International cancer epidemiology meetings.

Two consecutive international meetings on cancer epidemiology took place in Quito, Ecuador, from October 2 to 9, 1991. They were sponsored by the International Agency for Research on Cancer (IARC), the Pan-Amencan Health Organization (PAHO), the National Cancer Institute (NCI), the American Cancer Society, the Ministry of Health of Spain, the Italian League Against Cancer, and the Ecuadorian Society to Fight Cancer (SOLCA). The main organizers of the meetings were Dr. Nubia Mu#{241}oz, Dr. Maxwell Parkin (IARC), and Dr. Fabian Corral (SOLCA). The first event was a Seminar on Cancer Registries in Latin America in which the principles and methods of cancer registration, with special emphasis on the Latin American scene, were described and discussed as follows: general principles and methods, Maxwell Parkin (IARC) and Eduardo de Stefani (Institute on Oncology, Montevideo, Uruguay); quality control, Franco Bernino (National Tumor Institute, Milan, Italy) and Jaime Galceran (Cancer Registry of Tarragona, Spain); tumor coding and classification, Constance Percy (NCI, Bethesda, MD); population estimates and projections, Guillermo Llanos (PAHO); data sources, Lorenzo Gaf#{225} (Tumor Registry, Ragusa, Italy); analysis and reporting of data, Carmen Navarro (Cancer Registry, Murcia, Spain) and Evelyn Shambaugh (NCI); computer systems, Stephen Olivier (IARC); procedures manuals, Sharon Whelan (IARC). A critical analysis of the history of can:er registration in Latin America was presented by Pelayo Cornea. The five consecutive volumes of Cancer /ncidence in Five Continents, the gold standard of international cancer incidence data, has published data on Latin American populations intermittently, but only the Registry of Cali, Colombia, has supplied acceptable data for all the volumes. The reasons for the omission of incidence registries from the publication were characterized as: demographic growth that is outstripping the resources for diagnosis and registration; unrealistic ambitions of covering too-large populations; administrative problems, especially due to insufficient funds; and the 5hontsightedness of sponsoring institutions, both international and local. A discussion of the special situation of cancer registration in most Latin American countries followed, based on descriptions and discussions led by representatives of each country. The use of cancer registries was illustrated with presentations on determinants of cancer risk by geography by Dee West (Northern California Cancer Center, United States), ethnic classes by Canlos Mango (Oncocentro Foundation, Brazil), social classes by Maria Latorre (S#{227}o Paulo Cancer Registry, Brazil), and migration by Marco Geddes (National Tumor Institute, Genoa, Italy). The contribution of cancer registries to the initiation and support of etiological studies was illustrated for esophageal cancer by Eduardo de Stefani, for cervical cancer by Rolando Herrero (Social Security Institute, Costa Rica) and Xavier Bosch (IARC), and for gastric cancer by Pelayo Cornea. A special session was dedicated to the prevention of the two most important problems in Latin America, cervical cancer (Nubia Mu#{241}oz,IARC) and gastric cancer (Walter Oliver, Centno de Control de Cancer, San Cnistobal, Venezuela; Eva Buiatti, Prevention Oncology Centen, Florence, Italy; and Maxwell Parkin). The general strategy and methodology of screening programs were discussed by J. Chamberlain (Thames Cancer Registry, England). The final session, coordinated by Xavier Bosch, was dedicated to exploring and discussing ways to establish and reinforce connections (hermanamiento) between Latin American registries and registries in more developed countries. The European countries with the most presence at the meeting were Spain and Italy. Jesus Gonzales (Ministenio de Sanidad y Consumo, Madrid) and Marco Geddes described their programs. For the United States, representatives of registries with prominent Hispanic populations such as New Mexico (Thomas Becker) and California (Leslie Bernstein and Dee West) expressed their interest. A general discussion followed on the many opportunities for collaboration, especially personnel interchange and sources of funding. Several initiatives were explored at this session which it is hoped will bean fruit. The formation of an Association of Latin American Cancer Registries and its relationship with other international organizations were discussed. The second event was the annual meeting of the International Association of Cancer Registries (IACR). The delegates were welcomed by Solon Espinosa, President of SOLCA, and Plutarco Nananjo, Minister of Health of Ecuador. The conference centered around the subject of poverty and cancer. The keynote speaker was Lorenzo Tomatis, Director, IACR, whose comments appear as an Editorial in this issue. David Thomas (Fred Hutchinson, Cancer Research Center, Seattle, Washington), President of the Association, called attention to the increasing rates oftobacco-nelated cancers in Latin America. He reflected on the health problems created by the importation of tobacco products from the United States, which are of much greaten magnitude than those created by the illegal trade of drugs such as marijuana and cocaine. He suggested that the Latin American governments should ask the U.S. government to join forces to fight the tobacco cartel as they jointly fight the cocaine cartel. Session I on cancer in developing countries was introduced by Maxwell Pankin with an overview of the