?Background
The implementation of Population-Based Cancer Registries (PBCRs) requires sustained technical capacity, institutional coordination, interaction with key stakeholders, and skilled workforce. In Mexico, the first PBCR was established in Mérida, Yucatán, in 2016. A national network of PBCRs was launched in 2018, interrupted in 2020, and reactivated in 2023. These changes offer an opportunity to assess implementation challenges, identify operational assets, and inform strategies for sustainable national scale-up.
Objective
To assess the implementation status of the Mexican PBCR Network, identify key barriers and facilitators, examine the role of stakeholders, and derive actionable strategies to strengthen and sustain the network.
Methods
We assessed strengths and challenges in the implementation of the PBCR Network, with particular attention to operational components that have functioned effectively and can inform scale-up. Using the PBCR-Mérida experience as a reference, we analyzed implementation across four domains: governance, operations, human resources, and dissemination and communication.
Within each domain, strengths, weaknesses, barriers, and facilitators related to acceptability, feasibility, and sustainability were identified to inform strategic actions for continuous improvement and integration of recovered and newly established registries.
Results
The national PBCR Network currently comprises 10 nodes across northern, central, and southern Mexico. From the 2018–2020 period, three registries were recovered, although databases and procedures were incomplete and non-standardized. Subsequent efforts focused on integrating recovered registries with newly established ones, while strengthening quality control, coverage expansion, and process harmonization.
Drawing on the PBCR-Mérida experience, strengths were identified. Governance strengths include effective centralized technical coordination. In operations, strengths comprised a structured Information Sources Matrix, standardized registration procedures, and routine use of CanReg5 to ensure data quality. In the human resources domain, defined staff roles and continuous, practice-oriented training supported stable registry functioning.
Across the national PBCR Network, major barriers included insufficient funding, limited trained personnel, challenges in case ascertainment, inadequate information and communication technologies, and persistent difficulties in data management and quality assurance. Facilitators included the national legal framework for cancer registries enacted in 2017, the IARC–WHO collaboration agreement (2024), customized CanReg5 software, interinstitutional agreements with health providers and stakeholders, access to complementary research funding, and accumulated operational experience.
Based on this assessment, actions focused on harmonizing registration processes, strengthening quality control, expanding coverage, and promoting stronger articulation between public health institutions and the IMSS. As a result, the PBCR Network currently covers an estimated population of 13,272,550 individuals, with 37,481 new cancer cases validated to date.
Conclusions/Implications
Mexico’s experience demonstrates meaningful progress in the development of PBCRs; however, substantial challenges remain for achieving long-term sustainability and nationwide consolidation. PBCRs sustainability depends not only on legal frameworks but also on sustained capacity building, strengthened institutional coordination, and robust quality assurance mechanisms. These findings provide actionable lessons for translating registry research into effective national cancer surveillance and informed cancer control policy.