based on a way of life rather than its geographic localization. For example, patterns of cancer in the white population in Australia or South Africa closely resembles the pattern of cancers of Western Europe and North America.
(An exception may apply for carcinoma of the skin is relatively easy to occur in the pigmented skin does not get much sun exposure). That genetic factors are important in general does not appear from the comparison between the Negro nation in Africa and in North America.
The pattern of cancer in the first group shows characteristics that are also encountered in the various countries of Asia and Latin America from the second group is more 'western' '. Strong reason for the hypothesis that environmental factors and habits kehidupanlah which primarily determines the risk of various forms of cancer statistics obtained from migrating population.
Japanese children who immigrated to the United States has shown some differences from their parents (decreased gastric carcinoma, colon carcinoma and breast increases). In a country often obtained frequency differences between town and country.
Also in the Netherlands, it can be shown (and Meinsma Versluys, 1967). Diehl and Tromp (1953, 1955) has conducted a detailed investigation of the regional cancer mortality in the Netherlands. Typical for the pattern of cancer in the Western world is the frequency of lung cancer (in men) and the prostate, which is relatively high, mama, ovarian, corpus uteri (in women) and colon (in both sexes).
It's just a very striking alone, for other lokalisasis see the table. The global picture is not only colored but also complicated by national and regional specificities. In Africa for example, there are differences in inter-regional contrast in hepatoma frequency, and, more strikingly more about the frequency of esophageal carcinoma (Transkei, Nyanza) and tumor Burkit.
In Asia the Japanese people are karsioma gastric frequency is very high in many Chinese populations Nafospharynx cancer. Thus these observations is the starting point formulation of the hypothesis that the etiology of tumors. But the manufacture of demographic hypotheses.
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