34 Occupational Outlook Quarterly.Fall 2003

To some, her job title sounds scary. But cancer registrar

Suzanna Hoyler does vital work. She compiles information about cancer cases at the Washington Hospital

Center in Washington, DC. She gathers data that researchers, healthcare providers, and public policymakers

use to combat a common enemy: cancer.

Suzanna directs the efforts of a small team of cancer

registrars. Their core duties involve case finding, abstracting, and followup. “With case finding,” Suzanna says, “we

look at every diagnosis of cancer—and certain benign

tumors—and we read pathology reports and medical

records to decide whether a case is suitable for the

registry.” Cancer registrars working in a hospital make

registry entries only for patients who were diagnosed or

received a first course of treatment at that institution.

“Next, there’s abstracting cases,” she says. “That’s the

main job of summarizing the patient’s medical records.

You’re taking English-language medical jargon and

translating it into a coded structure that’s standard

across the country. For example, the code for lung

cancer is C34.”

In abstracting a case, a multitude of these specialized

cancer-registry codes are assigned to record demographic

information for the patient, type and location of the

cancer, stage of the disease, details and dates of treatment,

and treatment outcomes.

Cancer diagnosis and treatment involves several

procedures, which often are done at numerous locations.

The cancer registrar obtains information on treatment

provided to a patient at these other medical facilities, as

well. “Medical care is given in many places,” Suzanna

says, “so a patient might have a biopsy done in a

physician’s office, go somewhere else for a CAT scan,

and then come to us for surgery. We’re required to get

all of that information.”

The third component, following up, happens once a

year with every patient who has a record in the registry.

“We do followup,” Suzanna says, “by checking our records

to see if patients have been back to the hospital, by surveying doctors who were active on cases, and by writing to

the patients and asking them how they’re doing.”

Hospitals and other healthcare providers must submit

their registry data to be compiled in comprehensive State

cancer registries. The followup information that Suzanna

and other cancer registrars collect about patients allows

State health departments to calculate survival rates for

different cancers.

Other registry data allow public health officials to

identify geographic areas with a high incidence of

potentially screenable cancers diagnosed at a late stage.

Based on such information, screening programs can be

developed for the populations identified so that cancers

may be caught earlier, when they are easier to treat.

Registry data also support cancer research in various

ways. The hospital might be asked to participate in a

study involving clinical trials for treating a specific type of

cancer. “One of the ways we use the data,” Suzanna says,

“is to answer the question: Do we have enough patients

that meet the criteria for a clinical trial?” To find a quick

answer, Suzanna queries the registry data. “This might

You’re a what?

Matthew Mariani is desktop publisher for the OOQ, (202) 691-5728.
Occupational Outlook Quarterly.Fall 2003 35

save researchers from having to review the medical charts

of 400 patients to identify the 20 patients for a study,” she

explains.

Large medical facilities like Washington Hospital

Center also use registry data for business purposes. For

example, Suzanna looks at the data to identify trends in

services provided. If the hospital is increasingly treating a

certain type of cancer, hospital administrators may decide

to invest in expensive medical equipment used to treat

that cancer. This promotes efficiency in allocating

healthcare resources.

The occupation of cancer registrar is a specialty within

the broader occupation of medical records and health

information technician. Suzanna believes cancer registrars

may balance more varied duties and apply more in-depth

knowledge than do medical records and health information technicians in general.

“You’re not always sitting there coding all day,” she

says of cancer registry work. “You might do some case

finding, you might do quality control by reviewing

information abstracted by other registrars, you might

work on a special study or report, or you might be

abstracting cases or doing followup. Everything has to get

done at a certain time, but you decide how to manage

your desk.”

Suzanna enjoys applying medical knowledge in her

job. She knows which drugs are used to treat cancer and

which others are given to control side effects; she codes

the former in the registry, but not the latter. “You also

really have to understand a pathology report,” she says, “so

when you read about what tissue the cancer has affected,

you can code the stage of disease.”

Most people entering the occupation come from

among the ranks of medical records and health information technicians. They have related work experience and

often have an associate degree in health information

management. These technicians—and sometimes other

allied health workers—learn the specialized knowledge

and skills of a cancer registrar through on-the-job

training. A smaller share of workers attend 2-year programs specifically designed to train cancer registrars.

Eleven schools currently offer cancer registrar programs

approved by the National Cancer Registrars Association.

Like most cancer registrars, Suzanna has professional

certification, which she gained after passing an exam

given by the association. Candidates must meet minimum

education or experience requirements to sit for the exam.

In addition, registrars must earn 20 hours of continuing

education credits every 2 years to keep their credential.

According to the association, Suzanna is 1 of about

3,400 credentialed cancer registrars in the United States.

The Association estimates median earnings for cancer

registrars at between $30,000 and $35,000 per year. The

Bureau of Labor Statistics does not publish employment

and earnings data for cancer registrars.

Suzanna enjoys her job because, as she says, “I love

data.” And she thinks the occupation has a lot to offer.

“For someone who’s detail oriented, self motivated, and

likes a challenge, this work can be very rewarding,” she

says, “and I don’t think you ever stop learning.”

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X-ray image courtesy of Washington Musculoskeletal Tumor Center