History of Cancer Registration in the City-State


Singapore is a tiny city-state of 660 km2, with a total population of 3.9 million. The resident population (3.2 million) ispredominantly Chinese (77%), with 14% Malays and 8% Indians. The life expectancy is 75.6 years for males, 79.6 yearsfor females with a low infant mortality rate of 3.2 per 1,000 live births. Cancer is the commonest cause of death (26.6%)followed closely by ischaemic and other heart diseases (25.3%).The Singapore Cancer Registry (SCR) was founded in 1968 as a population-based registry covering the entire nationalpopulation. The registry collects notifications from medical practitioners of all cancer patients in Singapore. Reports ofcancer cases from pathology laboratories and hospital discharges are also routinely sent to the SCR. Singapore has a uniquenational registration number (NRIC) for all Singaporeans and permanent residents. For foreigners working in Singapore,a unique foreign identification number (FIN) is also available. These unique numbers have helped in identifying duplicateregistrations and record linkages.The SCR has electronic record linkage with the Death Register to ascertain the proportionof death certificate only notifications (DCOs). Over the 30-year period, the DCOs have declined from 5% to 1%, and theproportion of cases with microscopic confirmation has increased from 72.3% to 88.9%The SCR has published five monographs describing the trends of cancer incidence rates among the resident population(Singaporeans and permanent residents). In the latest monograph covering 1993-1997, cancer incidence among non-residentswas also described. Recently, in conjunction with the International Agency of Research on Cancer, a population-basedsurvival analysis was conducted. Several publications and a monograph are currently being prepared. Selected results ofthe incidence and survival will be presented.