Page 21 - Delaware Medical Journal - March/April 2021

QUALITY OF CARE
Introduction: The Delaware Cancer Registry (DCR)
staff and Delaware Cancer Registry Advisory Committee (DCRAC) members work together to provide cancer surveillance and to evaluate quality of cancer care
in Delaware.
Background: DCRAC members use quality of care measures from the American College of Surgeons Commission on Cancer (CoC)’s Cancer Program Practice Profile Report (CP3R) to evaluate the quality of cancer care in Delaware. Similar assessments of cancer care in Delaware using CP3R metrics have been conducted in the past. Four metrics were selected for review in this assessment.
Methods: Cases with diagnosis dates in 2016 and
2017 were selected from the DCR database according to CP3R measure specifications. DCR staff conducted research in the Delaware Health Information Network (DHIN) for cases that were missing complete treatment information. The DCR calculated performance on four measures covering three sites: breast, lung, and rectum.
All analyses were performed using SEER*Stat and SAS version 9.4.
Results: Overall, DCR cases met the standards for all but one of the CoC quality of care measures evaluated. DCR cases did not meet the HT (breast) standard of care measure for 2016 and 2017 diagnosis year data.
Conclusion: The DCRAC will continue to monitor the DCR’s performance and will work with the DCR annually to evaluate the DCR’s performance according to CP3R measures, using the most current information. An updated report will be posted on the DCR webpage and trends in percentage of DCR cases meeting standard
of care measures will be presented to DCRAC. In next steps, Delaware leadership will continue to assess and communicate with providers to better understand the quality of cancer care and to support efforts to meet the standard in the future. The DCRAC will collaborate with Delaware hospital cancer programs to maintain adherence to quality of care standards.
INTRODUCTION
The Delaware Cancer Registry (DCR) is a state central population- based cancer registry. It provides data for cancer surveillance
and control initiatives to the Division of Public Health (DPH) as well as to local, state, national, and international partners. The registry collaborates with various leaders and stakeholders across Delaware. One entity is the Delaware Cancer Registry Advisory Committee (DCRAC), a committee within the Delaware Cancer Consortium (DCC).

registrars and health care planners and policymakers. The committee provides guidance and support to the DCR toward
the goal of improving cancer registry operations, including timeliness, completeness, the quality of cancer data collection, and on the best use of cancer registry data for cancer surveillance and control initiatives, program planning, and cancer research. Its mission is to sustain the quality of Delaware’s cancer data.
BACKGROUND
DCRAC has promoted rapid cancer reporting across Delaware hospitals and medical facilities over the past several years. DCRAC members elected to assess the quality of cancer care
in Delaware by evaluating the state’s 2016 and 2017 DCR data. DCRAC members used quality of care measures from the American College of Surgeons Commission on Cancer (CoC)’s 1 The measures highlight strengths and areas for improvement in cancer care CoC’s recommendations. Similar assessments of cancer care in Delaware using CP3R metrics were conducted in the past.
CP3Rs estimate performance rates with 23 quality measures, from 10 primary sites including breast, colon, rectum, lung, cervix, gastric, ovary, endometrium, bladder, and kidney. In
this study, DCR data were evaluated using four CP3R measures. These measures addressed quality of care across three cancer sites. The four metrics chosen were: HT and nBx (breast); LNoSurg (lung); and RECRTCT (rectum). HT is a measure of aromatase inhibitors for women with AJCC T1cN0M0 or
Stage IB-Stage III hormone-receptor-positive breast cancer. nBx is a quality improvement measure to assess that biopsy of the primary site is performed to establish diagnosis of breast cancer.2 LNoSurg is a quality improvement measure to assess treatment for cN2, M0 lung cases.3 Lastly, RECRTCT is a quality improvement measure to assess the administration of preoperative or postoperative chemotherapy and radiation based on staging.4
Del Med J | March/April 2021 | Vol. 93 | No. 2
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Abstract