Challenges Faced by SEER's National Cancer Surveillance System Paper Example

Introduction

Cancer surveillance at the national level is carried out by SEER (American Cancer Society, 2018). One of the challenges faced by the Surveillance, Epidemiology, and End Results (SEER) database is that current data collection approaches are based on passive and active reporting from hospitals and laboratories, which are not timely (Katz, 2015). Another challenge that has been identified at the national level is lack of an objective standard for timeliness in measurement is fundamental (Jabour, 2015). For instance, the SEER program requires that 98% of cases need to be availed within 22 months while the CDC's National Program of Cancer Registries reporting of 95% of cases to be done within 24 months. Additionally, the North American Association of Central Cancer Registries mandates that 90% of cases be reported within 23 months following diagnoses for Silver Certification and reporting of 95% of cases within the same period following diagnosis for Gold Certification.

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The difference in timeliness of reporting of cancer data negatively affects the quality of data collected and analyzed. This is because timeliness in reporting is a critical element of quality data (Jabour, 2015). Current delays in reporting, of up to 24 months, negatively affect the quality of results through underestimation of the incidence rate resulting in inaccuracy of decline signal (Huang et al., 2013). Additionally, delayed reporting has been blamed for difficulty in making monitoring trends. These delays have also been found to limit the availability of data needed for research (Jabour, 2015).

Challenges Faced at the State-Level Cancer Surveillance System

Statewide cancer surveillance is carried out in strict adherence to the SEER guidelines. However, the challenges and problems experienced by the individual states in conducting the surveillance have been reported to be unique to each of the states (White et al., 2017). Even though the CDC provides adequate funding to each of the states to enhance set standards for ensuring the provision of complete, timely, and quality of cancer information (Skurka, 2017), timeliness has often been reported to be a challenge because the states take up to 24 months to submit the data to SEER national registry.

Similarities/Differences in Challenges Faced by National and State Surveillance Systems

Both the statewide and nationwide share similarities related to the challenges faced in surveillance. The main similarity is the problem of timeliness. Because both surveillance systems have been found not to generate data in a timely manner. This is because data collection strategies are based on passive and active reporting from hospitals and laboratories. No differences between the two systems were found.

Proposed Recommendations for Mitigation of the Identified Challenges

It is important to have continued improvement of the timeliness, efficiency, and accuracy of cancer surveillance systems. One of the ways of mitigating the challenges related to timeliness, efficiency, and accuracy is by ensuring that the surveillance system remains on the cutting edge of health information technology. This can be achieved by ensuring full electronic reporting as well as through automation of data management. Even though the National Program of Cancer Registries (NPCR) continuously makes progress in developing a robust capacity for electronic transfer of specific cancer data, Ryerson and Massetti (2017) noted that there is a lot to be done.

Additionally, Ryerson and Massetti (2017) explained that there is a need for sustained federal, state, and local cancer registry efforts towards the development of novel tools and software needed to accept additional electronic cancer records. Future development of new tools and software is vital in reducing the cost of cancer surveillance as well as in ensuring that there are timely surveillance and reporting of cancer data. The long-term decrease in the cost of surveillance is attributable to reduced time the registry staff spend in visually reviewing, coding, and entering of data. Instead, the development of robust surveillance tools and software ensures that registry staff spend more efforts in quality assurance thus making sure that the collected data is quality, complete, and timely.

Increased timeliness of cancer surveillance systems is expected to have positive impacts on the overall cancer healthcare system. For instance, improved timeliness is essential in expediting the admission of eligible patients in clinical trials, in identifying the initiation of individualized treatments or population-based treatments, and in monitoring the efficacy of effectiveness of the interventions (Groseclose & Buckeridge, 2017). The problem of passive reporting of surveillance data can be alleviated in the future through the development of real-time data collection methods, such as automation of clinical data sources and electronic health records (Katz, 2015). There is need to ensure SEER registries achieve a 100% automation of transfer and gathering of pathological data across hospitals.

There should also be sustained commitments towards enhancing the sensitivity and positive predictive value of future surveillance systems. According to Groseclose and Buckeridge (2017), increased sensitivity and positive predictive value of surveillance systems enhance the representativeness of the system. That is when the event under surveillance is considered, data collected using such a system is highly likely to be representative of the population.

References

American Cancer Society (2018). The American Cancer Society's Principles of Oncology: Prevention to Survivorship. Atlanta, Georgia: Wiley Blackwell.

Groseclose, S. L., & Buckeridge, D. L. (2017). Public health surveillance systems: recent advances in their use and evaluation. Annual Review of Public Health, 38(1), 57-79. https://doi.org/10.1146/annurev-publhealth-031816-044348

Huang, L., Midthune, D., Krapcho, M., Zou, Z., Horner, M.-J., & Feuer, E. J. (2013). Adjusting for reporting delay in cancer incidence when combining different sets of cancer registries. Biometrical Journal. Biometrische Zeitschrift, 55(5), 755-770. https://doi.org/10.1002/bimj.201100191

Jabour, A. (2015). Cancer reporting: timeliness analysis and process reengineering. Indiana University. Retrieved from https://scholarworks.iupui.edu/bitstream/handle/1805/10481/Jabour_iupui_0104D_10096.pdf;sequence=1

Katz, S. J. (2015). Cancer care delivery research and the national cancer institute seer program: challenges and opportunities. JAMA Oncology, 1(5), 677-678. https://doi.org/10.1001/jamaoncol.2015.0764

Ryerson, A. B. (2017). CDC's public health surveillance of cancer. Preventing Chronic Disease, 14. https://doi.org/10.5888/pcd14.160480

Skurka, M. A. (Ed.). (2017). Health information management: principles and organization for health information services. John Wiley & Sons.

White, M. C., Babcock, F., Hayes, N. S., Mariotto, A. B., Wong, F. L., Kohler, B. A., & Weir, H. K. (2017). The history and use of cancer registry data by public health cancer control programs in the United States. Cancer, 123 Suppl 24(Suppl 24), 4969-4976.