Title: Cancer Reporting in Texas Texas Cancer Registry Update
1Cancer Reporting in TexasTexas Cancer Registry
Update
- Nancy S. Weiss, Ph.D.
- Texas Cancer Registry
- Cancer Epidemiology and Surveillance Branch
- Texas Department of State Health Services
- September 29, 2005
2Overview
- TCR Administrative Changes
- Impact of 79th Texas Legislative Session
- New Initiatives and Partnerships
- TCR Reporting Changes for 2005 Cases
- Current Reporting Status and Other TCR Activities
- NAACCR Certification Results for 2002 Cases
- Upcoming Data Calls
- Data Availability and Research Using TCR Data
- Miscellaneous Updates
3Administrative Changes
Cancer Epidemiology And Surveillance Branch (45
Staff 14 Contractors/ In-Kind Staff)
Cancer Epidemiology Group (15 Staff)
Cancer Surveillance Operations Group (38 Staff)
4Cancer Surveillance Operations Group
- Registry Operations Manager - John Hopkins All
PHRs - Registry Operations Supervisors
-
- Regional Team Leads
- Quality Assurance Team Lead - Susan Perez
- Supervisor - Melanie Williams
- Velma GarzaPHRs 5/6, 7, 8/11 - Elaine Allgood
PHRs 2/3/4, 1/9/10
- - Dora Rodriquez PHRs 2/3/4, 1/9/10
- Judy Spong PHRs 5/6
- Nelda Gonzalez PHRs 7, 8/11
Cancer Epidemiology Group
579th Legislative Session
- No Changes to Reporting Law
- Increased funding for the TCR 2.2 million for
biennium -
Chapter 82, Health Safety Code - Cancer Incidence
Reporting Act (Effective September 1, 2001)
Lawsuit settlement funds Higher Education
Coordinating Board - Fee assessments from
academic centers
6Rule Reminders
- Chapter 91, Subchapter A TAC Amended April
24, 2003 - Text documentation to support dx,stage rx codes
required. - Monthly submissions required of facilities with
caseloads gt400. - - Otherwise on a quarterly basis.
- - Clinical labs must submit at least
bi-annually. - Electronic reporting required of facilities with
caseloads gt50. - Reporting by facilities and clinical labs
required within 6 months of dx/admission.
(extension for 2004 cases - 9 months) - Requests for personal cancer data for research
purposes must be approved by the TDH IRB. - Will be proposing rule amendments later this Fall
7On-going and New Initiatives
- Pathology Laboratory/Physician Reporting
- Academic Center Partnerships
- Casefinding and Data Collection Continuation
- Web-based Training
8Pathology Laboratory andPhysician Reporting
Initiative
- Capacity to identify unreported cases from
clinical labs and follow-back to physicians
developed - National Electronic Disease Surveillance System
(NEDSS) - SANDCRAB Lite for Path Labs
- Began preliminary data collection in FY05
- 9 Path Labs implemented reporting
- Over 16,000 reports received
9Partnership with Academic Centers
- Expansion of Regional Registry Presence
- Border area - TxAM School of Rural Public Health
- Tyler Area - to be determined
- Temporary Contract CTRs to Process Record
Backlogs - MDACC - Circuit Rider Abstractor - UTMB
- Path lab reporting, Texas - Mexico Data Sharing,
- CTR / Bachelors Degree Program -
UTHSC-SPH-Houston at Brownsville - Border Data Quality Improvement in Laredo area -
UTHSC - SA and San Antonio Cancer Institute
10Casefinding and Data Collection Pilot
- Pilot-One Time Funding from Preventable Health
Block Grant - Casefinding and Data Collection for 2004 cases at
154 Hospitals with lt100 Cases - 77 Participation of 199 Hospitals Invited
- 5,267 Cancer Cases Collected
- Improve Timeliness, Completeness and Quality of
Data
11Casefinding Data Collection Projectfor 2005 Cases
- Project funded by exceptional item
- 232 hospitals statewide invited and 208 will
participate (90) - Approximately 8,900 cases expected
- Work will be performed by contract CTRs
- Work to begin by December 2005 or January 2006
12TCR Reporting Reminders for 2004 Cases
- Collaborative Stage
- Revisions to coding guidelines 01.02.00
- Must be used with 2005 cases (up to facilities if
they choose to recode 2004 cases) - Revisions to algorithm which affect derived
stages - Thyroid primary revisions affect summary stage
- ACoS and non-ACOS facilities
- Both must submit detailed text to support coded
data items or enable staff to code
13TCR Reporting Changes for 2006 Cases
- 12 New Reportable Data Items
- Casefinding Source - NAACCR Data Item 501
- Primary Payer at Dx - 630
- Reason for No Surgery - 1340
- Rx Summ - Surg/Rad Seq - 1380
- Rx Summ - System Sur Seq - 1639
- Address at Dx Supplemental - 2235
- Text for Chemo, Hormone, BRM Other 2640,
2650, 2660, 2670 - Managing Physician 2460
- Follow-up Physician - 2470
- 6 Months Reporting Requirement
14Compliance Requirements
- 2003 cases - Were due by December 31, 2004
- (12 months reporting)
- 2004 cases - Extended to September 30, 2005
- (9 months reporting)
- 2005 Cases - Due June 30, 2006
- (6 months reporting)
15Cancer Reporting to the TCR
- Between September 2004 and September 2005
- - 230,254 reports were received and processed
(15 increase over last year). - - 101,006 Texas resident cancer cases for the
years - 2001-2004 were added to the database (9
increase over last year).
16Electronic Reporting to the TCR(2003 Cases)
- 97.5 of facilities reported electronically
(increase from 80) - 98 of records were reported electronically
- 62 of facilities reported using SCL (increase
from 47) - 25 of records were reported using SCL
- 55 of reports were from ACoS facilities
17Electronic Reporting via the Web(September 2004
- September 2005)
- CRESS (Cancer Registry Electronic Submission
System) and SCL FTP Users - No. of Facilities Reporting 409 (300 increase)
- No. of Submissions 2,407 (325 increase)
- No. of Records 143,695 (580 increase)
18Estimated Statewide CaseCompleteness
Expected Cases
Year
Percent
2000 2001 2002 2003 2004
95 98 97 88 49
81,960 83,959 86,086 88,268 90,356
(As of September 22, 2005)
19Status of Cancer Case Completenessby Public
Health Region
Percent
Texas
Public Health Region
20Reporting TimelinessTexas ACoS vs non-ACoS
Facilities2002 vs. 2003 Admissions
439
450
348
344
306
Median Days
2002
2003
2002
2003
ACoS (69 Facilities) non-ACoS (410 Facilities)
As of August 15, 2004
21Data Quality Audits
- Audits by TCR staff (or contractors) of
completeness and quality of data reported by
facility - - Casefinding 21 facilities audited for 2003
cases - - 2 Contract auditors selected through state
bid - process (3 CTRs performed work)
- - Results pending
22Regional TrainingsCollaborative Staging
Workshops Covering Collaborative Staging System
Guidelines / Revisions(by Emory University
Rollins School of Public Health)
- To provide training to state cancer reporters and
TCR staff - To offer continuing education credits for Texas
CTRs at no cost
- 5.5 CE Hours
- 6 Trainings - 132 Attendees
- Dallas 30
- Houston 23
- Austin 14
- TCR Staff 21
- San Antonio 28
- El Paso 16
23Texas Results of the NAACCR Registry
Certification(2002 Diagnosis Year)
Gold Standards Achieved
- Completeness of information recorded
- Duplicate Primary Cases
- Passing EDITS
- Timeliness
24Texas Results of the NAACCR Registry
Certification(2002 Diagnosis Year) (cont)
Silver Standard Achieved
- Death Certificate Only Cases
4.1 - Texas lt3 - Gold Standard
-
25NAACCR Registry Certification (cont)(2002
Diagnosis Year)
- Completeness of Case Ascertainment 88.8 -
Texas 90 - Silver Standard 95 - Gold
Standard
26NAACCR Call for Data2003 Cases
- Due December 1, 2005
- Target for Silver Certification
- CDC - U.S. Cancer Statistics - 2003 - January 2006
Other Calls for Data
27Availability of Texas Cancer Data
- Incidence 1995 2002
- Mortality 1990 2003
- Expected Numbers of Cancer Cases and Deaths, 2005
- Published Reports, Statistical Tables, Fact
Sheets on the Web - Special Data Runs Upon Request 1-800-252-8059
- TCR Web Site http//www.dshs.state.tx.us/tcr
28Recent Upcoming Cancer Reportsthat Include
Texas Data
National
- Special Colorectal Cancer Monograph in Cancer
- U.S. Cancer Statistics - 2002 (soon to be
released) - Annual Report to the Nation on the Status of
Cancer, 1975-2003, with a Special Feature on
Cancer in U.S. Hispanics/Latinos 1999-2003 - Central Brain Tumor Registry of the United
States, Primary Brain Tumors in the U.S.,
Statistical Report, 1998-2002
State
- Texas Cancer Facts and Figures, 2004
- Regional Facts Sheets, 2005
- County Facts Sheets, 2005
- Cancer Incidence and Mortality in Texas,
1990-2002 - Tobacco in Texas, 1998-2002
- Prostate Cancer Incidence, 1998-2002
- Breast and Cervical Cancer Incidence, 1998-2002
29Research Studies UsingTexas Cancer Registry Data
- UTSPH-Houston Air Toxics and Cancer in Houston
- University of Pittsburgh Graduate School of
Public Health Cohort Mortality and Cancer
Incidence Studies on Rahway, New Jersey Facility
(linkage completed) - UTSPH-Houston Analysis of Endometrial and Ovarian
Cancer Incidence, Stage at Diagnosis, Mortality,
and Survival by Race/Ethnicity, Socio-economic
Status, and Rural/Urban Residence in Texas,
1995-2002 - UCLA Ovarian Cancer Care and Outcomes Study
- Harvard Cohort Cancer Registry Follow-up Study
- UTSPH Houston Gynecologic Cancers Among
Veterans in Texas - MD Anderson/American Cancer Society Prostate
Cancer Screening Cohort Study - University of Alabama at Birmingham Study of Good
Year Tire Employees, Tyler, TX - Cooper Institute and Vanderbilt University Impact
of Physical Fitness and Exercise on Health Study
30The Power of Texas Data
- Prior studies indicated conflicting results
regarding if cervical cancer survival is affected
by race/ethnicity, rural status, education level,
and/or poverty. - Studies were limited by
- The number of cervical cancer cases/deaths
- The type of population
- Texas was an optimal state to further study the
impact of these factors on cervical cancer
survival - Large ethnically diverse population with large
urban and rural areas - All of these various factors could be analyzed
simultaneously
31The Power of Texas Data (continued)
- UTSPH-Houston conducted study, Socio-economic
Status as a Predictor of Cervical Cancer
Survival. - African Americans, low income, and those living
in rural areas may be at higher risk of dying
from a preventable cancer - Additional research needed on these high risk
women in order to identify missed opportunities
for preventing these kinds of deaths
- Lead to National Institute of Health funded
study, Understanding Disparities in Cervical
Cancer Survival Study to be conducted by the
UTSPH-Houston - Also lead to additional study of these factors
and their potential impact on endometrial and
ovarian cancers by team of gynecologic
oncologists from UTSPH-Houston and UT MD Anderson
32Miscellaneous Mentions
- Unknown Diagnosis Year Follow - back
- Death Clearance for 2003 cases
- SANDCRAB Lite - v 9.0 (NAACCR v 10.1)
-
-
- TCR Edits for Facilities with Vendor Software
- Electronic Death Information Update
- - National Death Index
- - Texas Vital Statistics
- Matching Documentation from Reporters for CDC
Grant