Around 1665 a London businessman, John Graunt, created
medical history by subjecting decades of mortality data
to critical and mathematical analysis. He literally invented
the science of medical epidemiology and statistics, publishing
a pamphlet with 108 conclusions. The list included such
revolutionary observations as the facts that women saw
physicians twice as often as men yet lived longer, and
plague epidemics moved outward from swampy areas. Graunt
also was the first person to use mortality statistics
to project population survival, probably by crudely fitting
data samples to a logarithmic curve. For his efforts John
Graunt became the first non-scientist appointed to the
Royal Academy.
A few years later Sir Edmund Halley, of comet fame,
used Graunt's inspiration to create the first actuarial
tables for an emerging French life insurance industry.
The "life table" concept is now the backbone of the
cancer outcomes analysis.
The first modern case registries for the study of cancer
emerged in the early 1900's as individual physician
or institutional projects in the United States or Europe.
In 1956 the American College of Surgeons (ACoS) formally
adopted a policy to encourage, through their Approvals
Program, the development of hospital based cancer registries.
It was believed that by periodically reviewing the results
of cancer treatment regimens, the hospitals and physicians
might reveal weaknesses in local patterns of care and
ultimately develop a better understanding of the disease
and its treatment. Early hospital registries were, for
the most part, inaccessible and unused card files of
data. The most valuable information came from large
central registry systems such as the NCI SEER program.
The advent of microcomputer registry systems in the
1980's created a new window of opportunity for making
registry information work to the patient's benefit.
Standardization of data collection has made it possible
to pool data from multiple registries in such projects
as the National Cancer Data Base (NCDB) of the Commission
on Cancer (CoC - a division of ACoS). Through the work
of the NCDB staff and others, we are gaining a new view
of community patterns of care and outcomes that often
challenge the classic medical literature. Within the
next decade we can anticipate a global standardization
of registry data collection and reporting that will
eventually have a profound effect on the management
and outcome of cancer.
To find out more about the history of the cancer registry,
click here to
take a look at a brief list of events related to cancer
registry and registration.
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