EDITOR, - S J Karp describes initiatives by clinical oncologists to evaluate their work in cancer treatmentcentres in Britain.1 This is an important step forward, but many patients with cancer are treated by general surgeons, physicians, or geriatricians in district hospitals. Sometimes cancer is diagnosed for the first time at postmortem examination. It is important to evaluate the treatment of all patients with cancer and not just those referred for specialist treatment, particularly in a system in which access to care is limited. Clinic based information systems may help to evaluate treatment provided by particular institutions but give an incomplete picture of care provided for people with cancer in Britain. Karp is therefore incorrect to dismiss the use of data from cancer registries in the evaluation of cancer treatment. Population based registries are important sources of data for evaluating cancer care in Britain. …