The National Clinical Database(NCD)started its registration in 2011 as the parent body ofthe database system linked to the board-certification system. Risk models of mortality or morbidity for 9 procedures in gastroenterological surgery have been established, and feedback reports to participants have been implemented. The NCD can provide data on each facility's severity-adjusted clinical performance, which can be compared with national or prefectural data. The NCD's huge stock of data also provides important information about operations on such topics as association between the participation of boardcertified surgeons and operative mortality, or the impact of hospital volume on risk-adjusted mortality. Breast cancer registry or pancreas cancer registry had been implemented into NCD in 2012, and several cancer registries have been implemented. With high level ofcompleteness ofthe registration, addition oflong term prognosis ofthe patients with cancer to NCD will improve cancer treatment nationwide.