The National Cancer Data Base: A Powerful Initiative to Improve Cancer Care in the United States

TLDR

The National Cancer Data Base is the world’s largest clinical cancer registry, receiving over one million annual case reports and encompassing more than 21 million patients from 1,430 hospitals, and is used to analyze national trends, benchmarks, and quality improvement in cancer care. This review describes the NCDB and its collected data, examines how it can be used to study clinical outcomes and quality of cancer care in the United States, and outlines the clinical care improvement tools provided by the NCDB and the Commission on Cancer to participating hospitals.

Abstract

2][3] Currently, the NCDB receives over one million cancer case reports annually from more than 1,430 hospitals.The NCDB now contains data on more than 21 million cancer patients diagnosed between 1985 and 2005, and is recognized as the largest clinical registry in the world.NCDB data are used to explore trends in cancer care, to examine regional and national benchmarks, and to serve as the basis for quality improvement activities ( http://www.facs.org/cancer/ncdb)The purposes of this review are: (1) to describe the NCDB and the data collected; (2) to discuss how the NCDB can be used to study clinical outcomes and the quality of cancer care in the United States; and (3) to describe the clinical care improvement tools provided by the NCDB and the CoC to participating hospitals. BACKGROUND: THE COMMISSION ON CANCER AND THE NCDBThe CoC is a multidisciplinary consortium of professional organizations that strive to improve cancer care through setting standards, prevention, research, education, and the monitoring of comprehensive cancer care. 4The CoC also accredits hospitals as cancer centers, based on their ability to provide a broad range of cancer-related services and specialists. 2The NCDB was started in 1989 by the ACoS and the CoC in conjunction with the American Cancer Society.The NCDB is housed at the ACoS headquarters in Chicago, Illinois.When the database was established any hospital could voluntarily report data to the NCDB, and during the mid 1990s, more than 2,000 hospitals were contributing cases.In 1996, all CoC-approved hospitals were required to report cancer cases to the NCDB, and in 2001, participation and the associated advantages of reporting to the NCDB were limited to those hospitals who had earned CoC approval. 5 PARTICIPATING HOSPITALSThe CoC classifies approved hospitals into teaching/research hospitals, comprehensive community cancer centers, and community cancer centers. 2 Teaching/research hospitals must be primarily affiliated with a medical school or National Cancer Institute (NCI)-designated comprehensive cancer center.Community cancer center designations are