Breast, Colon, and Prostate Cancer Data Quality and Treatment Patterns of Care Studies

The Institute of Medicine (IOM) of the National Academy of Sciences released a report in 1999 on Ensuring Quality Cancer Care noting that some cancer patients did not receive care known to be effective for their condition. In 2000, IOM further recommended that existing cancer data systems, such as population-based cancer registries, be enhanced and used for assessing quality of cancer care and examining variations in the use of appropriate standards of care in the United States (U.S.).

In response to the IOM recommendations, CDC's National Program of Cancer Registries (NPCR) has funded and collaborated with state population-based cancer registries to conduct patterns of cancer care studies. These studies are part of a larger NPCR initiative to conduct cancer surveillance studies with NPCR member registries. Activities within the NPCR initiative include developing, conducting, and evaluating cancer surveillance projects targeting specific cancers, such as breast, colorectal, prostate, ovarian, or oral/pharyngeal cancers.

Breast, Colon, and Prostate Cancer Data Quality and Treatment Patterns of Care (POC1) Study

In 2001, the NPCR initiated funding for its first patterns of care cancer study entitled the Breast, Colon, and Prostate Cancer Data Quality and Treatment Patterns of Care (POC1) study. Each of the seven participating registries is also part of the NPCR. Several manuscripts providing key results have been published in peer-reviewed literature—

Schymura MJ, Kahn AR, German RR, Hsieh MC, Cress RD, Finch JL, Fulton JP, Shen T, Stuckart E. Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1). BMC Cancer 2010;10(1):152.

Cress RD, Sabatino SA, Wu X-C, Schymura MJ, Rycroft R, Stuckart E, Fulton J, Shen T. Adjuvant chemotherapy for patients with stage III colon cancer: results from a CDC–NPCR patterns of care study. Clinical Medicine: Oncology 2009;3:107–119.

German RR, Wike JM, Wolf HJ, Schymura MJ, Roshala W, Shen T, Schmidt B, Stuckart E. Quality of cancer registry data: findings from CDC–NPCR's Breast, Colon, and Prostate Cancer Data Quality and Patterns of Care study. Journal of Registry Management 2008;35(2):67–74.

Byers TE, Wolf HJ, Bauer KR, Bolick-Aldrich S, Chen VW, Finch JL, Fulton JP, Schymura MJ, Shen T, Van Heest S, Yin X; for the Patterns of Care Study Group. The impact of socioeconomic status on survival after cancer in the United States: findings from the National Program of Cancer Registries Patterns of Care study. Cancer 2008;113(3):582–591.

Wu X, Richardson LC, Khan A, Fulton JP, Cress RD, Shen T, Wolf HJ, Bolick-Aldrich S, Chen VW. Survival differences between non-Hispanic black and non-Hispanic white women with localized breast cancer: the impact of guideline-concordant therapy. Journal of the National Medical Association 2008;100(5):490–498.

Alley LG, Fulton JP, Wike JM, Kahn AR, Roshala W, Chen VW, Rycroft RK, Bolick-Aldrich S, German R, Snodgrass J. Studying patterns of care: an evaluation of a project using CDC–NPCR data. Journal of Registry Management 2008;35(1):27–33.

Alley LG, Chen VW, Wike JM, Schymura MJ, Rycroft RK, Shen T, Bolick-Aldrich S, Roshala W, Fulton JP. CDC–NPCR's Breast, Colon, and Prostate Cancer Data Quality and Patterns of Care study: overview and methodology. Journal of Registry Management 2007;34(4)148–157.

McDavid K, Schymura MJ, Armstrong L, Santilli L, Schmidt B, Byers T, Steele CB, O'Connor L, Schlag NC, Roshala W, Darcy D, Matanoski G, Shen T, Bolick-Aldrich S. Rationale and design of the National Program of Cancer Registries' Breast, Colon, and Prostate Cancer Patterns of Care study. Cancer Causes and Control 2004;15(10):1057–1066.

Breast and Prostate Cancer Data Quality and Patterns of Care (POC-BP) Study

Initiated in 2005, the Breast and Prostate Cancer Data Quality and Patterns of Care (POC-BP) study is the most comprehensive POC study of the NPCR, involving researchers from CDC and seven states in different geographic areas. The study examines—

• Patterns of initial (first course) treatment received by female breast and prostate cancer patients
• The extent to which that care is concordant with nationally recognized treatment guidelines
• How patterns of cancer care vary by patient-, provider-, and health system-level factors
• The quality of the cancer data for the study

The routinely collected registry data are supplemented by re-abstracting hospital records and obtaining information about adjuvant treatment and comorbidity from physicians and outpatient facilities. In addition, the study's data will be linked with secondary files such as Medicare, census data, or hospital/physician files.

Registries Participating in NPCR’s Breast, Colon, and Prostate Cancer Treatment Patterns of Care Studies

NPCR-supported central cancer registries participating in breast, colon, and prostate PoC studies include—

• California Cancer Registry
• Colorado Central Cancer Registry
• Georgia Cancer Registry
• Illinois State Cancer Registry
• Kentucky Cancer Registry
• Louisiana Tumor Registry
• Minnesota Cancer Surveillance System
• New York State Cancer Registry
• North Carolina Central Cancer Registry
• Rhode Island Cancer Registry
• South Carolina Central Cancer Registry
• Wisconsin Cancer Registry