摘要：To support cancer control efforts, the National Program of Cancer Registries was established to enhance or develop cancer registries in every state. But there is an alternative. State cancer control programs could be adequately planned and evaluated without a cancer registry, and federal support of cancer registration could be selectively provided to registries that provide data needed to monitor cancer incidence and survival for the nation or that serve as a resource for population-based etiologic and cancer control research. The funds saved could be redirected to support the continued collection of high-quality cancer incidence and survival data for the nation as such efforts become more costly and complex in the future, and to expand support of population-based cancer research efforts. (Am J Public Health. 2002;92:1064–1066) IN A COMMENTARY PUBLISHED in the Journal in 2000, Izquierdo and Schoenbach 1 argued that “a national system of population-based cancer registries is essential to monitor state- and local-based cancer patterns and trends and to orient cancer prevention and control activities,” contending that “the main challenge is to continue nurturing the ongoing process: further expanding [cancer registration efforts] to cover all states. . . .” They predicted that “[w]ithin the next decade, the state cancer registry network and SEER [Surveillance, Epidemiology, and End Results] together will collect incidence data on approximately 97% of the US population, laying the foundation for a national system of cancer surveillance.” Although there is little doubt that some benefits would result from such a system, its development and maintenance would be very costly, and it therefore seems wise to consider alternatives. This article (1) questions the premise that cancer registries are essential for quality cancer control activities, (2) indicates the circumstances under which population-based cancer registries should be established and strongly supported, (3) argues against the establishment of a national system of universal cancer registration, and (4) urges that priorities be shifted from support of a nationwide system of cancer registries to more intensive support of registries meeting specific criteria on the basis of their usefulness for public health and research purposes.
