Are Tumor Registries a Good Way To Measure the Quality of Breast Cancer Care?

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The summary below is from the full report titled "Determining the Quality of Breast Cancer Care: Do Tumor Registries Measure Up?" It is in the 2 May 2000 issue of Annals of Internal Medicine (volume 132, pages 705-710). The authors are N.A. Bickell and M.R. Chassin.

What is the problem and what is known about it so far?

Hospital tumor registries record information about cases of cancer treated at a particular hospital. This information is useful in doing cancer research and developing policies on cancer care. Some people would also like to use registry information to judge the quality of treatment for cancer. However, little is known about the accuracy and completeness of tumor registries.

Why did the researchers do this particular study?

The researchers wanted to determine whether the information in tumor registries provides an accurate picture of the cancer treatment.

Who was studied?

At three New York City area hospitals, all 356 women with newly diagnosed stage I or II breast cancer who underwent surgery for the cancer from November 1994 through August 1996. Cancer stage is a measure of how far the disease has progressed.

How was the study done?

The researchers compared the information for these women found in the tumor registry with the information collected from a detailed review of all of their medical records.

What did the researchers find?

The tumor registries contained accurate information about the stage of the cancer and type of surgery. However, information about treatment with radiation therapy, hormonal therapy, and chemotherapy was often missing from the registries. This suggests that tumor registries underestimate the proportion of women who received appropriate radiation therapy, hormonal therapy, and chemotherapy.

What were the limitations of the study?

This study involved only breast cancer in only three tumor registries and might not apply to registries at other hospitals. It is also possible that the accuracy of tumor registry data is different for types of cancer other than breast cancer.

What are the implications of the study?

Tumor registries contain fairly complete information about the therapy patients received while in the hospital (for example, surgery). However, registries may miss a substantial amount of information about the types of therapy typically given on an outpatient basis (for example, radiation therapy, hormonal therapy, and chemotherapy). Tumor registries may not provide an accurate picture of the type and quality of cancer care, particularly as more care is delivered in the outpatient setting.