Part 3 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer Registries are staffed with Cancer Registrars who have met the stringent and complex requirements for education, training and work experience. While some Registries have non-credentialed staff who perform administrative tasks or are in training for their credentialing exam, most Registrars are certified tumor registrar’s, or CTRs. Only CTRs can abstract from the medical record cancer information that is reported and used for statistical and quality studies.
There are several processes, or phases, to cancer data collection and reporting. It starts with casefinding, or identifying the people with cancer who have been diagnosed or treated at the hospital or other medical facilities. Most patient’s start their cancer journey with a visit to their primary care physician (or PCP) and are then referred to specialists who will diagnose and recommend treatment for their specific type of cancer.
“Casefinding is like casting a net far and wide to “capture” all the reportable cancer cases.” (1)
CTRs look at the medical record and through manual or automated processes enter the cancer site, histologic type, patient demographics (such as gender, race or age) and the extent of disease (or the stage) into the case abstract. Some Cancer Registries will collect additional medical and scientific data elements, such as the type of treatment, and then follow the patient each year to track any reported recurrence and lifetime survival.
(1) Surveillance, Epidemiology and End Results (SEER), National Cancer Institute
Part 2 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer data is collected in the USA by a system of registries. Data collected depends on the purpose of each registry and there are two primary types:
Hospital Registries, usually a department in a hospital, cancer center or medical facility.
Population-based Registries, typically found in state health department or government agency.
Hospital Registries provide hundreds of data elements, some of which are quite complex, that is used to study and evaluate the patient care process given within the hospital. Hospital-based data is focused on things like the care of the cancer patient (from diagnosis, treatment and on to lifetime follow-up) to educating the healthcare providers. If a hospital is part of a system or affiliated group of hospitals they may pool their data and use the collective information to learn more about how the different types of cancers respond to the care given system-wide. Pooled data can be used in studies to compare trends or patterns of care, demographic or population subsets or by geographic region.
Population-Based Registries are often a part of a state, or even national, health department system. They collect the information on all cases diagnosed within a certain geographic area. They also pull together information from the reporting facilities within their geographic region that may include, but is not limited to:
Hospitals,
Doctor’s offices,
Nursing homes,
Pathology laboratories,
Radiation and chemotherapy (infusion) treatment centers,
Ambulatory care facilities or clinics,
Or other cancer care facilities.
Population registries use this larger pool of data to study new cancer cases (or incidence) and death rates (or mortality) in the regions across the United States. Population-based registries can look at cancer rates in certain types of jobs or groups of people, and see if the cancer survival is improving or not in each group. They can also watch trends over time to find out if the rate of a certain type of cancer is increasing or declining over time. Lastly, they can monitor the incidence or mortality rates in age or ethnic groups to see who is most affected by different types of cancer. One example of this type of analysis is published in the Cancer Facts & Figures each year by the American Cancer Society.
Information also reported by hospital-based and population-based registries helps to guide local, regional and national cancer prevention and control programs that focus on changing certain behaviors (like smoking), lifestyle (like healthy eating habits) or environment risks (like asbestos exposure). The data from a cancer registry helps to identify a specific need for increased cancer screening (like lung cancer screening) in a certain region or area.
Part 1 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer surveillance is defined by the American Cancer Society as the “ongoing, timely, and systematic collection of analysis of information on new cancer cases, extent of disease, screening tests, treatment, survival and” mortality (ie cancer-related deaths). In a nutshell, scientists, researchers and healthcare providers keep an eye on all things cancer and track it for public health purposes.
How is cancer data used? Cancer data is used to look at trends over time, to identify patterns in geographic regions or groups of people, or to show if cancer screening or other cancer-prevention activities are making a difference. For example, the data can show a difference in new cancer diagnosis rates, death rates, or in a decrease in behaviors that are known to increase a person’s risk for getting cancer, such as tobacco smoking.
There is no single surveillance or cancer program in the United States that collects data on all the new cancers diagnosed each year. Some segments of the US population are covered by separate programs sponsored by government or private organizations who provide reliable data on their own segments or defined populations and groups. These programs are built around the cancer registry, or registries that are established to record, classify and report cancer case data in the areas they cover.
Published in: The Baltimore Sun / Reuters, May 8, 2013
NEW YORK (Reuters Health) – Professional medical societies don’t often consider costs when they’re developing their treatment guidelines for specific conditions, according to a new study. Researchers found that just over half of the top medical societies with at least 10,000 members considered costs when developing best practices. The other half either implicitly considered costs or didn’t address them at all. “Even when they said they looked at costs, they didn’t seem to have a clear, consistent or rigorous way to do so,” said Dr. Steven Pearson, the study’s senior author and a visiting scientist in the Department of Bioethics at the National Institutes of Health in Bethesda, Maryland.
Congratulations to all the National Cancer Registrar’s Association (NCRA) 2011 award winners! Awards were given at the 35th Annual Education Conference held in Washington, D.C., in April, 2012.
On Tuesday, May 22, 2012 Registry Mindset was pleased to sponsor the first Cancer Registry Leadership Mentoring Group. Members on the call will participate in monthly calls and webinars to grow the leadership skills of each member as well as those of cancer registrars around the world.
Vision Statement: We envision a future where every cancer registrar:
Has the mindset, skills and resources needed to consistently achieve successful outcomes as effective leaders.
Is empowered to enthusiastically explore new leadership opportunities that support advances in cancer registration, science, medicine and quality control.
Is engaged in a culture of mentoring other cancer registrars, and
Influences his/her team to achieve excellence in oncology healthcare.
If you, or another cancer registrar would like to join this dynamic, forward-thinking group of cancer registry professionals click here and sign-up today!
Cancer Registrars have been using ICD-10 mortality codes for some time and we are familiar with coding and standards changes. But, what is the “inside scoop” on why are ICD-9 codes are being replaced? Here are some quick facts on what is happening in the industry.
ICD-9-CM is a diagnostic and procedural classification system originally developed in the 1970’s. As you might expect, its use has surpassed the original design and ICD-9 is no longer effective. It simply cannot be stretched or updated any further to support 21st century medicine and healthcare.
United States is the only industrial nation that has not upgraded its morbidity classification system. By upgrading to ICD-10 we will improve our ability to monitor and respond to international health events, increase the value of theUS’s investment in SNOMED-CT®, and help provider organizations to achieve better benefits from the electronic health record (EHR).
Briefly, ICD-9:
Does not have adequate specificity and detail.
Is running out of capacity and its limited structural design cannot accommodate new advances in medicine, medical technology, or the rapidly growing need for quality data.
Is obsolete and no longer reflects current knowledge of disease processes, medical terminology or 21st century practices of medicine.
Impedes the use of a standardized system needed to compare costs and outcomes from different medical technologies and specialties.
Cannot support theUnited States’ transition to an interoperable health data exchange format.
In summary, replacing the ICD-9 system with ICD-10 will help us to better maintain clinical data comparability with the rest of the world regarding conditions and diseases that require healthcare services. ICD-10 makes it easier, and this directly affects cancer registrars, to share disease and mortality data during these critical times for public health.
Cancer Registrars are already asking what the “ripple effect” will be for them. The answer is simple, we don’t know yet. Perhaps there will be change, but until ICD-10 is fully implemented the cancer registrar would be better served by developing an understanding of what is needed to analyze and report accurate and quality data in the 21st century and adopting a mindset that welcomes expanded use of cancer registry data and patient care outcomes.
To learn more about ICD-10 visit the American Health Information Management Association (AHIMA) website by clicking here. Check back to our website for future posts about what is happening with ICD-10 and other planned training events such as webinars, white paper summaries and more.
If you find this post helpful, add a comment below and tell us why!
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Michele Webb creator of http://www.RegistryMindset.comthe cancer registrar’s best online resource, is a nationally recognized, certified cancer registrar, committed to Cancer Registry leadership and professional education as a coach, mentor, motivational speaker and author. You have permission to repost this article as long as do not alter it in any way and give a link back and credit to the author and this URL.
Have you listened to the news recently? If so you probably heard at least a few of these words: crisis, disaster, scandal, tragic, threat, devastation, danger, emergency, shooting, crash, and the list goes on. No wonder people feel hopeless or become apathetic! The few moments of news that is uplifting does nothing to counter the barrage of negativity and media hype.
Not too long ago Darren Hardy, editor of Success magazine interviewed racing legend Mario Andretti. When asked what his No. 1 success tip was, Andretti said, “Don’t look at the wall. Your car goes where your eyes go.” As a teenager I frequently went rock climbing and rappelling. The secret was to not look down or to think about going down. You enjoyed the activity when you admired the scenery around you and trusted your gear to get you safely up or down the face of the rock. Imagine a tightrope walker who only focused on the ground. If they do not look up and focus on the rope, they will fall!
Our brains are complex organs but there are some simple rules you can follow to be in control of your life and your success as a cancer registrar. Your mind will hold whatever it is you think about, talk about and act on. If your mind is filled with negative thinking or if your social circles are filled with negative people who incessantly dwell on the dark side of life. Or, if words like, too busy, overworked, misunderstood, not valued, or no one cares are in your vocabulary, that is what you will get back in life. You’re probably familiar with the adage, “garbage in, garbage out.”
We get in life what we create and our expectations drive the creative process that we call life. Our expectations come from what we think and talk about. They come from the thoughts and words of people we associate with and the relationships we form. Whatever we allow ourselves to see and hear has an impact on our brain.
In your cancer registry, what do you talk about? What is the focus of your conversations and what do you want to happen? Is your talk or behavior positive or is it one of “doom and gloom?” If there is only grumbling about too much work to do, or if you only gripe about the new reporting rules or standards or the water-cooler talk is about team members who you feel are not supporting or valuing your work, then consider cleaning house!
It’s time to flush your mind and develop a positive, inspirational and supportive environment. By changing your thoughts and behaviors you can overcome challenges and obstacles that would have otherwise sent you into a blue funk. Creating a mindset of gratitude, abundance, health, love and joy so that you can grow and be successful is a constant challenge, but one that CAN be done.
It is time to take back control of your mind and your life. If you focus your thoughts and attention on what is right in the world and in your workplace then others will not have the power or potential to do you harm. If you focus your attention on ideas, information and knowledge and with an eye to the mission and values of your organization you will be able to serve others and grow your value as a cancer registrar and member of your family and community. By taking back control of your mind and focus you can make a positive difference in the world.
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Michele Webb creator of http://www.RegistryMindset.comthe cancer registrar’s best online resource, is a nationally recognized, certified cancer registrar, committed to Cancer Registry leadership and professional education as a coach, mentor, motivational speaker and author. You have permission to repost this article as long as do not alter it in any way and give a link back and credit to the author and this URL.
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