Latvia
Aivars Stengrevics
Latvia, one of the Baltic countries, is situated in the north-eastern part of Europe (20°58' to 28°14'E, 55°40' to 58°05'N) and has a total area of about 64,600 km2. Latviašs neighbouring countries are Estonia to the north, Lithuania to the south, Russia to the east and Byelorussia to the south-east. The western coast of Latvia is washed by the Baltic Sea. The capital city is Riga, which is situated in the central part of Latvia on the coast of the Gulf of Riga. The land area of Latvia is fairly flat: 57% of the territory does not exceed 100 m, and the highest point is only 311 m above sea level. The inland's water area of about 2,500 km2 is composed of a number of rivers and lakes, particularly located in the eastern part of Latvia. About 1/7 of the territory is woodland, where the prevalent types of wood are mixed coniferous and leafbearing woods. Latvia has a maritime climate. The mean temperature of the year is 5°C to 7°C with an absolute maximum of plus 36°C and a minimum of minus 42°C. The temperature in summer is typically 20°-22°C, in winter about minus 10°-25°C. In 1995 the estimated population in Latvia was 2,530,000: 58% of it were Latvians, 33% Russians, 4% Byelorussians, 3% Ukrainians, and 2% Polish. Other nationalities, mainly Lithuanians and Estonians, and ethnic Jews constitute 3% of the total number. The main branches of the Latvian national economy have historically been agriculture, dairy-farming, cattle-breeding and sea fishery. As a newly established independent republic in the period between the World Wars Latvia could boast of rapidly developing radio and electromechanical industries. Both agriculture and the industrial branches were destroyed during World War II and the following 50 years of Soviet regime. Meanwhile the majority of intellectual workers, intelligentsia and most of the farmers were physically exterminated. At present 16% of the population are employed in agriculture, about 18% in the industrial sphere and about 6% in the fishing industry. The favourable geographical situation and the adjacent seashore with two convenient ports Liepaja and Ventspils have created the preconditions for development of transport and shipping industries. Since 1991 the population's natural increase has been negative, in 1995 it was minus 7%. The life expectancy for the male population is 61 years, for females 73. The birth rate is gradually decreasing. In 1995 it was 8.5/1000. At the same time the mortality rate is slightly growing (1,590/105 in 1995). Among the leading causes of death are cardiovascular diseases (860/105), cancer (220/105), accidents and cases of intoxication (210/105).
Cancer registration
The population based cancer registration in Latvia began in 1953. Since 1963 it has been monitoring the entire country. In 1978-1979 the registered information was computerised and systematised. In July 1993 the Latvian Cancer Registry was founded as an independent organisation. The Registry collects notifications from physicians of any medical institutions, autopsy and forensic medicine departments. According to official regulations, every practicing physician (at hospitals, out-patient clinics, autopsy/forensic medicine departments etc.) has to notify the Registry about incident cancer cases. In 1995 about 5% of all primary cancer cases were based on the death certificate only: for stomach cancer 6%, colon cancer 8%, rectal cancer 1.2%, breast cancer 1.1%, brain and nervous system cancers 30%. The rate of morphologic confirmation was 77% (stomach cancer 75%, rectal cancer 88%, lung cancer 52%, breast cancer 93%, corpus uteri cancer 98%, pancreas carcinoma 22%). The ICD-9 coding system was used in the 1980s. Since 1995 data were converted to the ICD-O system. Registry data are followed up with local data from rural districts, cities, large hospital and special centres and with data from the Central Bureau of Statistics twice a year. Data about treatment are also included in the Register. Multiple cancers are identified according to IARC rules. The most common cancer sites are lung cancer in the male and breast cancer in the female populations with a gradual increase in the incidence rate (from 59/105 in 1989 to 65/105 in 1992 for male lung cancer; from 31/105 to 40/105 for female breast cancer). Cancers showing a rapid increase in the incidence level include cancers of the kidney, prostate, thyroid and oesophagus, corpus carcinoma, skin melanoma, and myeloid leukaemia. The highest mortality level in 1992 was connected with cancers of the lung (64/105) and stomach (30/105) among the male population, and with cancers of the breast (16/105) and stomach (12/105) among the female population. Yet the most rapid mortality increase has been observed in laryngeal, renal, oesophageal and thyroid cancer in males, and in renal, endometrial and thyroid cancer, and malignant melanomas in females.