History of the Annual Report

The Annual Report on the Results of Treatment in Gynecologic Cancer has its roots in work originally produced by the Radiological Subcommission of the Cancer Commission of the Health Organisation of the League of Nations. In 1928, this group was asked to explore the possibility of having uniform statistical information on the results of radiotherapeutic treatment methods for uterine cervical cancer. This Subcommission recommended that this could only be accomplished if various institutions would produce their results in a uniform and consistent manner. The task of producing such results was given to J Heyman from the Radiumhemmet in Stockholm, A Lacassagne from Radium Institute of the University of Paris, and F Voltz from Munich. The recommendations of these experts, with minor modifications, were adopted by the Subcommission and published in April of 1929 [1]. One of the major items that emerged from this activity was a classification system for grouping carcinoma of the uterine cervix into different stages according to the extent of the growth. This system became known as the League of Nations Classification for cervical cancer and was amongst the first attempts at having an international staging system for this disease. Although the recommendations made by the Radiological Subcommission for collecting and analyzing materials were adopted in several countries, widespread use did not occur. In July 1934, the Health Organisation held a conference in Zurich, attended by former members of the Subcommission and other international experts, to advise what further action might be pursued to facilitate wider endorsement and adoption of these principles. This conference recommended that a publication in the form of an annual report should be issued by the Health Organisation analyzing the results of treatment by radiotherapy in cancer of the uterine cervix, estimated after an observation of 5 or more years. It was stated that the primary objective of the proposed annual statistical report should be to provide a convenient work of reference for those who wished to know the results and statistics regarding patients treated with radiotherapy for cancer of the cervix uteri. The recommendations of the Zurich conference were adopted by the Health Committee in 1935 and in October of that year an Advisory Committee, chaired by J Heyman, was appointed to carry out this task. The first three Annual Reports were issued in 1937, 1938 and 1939, and contained only the results of cervical cancer treated by radiotherapy, but indicated that future reports would be expanded to hopefully include material relating to carcinoma of the corpus uteri and of the vagina. The first Annual Report contained statements from the six participating institutions listed in Table 1. In an attempt to promote more uniform grouping of cases, to minimize variation and to secure comparabilities and statistics for the Annual Report, Heyman and Strandquist published the first Atlas on Cervical Cancer Staging, in 1938. The second Annual Report, published in 1938, contained changes to the wording and definitions for the various stages of cervical cancer and, as such, represents the first recorded changes to the cervical cancer staging system. No further changes were made until 1950, at which time the Editorial Committee met with nine American representatives at the International Gynecological Congress and Fourth American Congress of Obstetrics and Gynecology, held in New York in May 1950.