2009 Cancer Registry
The cancer registry staff at MeritCare Roger Maris Cancer Center has been extremely busy since last year's report was completed. Every three years, MeritCare Hospital and Roger Maris Cancer Center participate in an American College of Surgeons (ACoS) Accreditation Survey. The cancer registry ensures that timely, accurate and complete data is maintained on all types of cancer and certain benign conditions diagnosed and/or treated at MeritCare Roger Maris Cancer Center. This important day-to-day work has implications for cancer care on the national, regional and local level. A large portion of the information that is reviewed for the survey comes directly from the cancer registry department. For months prior to the April survey, cancer registrars were pulling data from our cancer registry database, Metriq, to be used for the survey process. The Commission on Cancer (CoC) Program Standards includes an entire chapter dedicated to Cancer Registry Operations. Of the 37 CoC standards, the cancer registry department maintains responsibility for ten standards. In addition to those standards, the department organizes weekly cancer case conferences and maintains the required documentation. The survey was very successful with MeritCare Hospital and Roger Maris Cancer Center obtaining ACoS accreditation with commendation.
Seeking Accreditation
In addition to the survey for renewal of ACoS accreditation, MeritCare decided to seek the new accreditation distinction by the National Accreditation Program for Breast Centers (NAPBC). Working with the Breast Cancer Study Group, the cancer registry department gathered data specific to our breast cancer population. With the NAPBC survey only one week after the ACoS survey, the cancer registry department staff worked diligently to present quality data for both surveys. Again, their diligence was rewarded by becoming one of the first 50 Breast Cancer Centers to obtain NAPBC accreditation.
Gathering, Processing, Reporting
The information collected by cancer registrars goes beyond the episodic information contained in the health care facility record. Cancer registrars gather a complete summary of a patient's disease, from diagnosis to life's end. The abstract provides an ongoing account of the cancer patient that includes history, diagnosis, treatment and current status. Lifetime follow-up is an important aspect of the Cancer Registry. Current patient follow-up serves as a reminder to physicians and patients to schedule regular clinical examinations and provides accurate survival information. Notable statistics include:
- As of Sept. 2009, a total of 20,167 analytic cases have been entered into our cancer registry database since Jan. 1, 1996. Current follow-up data has been conducted on 95 percent of those patients still living, exceeding the required rate of 80 percent in accordance with American College of Surgeons standards.
- The number of cases requiring abstracting (diagnosed and/or first treated at the cancer center) reached 1,618 for cancer cases diagnosed in 2008. These cases were then reported to the North Dakota and Minnesota Central Registries. Data collected is also reported annually to the National Cancer Data Base (NCDB), as required by federal law.
- Initial data submission for 2007 cases, reported in the fall of 2008, was error-free.
Accuracy in submitting data is important for several reasons:
- Local, state and national cancer agencies use registry data in defined areas to make important public health decisions that maximize the effectiveness of limited public health funds.
- Cancer registry data is a valuable research tool for those interested in the etiology, diagnosis and treatment of cancer.
- Fundamental research on the epidemiology of cancer is initiated by using accumulated data provided to the NCDB.
Using Cancer Registry Data to Strengthen the Cancer Program
The cancer center uses cancer registry data to strengthen the cancer program with the ultimate goal of improving patient care. The database contains a wealth of information. The cancer registry staff completed 29 internal oncology data requests in 2008. Examples related to breast cancer include:
- Current cancer status of patients diagnosed with invasive lobular breast cancer from 1996 through 2007.
- All HER2/neu positive breast cancer patients - used for prescreening for clinical research study consideration.
- Breast cancer cases presented at cancer case conferences.
- Data on women with breast cancer who were offered and/or treated with breast conserving surgery.
- Number of patients who have HER2, ER and PR negative breast cancer.
Other data requests were related to prostate, lung, lymphoma, colorectal, leukemia, head and neck, brain and ovarian cancers.
Advancing Multidisciplinary Care
Another important role of the cancer registry staff involves coordinating case conferences – a key to advancing the multidisciplinary approach to cancer care. In 2008 at MeritCare:
- Forty-six facility-wide cancer case conferences were held, representing 149 total cases. An additional 19 radiation oncology department-specific conferences were held for a total of 344 prospective cases.
- Eighty-seven percent of the facility-wide cases and 100 percent of the department-specific conferences presented included a discussion on concurrent diagnostic, treatment and follow-up options (prospective) to improve patient care and outcomes.
- Multidisciplinary attendance included, but was not limited to, medical oncologists, radiation oncologists, radiologists, pathologists, surgeons, physician assistants, nurse practitioners, clergy, medical residents, nurses and clinical research associates.
- A breast cancer specific, facility-wide conference was formed. This allows for an increased number of breast cancer cases to be discussed.
Maintaining a cancer registry ensures that health care professionals have accurate and timely information, while ensuring the availability of data for treatment, research and educational purposes. MeritCare Roger Maris Cancer Center is committed to this high standard for the benefit of present and future patients.
