The Cancer Information Services and Surveillance Division is in charge of providing credible cancer information to patients and their families, the public, healthcare professionals, policy makers and researchers. The division also collects accurate and useful information on cancer statistics at the national level. We promote the standardization of hospital-based cancer registries in designated cancer hospitals and population-based cancer registries in prefectures. The data are collected from both hospital-based and population-based cancer registries, analyzed to calculate accurate cancer statistics and disseminated throughout Japan.

Development of a reliable cancer surveillance system in Japan is stated as a key element in the Cancer Control Act. Standardization and quality improvement of population-based cancer registry are essential in ensuring the success of the Act ⁽¹⁹¹⁾.

The Division supports all the 35 registries in practical terms, by disseminating up-to-date information through websites and mailing lists, by setting up a Q&A service, by holding 2-day educational workshops for cancer registrars and administrative officers, and by providing 3-day site visiting training of the Standard Database System (SDS).

Standardization of the population-based cancer registry is a continuous ongoing process: more than 15 registries use the standard registry form, and 13 had introduced the SDS as of December 2008. The Division published and distributed the brochure on cancer registration in collaboration with the Japanese Association of Cancer Registries in order to enhance the public's understanding of our activities.

The national cancer incidence was estimated based on the data from 15 cancer registries ⁽¹⁹²⁾. The incidence data were then analyzed in detail by cancer site ⁽¹⁹³⁾. By using the cancer registry data, we also calculated the risk to develop or to die of cancer ⁽¹⁹⁴⁾.

Since a hospital-based cancer registry is essential to evaluate cancer care in each hospital and also to achieve high completeness of population-based cancer registries, it should be established urgently in an earlier phase of the 10-year program. The Division plays an important role as a driving force for the standardization and quality improvement of hospital-based cancer registries, which has been performed at 351 designated regional cancer care hospitals, treatment centers, and over 100 other hospitals in 2008.

In collaboration with other relevant parties, the division develops data standards for hospital-based cancer registration, modifies datasets every year, and distributes the standardized hospital-based cancer registry software "Hos-CanR", which is used in about 250 hospitals. The Division also devised an education program for cancer registrars, held week-long workshops for experts in Tokyo three a year, and 2-day workshops for beginners twice a year at 8 cities in which about 1,000 registrars participated. Furthermore, the Division has managed the National Cancer Center Hospital Cancer Registry since 2004, registering more than 8,000 records a year.

Ensuring quality of cancer care is an important aspect of cancer control. We have developed quality indicators for 5 major cancers in Japan and palliative care. To enable timely feedback, these quality indicators focus on process of care rather than outcomes. We now are pilot testing the feasibility of these quality indicators in the real practice setting.

The Division is in charge of providing information on cancer statistics. The updated data of cancer mortality, incidence, survival, and prevalence, the secular trends of cancer mortality and incidence, and the framework of cancer control in Japan have been published both in English and Japanese: "Cancer Statistics in Japan". International comparisons of time trends in the incidence were conducted for cancers arising from various sites ^(195-204).

In collaboration with the Japan Public Health Center-based prospective Study and other epidemiological and clinical studies, the association of various risk/prognostic factors and cancer have been evaluated ^{(205, 206)}. A statistical contribution is being performed for therapeutic development ^{(207, 208)}. A new cohort is being established for breast cancer patients, to investigate the effect of lifestyle factors and alternative medicine on their QOL and prognosis. As for the educational contribution, an e-learning system for clinical research methodology has been established for anyone involved in clinical research.

The mission of the Cancer Information Services is to provide credible information about cancer. In the National Cancer Information Network, Cancer Information Services plays an important role in providing cancer-related information directly to our audiences, including patients and their families, public, healthcare professionals, policy makers and researchers, but also indirectly by supporting the 351 designated cancer care hospitals and their cancer information & support centers. Currently, multi-channel cancer information services are provided through the internet, brochures, lectures, and public meetings. Post-recurrence distress and coping strategies were investigated among relapsed breast cancer patients ⁽²⁰⁹⁾.

The National Cancer Center is designated by the World Health Organization as the WHO Collaborating Center (WHO-CC) for Reference on Smoking and Health and this Division is responsible for running the Center. Regarding the health effects of smoking, reduced life expectancy due to smoking was estimated in large-scale cohort studies in Japan ⁽²¹⁰⁾. Smoking behavior was surveyed among members of the Japanese Cancer Association ⁽²¹¹⁾. Lung cancer occurrence in never-smokers was investigated using the data from 13 cohorts and 22 cancer registry studies ⁽²¹²⁾. The population attributable fraction of active smoking was estimated using pooled data from large-scale cohort studies in Japan ⁽²¹³⁾.