The National Cancer Registry, which was first established in 1986, was taken over and developed into its present form by Professor Freddy Sitas from 1991 until 2002, and Ms Nokuzola Mqoqi from 2003 until 2006. It plays a vital role in maintaining and developing national and international awareness of the enormous and growing problem of cancer in the South African population.

Cancer is one of the major killers throughout both the developed and developing world, including South Africa. Indeed the 2001 data in this report shows that South African males have a lifetime risk of 1 in 6 of developing cancer, while South African females have a lifetime risk of 1 in 8 of developing cancer.

This report, covering the years 2000-2001, will be widely used and quoted by many organizations both in the public and private sector. Government bodies including the Departments of Health, Home Affairs and Finance need to know how many people develop and die from cancer, while this information will be critical to the financial planning of many private sector bodies including medical aids, life insurance companies, pharmaceutical companies, private hospital groups and financial institutions.

Although this is a pathology based registry, resulting in under-reporting of many malignancies, some more than others, many critical decisions need to be made based on its data. A planned population based registry will be even more vital, especially when decisions relating to screening, prevention, as well as cancer treatments are made.

The latest 2000-2001 National Cancer Registry Report shows fascinating trends about cancer reporting in South Africa, when compared to its predecessors, although there is a slight drop in overall numbers due to the lack of reporting by a few private laboratories. Males have a lifetime risk of 1 in 6 of getting cancer, as opposed to 1 in 4 in the previous report, with cancers of the prostate (1 in 23), lung (1 in 69), oesophagus (1 in 82), colon/rectum (1 in 97) and bladder (1 in 108) predominating. Prostate cancer therefore remains the most common major cancer in men, with lung, oesophagus and colorectal cancer following closely behind. In women the lifetime risk of getting cancer is now 1 in 8, as opposed to 1 in 6 in the previous report, with cancer of the breast (1 in 29) and cancer of the uterine cervix (1 in 35) predominating. Uterine, colorectal and oesophageal cancer follow, as was the case in 1998-1999.

Lung cancer remains a growing health problem in both sexes. Although males far exceed females, the long term effects of smoking will result in an increasing incidence of lung cancer in females for many years to come. It will be decades before recent anti-smoking drives and legislation reduce these figures. As previously mentioned, the reporting of many cancers is suboptimal due to a lack of tissue diagnoses. An important example is hepatocellular carcinoma which is grossly under-reported, as it is usually diagnosed clinically and by a blood test, without a tissue diagnosis, but this still remains in the top 15 cancers. Over 700,000 new cases per year are diagnosed throughout the world, especially in southern Africa and the Far East, which are endemic areas for the hepatitis B virus, the major causative agent of this disease. A future population based registry as well as better cancer diagnoses, especially in rural areas, will give us a more accurate picture of this usually fatal malignancy, as well as many other pathologically under-diagnosed cancers.

Funding remains a major problem for the registry, which primarily relies on support from the National Health Laboratory Service and the Department of Health. The task of collecting and analysing data from most of the pathology laboratories throughout South Africa is an enormous one and requires a dedicated staff as well as advanced computer and statistical support. This is a costly exercise needing further funding from both the private as well as the public sector to increase the efficiency of data collection and analysis, especially if the planned population based registry is to succeed. Hopefully we will soon be able to broaden our support base to involve all role players in the Health Care Sector to enable us to maintain and develop this National Asset well into the future.

On behalf of the Scientific Advisory Committee, I would like to congratulate Patricia Kellett and the rest of the National Cancer Registry staff for their tremendous work in completing this report. I would also like to thank Nokuzola Mqoqi, Acting-Head of the National Cancer Registry from 2003 - 2006, Margaret Urban of the Cancer Epidemiology Research Group (CERG) of the University of Witwatersrand, Professor Brendan Girdler-Brown, Extraordinary Professor, School of Health Systems and Public Health, University of Pretoria Faculty of Health Sciences and Professor Glynn Wessels, Department of Paediatrics, University of Stellenbosch, for their important contributions to this report. In addition I would also like to thank the Cancer Association of South Africa for helping to supplement the funding obtained from the National Health Laboratory Service and the Department of Health, as well as to thank the many state and private laboratories who have contributed data to the Registry, without whose support this report would not have been possible.


Professor Paul Ruff,
Chairperson, Scientific Advisory Committee
Professor and Head, Division of Medical Oncology, Department of Medicine, University of Witwatersrand Faculty of Health Sciences.