Cancer registries have fundamental roles in cancer surveillance, research, and health services planning,monitoring and evaluation. Many are now assuming a broader role by contributing data for health-servicemanagement, alongside data inputs from other registries and administrative data sets. These data are beingintegrated into de-identified databases using privacy-protecting data linkage practices. Structured pathologyreporting is increasing registry access to staging and other prognostic descriptors. Registry directions need tovary, depending on local need, barriers and opportunities. Flexibility and adaptability will be essential to optimizeregistry contributions to cancer control.