CANCER IN YORKSHIRE 1989-93

FOREWORD  

The last Quinquennial Review, published in 1991, was produced under the stewardship of the then Director of the Cancer Registry, Professor Charles Joslin. The focus of that report was, for the most part, a regional one concentrating on graphics showing the epidemiological characteristics of the different cancers, backed by extensive tables. A novel feature was the inclusion of an analysis of time delays in the referral of new cancer patients, from general practitioner to hospital, and from being seen by a specialist to the initiation of treatment.

The present report, produced under the direction of a new Registry Director, Professor David Forman, is produced at a time when interest in cancer statistics is at an all time high. Those, principally clinicians and public health specialists, who have always used these data, continue to do so. To these are now added a range of staff and organisations interested not so much in the epidemiology of the diseases as in the epidemiology of the health care of patients with these diseases, and in outcomes. This transformation has been stimulated by the Chief Medical Officers of England and Wales through their policy document on cancer services (published in 1995). As this begins to be implemented, a process requiring the identification of cancer centres and units, the focus of interest is increasingly on site-specific data for the common cancers. If registries had not already been invented there would now be a strong lobby to create them.

The current high level of demand for basic information comes at a time when registries are gearing themselves up to satisfy a new and demanding national operational requirement for the data they should record. The value of population-based, consistently produced, and reliable information is at a premium. We are fortunate that the Yorkshire Registry has, over many years, developed both the range and quality of the data it holds, and so is able to respond to the challenges of providing information for those now requiring it. As was seen following the publication of the site-specific report on breast cancer, publication of some data can be controversial (see the Autumn 95 YCO Oncology Newsletter - No 20). Whilst these are important issues which need to be handled sensitively, a major task for cancer registries is to place statistics about cancer in the public domain. Population based information, properly presented, will always invite questions and promote comparisons. The explanations for apparent differences in the data for different places are often unclear. Publication of fresh information may therefore prompt difficult or uncomfortable questions requiring research or more detailed enquiry. This is surely part of the value to society of investing in the collection of such information over many years.

Those involved in preparing this report have sought to present the data in ways which are both accessible and relevant to those who will use it. The Quinquennial Report generates considerable additional work for the team concerned (in particular Lesley Rider, Andrew Smith, Roman Tatarek-Gintowt, Colin Johnston, and Anthony Hilton) working under the leadership of the Registry Director. Thanks are due for their hard work and for the innovative way in which this Quinquennial Report is presented.

Professor R A Haward
Director of the Yorkshire Cancer Organisation
Professor of Cancer Studies, University of Leeds
October 1996


contents - foreword - introduction - executive summary - acknowlegements -
activities of the registry - key site analysis (graphics) - more graphics - statistical tables - statistical methods - population tables - CR2 form (37k)