The Effectiveness of Surveillance Systems in Monitoring Cancer in the United States Paper Example

Surveillance of Cancer at the Local

In the United States, surveillance of cancer at the local level happens at the county levels such as in Baldwin County in the State of Alabama. The monitoring of both the local and the state-level cancer data is undertaken by the Alabama Statewide Cancer Registry (ASCR) which collects data in all the counties of Alabama and combine to produce statewide cancer surveillance data. Additionally, at the local level, healthcare facilities, e.g., pathology laboratories, physicians' offices, and hospitals send data about cancer cases to the local cancer registry (CDC, 2018). It has also been reported that most cancer data from the local hospitals are sent by highly trained cancer registrars from the patients' health record to the registry's computer software using standardized codes (CDC, 2018). After that, the data is transferred to the central cancer registry.

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Cancer Surveillance at State Level

At the State Level, such as in the State of Alabama, cancer surveillance is conducted using a state registry, e.g., the Alabama Statewide Cancer Registry, ASCR (CDC, 2016; County Health Rankings, 2018; International Agency for Research on Cancer, 2019). This is a statewide, population-based cancer registry tasked with collecting data related to all cancer cases that underwent diagnosis or treatment in Alabama. The ASCR data collection dates back to 1st January 1996, following its establishment in 1995 as mandated by Alabama state law (Act 95-275) that enforced reporting of cancer (Alabama Department of Public Health, 2017).

The ASCR found is part of the Bureau of Family Health Services and is tasked with providing accurate and current cancer data in Alabama. Additionally, it is useful in the identification of high-risk cancer population, checking trends in cancer incidence, supporting studies aimed at preventing cancer, and planning cancer control interventions. The ASCR participates in the National Program for Cancer Registries (NPCR), whose role is to fund, guide, and implement program standards for all statewide cancer registries found in the USA (Alabama Department of Public Health, 2017).

Cancer Surveillance at the National Level

Cancer surveillance at the national level is carried out by the Surveillance, Epidemiology and End Results Program (SEER), which is found within the National Cancer Institute's (NCI) Surveillance (Beatty, 2016; Loda, Mucci, Mittelstadt, Van Hemelrijck, & Cotter, 2016). The SEER program is a large population-based registry tasked with collecting data from specific geographical regions representing 28% of the United States population. The SEER surveillance gathers data related to new cancer cases, survival rates, and prevalence (American Cancer Society, 2018). Currently, SEER has been reported to capture 400,000 of cancer cases every year and to store about 30% of the United States cancer data (Duggan, Anderson, Altekruse, Penberthy, & Sherman, 2016).

The SEER data are abstracted from the patients' pathology report and for 80% of the cases, pathology reports are retrieved by electronic means in real-time from about 360 laboratories (Duggan et al., 2016). The data are then compiled forming a final case record along with data derived from other sources. Some of these sources include death certificates, freestanding diagnostic imaging and chemotherapy clinics reports, and patient medical records. In the past, cancer data extraction was manual; where the abstracted standard data items were manually entered in a data gathering template. However, current data collection is electronic and involves the automated coding of data fields using natural language processing (NLP) software.

The effectiveness of Surveillance systems in monitoring Cancer

Quality assurance is an essential component of SEER (Furlow, 2015). The national surveillance system, SEER, is regarded as the gold standard for data quality among all cancer registries found in the united states and across the world (Duggan et al., 2016). The high quality of the collected data is attained through contractual agreements with regional registries, which are needed to meet SEER'S quality standards before transmitting the data. Additionally, SEER has a quality program which is comprised of the continuous data monitoring and evaluation for identifying areas that need improvement, and data quality control for preventing and correcting errors.

It is also worth noting that the state-level cancer registries must meet the stringent SEER's requirements regarding the quality of data (such as completeness and missing data). Consequently, it can be concluded that statewide data is useful in monitoring cancer. Similarly, the SEER's national cancer surveillance has high efficacy in the monitoring of cancer trends because the data meets high-quality standards. Finally, the local surveillance of data adheres to the state-level SEER's requirements of high quality further ensuring that all levels of yield quality data.

Government's Responsibilities for Monitoring Cancer at Various Levels

The monitoring of cancer at different political levels adheres to the same SEER's standards. Consequently, it can be concluded that no differences exist in reporting requirements at all levels. It can be concluded that at all levels of governments data meet high-quality requirements such as accuracy and completeness. Because of this, the data collected from all the levels of government are effective in monitoring cancer.

Suggestions on how I will Utilize what I have learnt in this Exercise

This assignment has enabled me to know that the most crucial aspect of cancer surveillance is making sure that the data collected is of high quality. In the system that I am currently constructing, I will ensure that quality is achieved by making sure that pathology data is complete and free of any errors. I will also make sure that no mistakes are made when entering information thus ensuring that there are no missing data.

References

Alabama Department of Public Health (2017). Alabama statewide cancer registry. Retrieved from http://www.alabamapublichealth.gov/ascr/index.html

American Cancer Society (2018). Cancer surveillance programs and registries in the United States. Retrieved from https://www.cancer.org/cancer/cancer-basics/cancer-surveillance-programs-and-registries-in-the-united-states.html

Beatty, C. F. (2016). Community Oral Health Practice for the Dental Hygienist-E-Book. Elsevier Health Sciences.

CDC (2016). Alabama cancer control plan 2016-2021. Retrieved from ftp://ftp.cdc.gov/pub/Publications/Cancer/ccc/alabama_ccc_plan-508.pdf

CDC (2018). About the program. Retrieved from https://www.cdc.gov/cancer/npcr/about.htm

County Health Rankings (2018). Alabama. Retrieved from http://www.countyhealthrankings.org/using-the-rankings-data/finding-more-data/alabama

Duggan, M. A., Anderson, W. F., Altekruse, S., Penberthy, L., & Sherman, M. E. (2016). The surveillance, epidemiology and end results (Seer) program and pathology: towards strengthening the critical relationship. The American Journal of Surgical Pathology, 40(12), e94-e102. https://doi.org/10.1097/PAS.0000000000000749

Furlow, B. (2015). US national cancer institute investigates psa coding errors. The Lancet Oncology, 16(6), 614. https://doi.org/10.1016/S1470-2045(15)70196-8

International Agency for Research on Cancer (2019). Alabama statewide cancer registry profile page. Retrieved from http://www.iacr.com.fr/index.php?option=com_comprofiler&task=userprofile&user=901&Itemid=498

Loda, M., Mucci, L. A., Mittelstadt, M. L., Van Hemelrijck, M., & Cotter, M. B. (Eds.). (2016). Pathology and epidemiology of cancer. Springer.