Abstract 4188: Registering cancer recurrence in a population-based registry: The value of pathology data
Authors: Moubadder Leah , Chang Audrey , Ward Kevin C. , Lash Timothy L. 
Published: August 2019

Abstract
INTRODUCTION No population-wide cancer registry systematically records recurrence. It is often requested of U.S. registries, but cannot be provided. To fill this gap, the Georgia Cancer Registry (GCR) has embarked on a five-year project to add recurrence data to the registry for early-stage breast, prostate, colorectal cancer and lymphoma patients. Multiple data streams will be used to provide signals of recurrence, which will then be validated by a Certified Tumor Registrar from the registry staff. Electronic pathology data are submitted in real-time to the GCR and could be a key data stream to signal recurrences.
METHODS We created cohorts of early-stage breast and colorectal cancer patients treated at Commission on Cancer (CoC) facilities in Georgia and for whom the CoC facility both reported their pathology data to the GCR electronically and had documented a recurrence in the patient’s record. A randomly selected sample (n = 60) from each cohort was linked to electronic pathology (E-Path) reports in the registry to evaluate a) the proportion of patients with a report available in the GCR within 10 days of the documented recurrence and b) the proportion of patients whose E-Path report included the specific term(s) “recurrent”, or “recurrence(s)”. All pathology reports were manually reviewed to make the above determinations.
RESULTS All 60 cases from each cancer site had E-Path reports available for the incident cancer that was diagnosed. Upon manual review, 67% of breast cases and 63% of colorectal cases had reports in the registry within 10 days of the recurrence date reported by the CoC facility. When examining all reports for a given patient, regardless of date, for use of the specific term(s) “recurrent”, or “recurrence(s)”, only 18% of breast cases and 9% of colorectal cases contained these exact terms. CoC facilities also attempt to document the location of the recurrence in addition to the date. For cases with reports available in the registry within 10 days of the recurrence reported by the CoC facility, confirmation of the recurrence location was documented in the pathology report for the majority of patients (78% for breast and 89% for colon).
DISCUSSION E-Path reports will be an important source of information to signal recurrences, but the specific use of recurrence terminology was limited in the sample of reports selected for this study. Use of the terms “metastatic” or documentation of other organs as “positive for malignancy” was much more common. Not all recurrences will be signaled by E-Path reports, so the use of additional data streams as planned by this project will be critical and validation of these signals by trained staff will establish the gold standard of true recurrences. This ambitious project is just launching, with the aim of providing the first-ever descriptive data about recurrence rates for four common cancers over up to ten years of follow-up.
Citation Format: Leah Moubadder, Audrey Chang, Kevin C. Ward, Timothy L. Lash. Registering cancer recurrence in a population-based registry: The value of pathology data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4188.