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，因此有可能患上癌症。 癌症复发没有关于癌症复发风险的基于人群的信息。几十年来， 死亡率一直是监测癌症护理进展的唯一结果。正如癌症护理 然而，复发率和死亡率之间的对应关系已经减少。最近的一 《国家癌症研究所杂志》上的一篇评论强调，缺乏关于癌症的监测数据， 复发是癌症护理领域中比较有效性研究的障碍， 癌症护理质量。在临床环境中，由于缺乏按癌症类型划分的甚至基本的复发风险数据， 分期是知情的医患决策和风险分层的障碍。一个高质量的登记册， 癌症复发将填补这些空白，为癌症研究开辟新的途径，并使改善 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。 格鲁吉亚为首次癌症复发登记提供了理想的环境。的人口 约有1 000万人在所有主要人口特征方面都各不相同。人口众多， 关于复发的足够数据将迅速积累。多样化的种群保证了 人口统计学特征的复发风险将得到充分表征。格鲁吉亚癌症 登记处一直是国家癌症研究所的监测流行病学和结束的长期成员 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 人口和格鲁吉亚癌症登记处有正确的基础设施，以实现以下两个目标： 目标#1：使用六个数据流来表示格鲁吉亚癌症幸存者中可能发生的复发 被诊断患有四种癌症类型之一（乳腺癌，前列腺癌，结肠直肠癌或淋巴瘤），审查医疗记录， 验证真正的递归，并实施不断学习的过程，以提高准确性，效率， 登记程序的可持续性。 目标#2：对于这四种癌症类型，它们代表了43%的发病病例和58%的流行幸存者， 美国，产生了有史以来第一个描述性数据的风险和复发率超过十年的后续行动 并评估这些是如何随着人口统计学特征而变化的。 通过实现这些目标，我们将填补有关癌症结果的知识库中的一个重要空白， 为关于复发模式和预测因素的创新研究提供基础。复发数据将 通过现有机制向其他研究人员提供，以便从 一开始此外，随着基础设施的巩固和方法的优化， 协议将可传送到具有类似基础设施和法律的权威的癌症登记处。

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 .