Background: Cancer registries traditionally have relied upon hospital data to estimate site-specific cancer incidence in a population. In the last few years, the CDC has helped expand the role of registries to provide key information on patterns of cancer care. As a result, registry data have great potential for research on trends of cancer care in the population as well as patterns of care and disparities in care access and outcomes of vulnerable groups such as minorities and the underserved. With the diagnosis and management of many cancers shifting from the traditional hospital setting to the ambulatory setting, more complete diagnostic, treatment, and follow-up information from physician offices and other non-hospital settings is required. We have found that instances of low data quality are not randomly patterned, and thus can be statistically predicted with known accuracy. On this basis it is feasible to develop targeted audit protocols (TAP) that meet or exceed program thresholds for data quality. Objectives: This 3-year project is designed to improve the completeness, timeliness, quality and use of recent first course of treatment and stage data in the North Carolina registry;and to describe patterns of care in randomly selected samples of 600 white and nonwhite cases of female breast cancer cases stages l-lll (N=1,200) and 600 white and non-white cases with prostate cancer, all stages (N=1,200) contained in the NC registry in the two most recent diagnosis years available This work builds upon the past collaborative work of Wake Forest University and the North Carolina Central Cancer Registry (NC CCR) on patterns of cancer care. In our proposed work, we plan to implement efficient strategies for data quality assessment and improvement, and assessment of patterns of cancer for breast cancer and prostate cancers within the total sample, by race/ethnicity groups, and by markers for poverty. Specifically, in this three year study we would: 1) Test the efficiency and effectiveness of a targeted audit protocol (TAP) for registry data to improve the overall quality of registry data. 2) Assess the quality, completeness of staging and first course of treatment collected by the NC CCRby electronic edits and professional case record re-abstraction. 3) Describe the percentage of reported cases with female breast cancer that receive standard of care in North Carolina. 4) Describe the patterns of care with prostate cancer in North Carolina, considering patient (distance to radiation facility, age, race, disease status such as stage/grade/serum markers, urban/rural zip code) and system, or facility level variables (procedure volume, registry hospital, provider type). 5) Participate in the analysis of aggregate data and follow common protocols of the collaborative PoC group.
