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Nova Scotia Cancer Registry |
The Nova Scotia Cancer Registry (NSCR) has population-based incidence data that dates from 1964. Originally the NSCR was administered jointly by the Department of Health and the Medical Society of Nova Scotia. In 1981, responsibility for its operation was transferred to the newly formed Cancer Treatment and Research Foundation of Nova Scotia, which is in turn supported by the Nova Scotia Department of Health.
Throughout the Registry's history there has been a legal requirement to register all newly diagnosed cases of cancer. The data from 1971 to 1994 (the most recent available) are considered quite reliable. The sources of cancer registration have expanded over the years from completed Nova Scotia Cancer Registry Forms (1964 to current), to include Pathology Reports (1982 and onwards) and Nova Scotia Vital Statistics Department. Deaths that occurred between 1969 and 1989 were added through a record linkage contract with Statistics Canada, and include deaths to former Nova Scotia residents who died elsewhere in Canada. Since 1989 death certificate information for all provincial deaths has been added as part of an annual probabilistic record linkage process. A benefit of this record linkage step is a second and independent search for duplicate registrations. All residents of the province are covered by a provincially-funded comprehensive Health Insurance scheme. The plan's unique identity number aids considerably in the maintenance of the unduplicated patient index. Copies of the claims records from that system are held by the Population Health Research Unit (PHRU), at Dalhousie University, under the management of the Department of Community Health and Epidemiology.
All malignant and in-situ tumors (as well as some benign conditions) are reportable by law within the province. The melanoma annual incidence rates in Nova Scotia are approximately 14 per 100,000 in males and 12 in females. Non-melanocytic skin cancer (NMSC) has a reported incidence rate of approximately 2000 per 100,000 in males and 160 in females. Skin cancer presents some unique reporting problems, as is true elsewhere. It is believed that the number of basal cell and squamous cell tumors of the skin is under-reported; however, it is not currently known just how serious the under-reporting is. The Provincial Cancer Incidence Report for the years 1993-1994 marks the last attempt to make an actual count of new instances of non-melanoma skin cancer (NMSC), mostly basal and squamous cell tumors. In the future, the Nova Scotia Cancer Registry will collect all data possible on NMSC, but will not analyse this data in its entirety. Indeed, sample methods will be used to estimate the total number of new diagnoses by pathology report, and estimated counts and rates will be reported, along with guidelines for their interpretation.
The Registry covers the whole of the Province of Nova Scotia, one of the three Maritime Provinces of Canada, which lies to the south of the St. Lawrence River, east of the Gulf of Maine, west of the Atlantic Ocean, and south of the Provinces of New Brunswick and Prince Edward Island. Most of the province lies less than 200 metres above sea level, the highest point being at 529 metres in the Cape Breton peninsula. The province lies between longitudes 59 and 67 degrees West and latitudes 43 and 47 degrees North. It covers an area of 55,491 square kilometres.
The NSCR produces an annual report of incident cases, by sex, age, and cancer site, but data quality has been addressed extensively in recent years, with the result that previous annual reports may not be the best means of obtaining consistent descriptions of temporal variation. The geographic data available are restricted to the address of the subject at the time of diagnosis, and are usually available from the pathology report or tumor report form (completed by medical records departments of diagnosing hospitals). Address information is somewhat less consistently available if the source of the registration is a death certificate. Approximately 95% of the new cases can be allocated to a Canadian Postal Code. Although cases can be classified by Postal Code, the level of geographical detail for population estimates that is available from published sources is the county, of which Nova Scotia has 18.
The 1991 census shows the total population of Nova Scotia as 918,000, of which 44% were of British origin, 6% French and 55 other European. A further 5% were of other single ethnic origins, while the remaining 40% were of multiple ethnic origin. At that time, the active labour force (447,000) of Nova Scotia was employed in the following broad categories of industry: wholesale and retail trade, 18%; manufacturing, 11%; primary industry (agriculture, fishing, forestry, mining), 7%; construction, 7%; and transportation, 4%. The remainder were employed in occupations in service, government, education, or health care sectors. Of the 1991 population, 54% lived in designated urban areas, 44% lived in rural non-farm residences, and 2% lived on rural farms.
The Nova Scotia Cancer Registry is active in the Canadian Council of Cancer Registries, and is a full member of the North American Association of Central Cancer Registries. Its affiliation with the cancer registries in other Atlantic provinces (New Brunswick, Prince Edward Island and Newfoundland) facilitates the rapid notification of registration information to ensure that residents of one province receiving treatment in another are correctly allocated to their home provinces. Reliability trials performed cooperatively with the other Atlantic registries have served to enhance the consistency of the application of coding rules. At the end of each calendar year, a series of edit checks ensures the quality of the data, which is then sent to Statistics Canada to become part of the Canadian Cancer Registry. The province's cancer statistics are published annually and given to users and to the providers of information.
Information available to individuals and local, provincial, and national organizations include: the number of registrations by cancer site, age group, gender, and date of diagnosis; incidence and mortality rates, crude and age-standardized; time trends in cancer incidence from 1969 to 1994, and geographical area analysis. Requests for access to the Registry data should be in writing to the NSCR contacts listed below. The nature of the request must be stated: cancer site, age groups of interest, time periods, and geographical data. Requests for tabulations, rate computations, temporal and geographic analyses can usually be accommodated within the normal workload; there may be charges to cover costs.
Available Reports
Contact Information
Phone: (902) 428-4258/428-4257
Fax: (902) 428-4277
E-mail: ron.dewar@dal.cas
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