Registering Cancer Recurrences in the Georgia Cancer Registry

美国有1500万癌症幸存者，其中大多数被诊断为早期疾病，因此面临着 癌症复发。没有基于人群的关于癌症复发风险的信息。几十年来， 死亡率一直是监测癌症护理进展的唯一可用结果。就像癌症护理一样 然而，情况有所改善，复发和死亡率之间的对应关系已经减少。最近 《国家癌症研究所杂志》的评论强调，缺乏对 复发是癌症治疗领域中比较有效性研究的障碍，也是研究 癌症护理质量。在临床环境中，缺乏按癌症类型划分的基本复发风险数据和 分期是知情的医患决策和风险分层的障碍。高质量的注册表 癌症复发将填补这些空白，为癌症研究开辟新的途径，并使 临床护理直接关系到所有早期癌症患者最显著和最直接的结果。 佐治亚州为首次癌症复发登记提供了理想的环境。中国的人口 大约1000万人在所有主要人口特征方面都是不同的。庞大的人口确保了 关于复发的足够数据将迅速积累。多样化的种群确保了异质性 将充分说明人口统计特征对复发风险的影响。佐治亚州癌症 注册处一直是国家癌症研究所监测流行病学的长期成员 结果计划，由疾病控制中心建立的国家癌症登记计划 和预防，以及北美中央癌症登记协会。因此，格鲁吉亚有权 人口和佐治亚州癌症登记处有适当的基础设施来实现以下两个目标： 目标1：使用六个数据流发出乔治亚州癌症幸存者潜在复发的信号 被诊断为四种癌症之一(乳腺癌、前列腺癌、结直肠癌或淋巴瘤)，查看医疗记录以 验证真实的递归，并实施持续的学习过程以提高准确性、效率和 登记过程的可持续性。 目标2：对于这四种癌症类型，这四种类型代表了43%的发病病例和58%的流行幸存者 美国，在十年的随访中首次产生了关于风险和复发率的描述性数据 并评估这些指标随人口统计特征的变化情况。 通过实现这些目标，我们将填补关于癌症结果和 为对复发模式和预测因素的创新研究提供基础。重复数据将 通过现有机制提供给其他研究人员，因此资源共享将从 一开始。此外，随着基础设施的巩固和方法的优化，递归配准 协议将被传输到具有类似基础设施和法律权威的癌症登记机构。

There are 15 million US cancer survivors, most diagnosed with early-stage disease, so at risk for a cancer recurrence. There is no population-based information about the risk of cancer recurrence. For decades, mortality has been the only outcome available to monitor progress in cancer care. As cancer care has improved, however, the correspondence between recurrence and mortality has diminished. A recent commentary in the Journal of the National Cancer Institute emphasized that the lack of surveillance data on recurrence is a barrier to comparative effectiveness research in the realm of cancer care and to research on cancer quality-of-care. In the clinical setting, the lack of even basic recurrence risk data by cancer type and stage is a barrier to informed patient-physician decision-making and risk stratification. A high-quality registry of cancer recurrences would fill these gaps, open new avenues for cancer research, and enable improvements in clinical care tied directly to the most salient and immediate outcome for all early-stage cancer patients. Georgia provides an ideal setting for the first-ever registry of cancer recurrences. The population of about 10 million is diverse with respect to all major demographic characteristics. The large population ensures that adequate data on recurrences will accumulate rapidly. The diverse population assures that heterogeneity of recurrence risk by demographic characteristics will be adequately characterized. The Georgia Cancer Registry has been a long-term member of the National Cancer Institute’s Surveillance Epidemiology and End Results program, the National Program for Cancer Registries established by the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Thus, Georgia has the right population and the Georgia Cancer Registry has the right infrastructure to accomplish the following two aims: Aim #1: Use six data streams to signal potential recurrences occuring among Georgia cancer survivors diagnosed with one of four cancer types (breast, prostate, colorectal, or lymphoma), review medical records to validate true recurrences, and implement constant learning processes to improve accuracy, efficiency, and sustainability of the registration process. Aim #2: For these four cancer types, which represent 43% of incident cases and 58% of prevalent survivors in the US, generate the first-ever descriptive data on the risks and rates of recurrence over ten years of follow-up and evaluate how these vary by demographic characteristics. By achieving these aims, we will fill an important gap in the knowledge base regarding cancer outcomes and provide a foundation for innovative research on patterns and predictors of recurrence. The recurrence data will be available to other researchers through existing mechanisms, so resource sharing will be enabled from the outset. Furthermore, as the infrastructure solidifies and the methods are optimized, the recurrence registration protocols will be transportable to cancer registries with similar infrastructure and legal authority .