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TABLE 1: Delaware Cancer Registry (DCR) Performance According to the American College of Surgeons Commission on Cancer (CoC)’s Cancer Program Practice Profile Report (CP3R) Standard of Care Measures, 2016 and 2017 cases.
SITE
SELECT MEASURES
COC STANDARD / %
DCR 2016 CASES MEETING COC STANDARD
DCR 2017 CASES MEETING COC STANDARD
Breast
HT - Tamoxifen or third-generation aromatase inhibitor is recommended
or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0, or stage IB-III hormone- receptor-positive breast cancer
4.4 / 90%
88.0%
80.5%
Breast
nBX - Image or palpation-guided needle biopsy to the primary site is performed to establish diagnosis of breast cancer
4.5 / 80%
84.4%
87.8%
Lung
LNoSurg - Surgery is not the first course of treatment for cN2, M0 lung cases
4.5 / 85%
95.6%
92.3%
Rectum
RECRTCT - Preoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or postoperative chemo and radiation
are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is recommended; for patients under the age of 80 receiving resection for rectal cancer.
4.5 / 85%
100.0%
92.9%
Sources: Delaware Cancer Registry, American College of Surgeons CoC Quality of Care Measures, Revised January 30, 2018. www.facs.org/quality-programs/cancer/ncdb/qualitymeasures
METHODS
Cases with diagnosis dates in 2016 and 2017 were selected
from the DCR database. Additional selection criteria were applied to create subsets according to each of the CP3R measure Health Information Network (DHIN) for cases that were missing complete treatment information, and data were added to the DCR database when found in the DHIN, to accurately record DHIN updates included, and categorized cases as either meeting the standard or not meeting the standard. All analyses were performed using SEER*Stat and SAS version 9.4.
RESULTS
Table 1 displays the percentages of DCR cases meeting selected CoC quality of care measures and the description of each measure.5 Overall, DCR cases met the standards for all except one measure. DCR cases did not meet the HT (breast) standard of care
measure for both 2016 and 2017 diagnosis year data. In Delaware, the HT standard measured at 88% in 2016 and decreased to 80.5% of 90%, respectively.
There was an increase in percentages that met the standard for the CoC measure nBx (breast) across the study reporting period, measuring 84.4% in 2016 and increasing to 92.3% in 2017. For CoC measures LNoSurg (lung) and RECRTCT (rectum), the percentages met the standard for both years, but also decreased between 2016 and 2017.
CONCLUSION
The success of the CoC’s CP3R demonstrates that improvements in data quality and patient care are possible when the entire cancer committee supports system level enhancements to ensure complete and precise documentation. This is evident in the current mortality statistics. Between 2002-2006 and 2012-2016, Delaware’s all-site cancer mortality rate decreased by 10%. Further, the American
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Del Med J | March/April 2021 | Vol. 93 | No. 2
