The main findings from reports published in scientific journals on the criteria and methods used to assess fitness for work were reviewed. Systematic searches were made using internet engine searches (1966–2005) with related keywords. 39 reports were identified, mostly from the US and western Europe. Assessment of fitness for work is defined by most as the evaluation of a worker’s capacity to work without risk to their own or others’ health and safety. It is mainly assessed at recruitment (pre-offer or post-offer), and when changes of work or health conditions occur. Five main criteria used by occupational doctors to evaluate fitness for work were identified: the determination of worker’s capacity and worker’s risk in relation to his or her workplace, as well as ethical, economic and legal criteria. Most authors agreed that assessment tools used need to be specific and cost-effective, and probably none gives unequivocal answers. Outcomes from fitness for work assessments range from “fit” to “unfit”, with other possible intermediate categories such as “fit subject to work modifications”, “fit with restrictions” or “conditionally fit (temporarily, permanently)”. Workplace modifications to improve or adjust working conditions must always be considered. There is confusion about the decision-making process to be used to judge about fitness for work. There is very scarce scientific evidence based on empirical data, probably because there are no standard or valid methodologies for all professions and circumstances.

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One out of four cancer deaths in women are due to breast cancer and female genital cancer. Mortality data are a basic information source to study disease characteristics in the population. A descriptive study on breast and female genital cancer mortality was carried out in Aragón covering the period 1975-84. Geographical differences and variations on mortality rates between the periods 1980-84 and 1975-79 have been studied. A mortality rate of 40.2 per 100,000 women per year has been observed for these tumours. Breast cancer accounted for 55% of these deaths. Reduction of mortality rate was seen for uterus non-specified between the periods 1980-84 and 1975-79, probably due to an improvement in quality of death certificates for uterus cancer. Higher mortality rates have been observed in the town of Zaragoza than in other parts of Aragón. This suggests the town of Zaragoza as priority in strategies of prevention and control programs.

The critical evaluation of the publications made it possible to identify some elements related to the analysis methodology and design which would heighten the quality of the healthcare technology assessment. Healthcare registries in Spain have developed recently and to differing degrees. Important areas without any records and improvement elements related to the use of healthcare registries for healthcare technology assessment were detected. It would be advisable to avail of a register of registries which would provide relevant, up-dated information thereon.