Lithuania
Juozas Kurtinaitis
Lithuania is situated on the Baltic Sea, and it is 64,000 km2 in area. The population of Lithuania was 3,690,000 in 1989, of which 832,000 were children. The majority of the population are Lithuanians (80%), 15% are Russians, and 4% Polish. The main areas of occupation 1990 were industry (40%), agriculture (25%), construction (15%), and transport and communication (4.5%). The registration of cancer incidence in Lithuania began in 1957. The Department of Epidemiology of the Institute of Oncology was responsible for the collection and the statistical and epidemiological interpretation of the data. Attempts to establish a population-based cancer registry were made in 1975, and the Lithuanian Cancer Registry was set up in 1990 as a separate department of the Oncology Centre in Vilnius. There are four other cancer hospitals in the country. Lithuania is administratively divided into 44 regions, and there are local oncology services in nearly every region. The registration of cancer is based on compulsory reporting of all new cancer cases in the whole of Lithuania. The Lithuanian Cancer Registry receives approximately 12,000 notifications on new cases of cancer each year. The notifications include identification data (name, surname, sex, year of birth, nationality, occupation, place of residence) and data of cancer diagnosis (cancer site, stage, TNM, clinical group, date of diagnosis, and diagnostic procedures). It has been compulsory to register histological types of tumours since 1993. Cancer cases are coded according to ICD-9 topographic and ICD-O morphologic codes. The Cancer Registry has responsibility at Lithuania's Department of Statistics to check death certificates of cancer patients and examine them for validity of coding and completeness. The patient's name, main and contributory causes of death, date and place of death are stored on computer records of the Cancer Registry. Approximately 2% of cancer diagnoses are made at autopsy, and 6% are found from death certificates only. Medical doctors in outpatient clinics provide the active follow-up of cancer patients in Lithuania. Information on the patients¹ social origin, occupation, methods of examination and treatment, the result of histological confirmation, reasons for late detection of the tumour, the procedure for rehabilitation, the placement of treatment and place and date of death are stored on follow-up cards. The files of the cards are not computerised, but make it possible to trace cancer patients manually. The Cancer Registry does the passive follow-up of cancer patients. Twice a year the Registry matches the collected data on cancer cases with the data stored in outpatient clinics. The registrars of the Cancer Registry periodically match the data collected by the local medical services with the data stored in the Registry. The Cancer Registry is responsible for supplying the Ministry of Health with annual reports.