Background: Meeting a Data Collection Need
Cancer stage is currently collected using three different staging systems with three different purposes and three different sets of rules. Different needs exist for different agencies; for example, TNM provides forward flexibility and clinical utility, SEER EOD provides longitudinal stability for epidemiological studies, and SEER Summary Staging provides data population surveillance.
The three staging systems use different rules for data collection. Timing of data is different among the three systems, and so are rules for integrating clinical and pathological data.
Using three different systems could affect the quality of data, especially when there are conflicting rules. In addition, duplication of effort occurs when multiple data sets on the same patient are collected. Finally, physician staging and cancer registrar staging cannot be compared consistently. Registrars have always reviewed physician staging and revised it when necessary, which increases cost and labor.
These disadvantages will be eliminated with CS, a unified data collection system. Collaborative Staging is designed to provide a common data set to meet the needs of all three staging systems, TNM, SEER EOD, SEER SS, and provide a comprehensive system to improve data quality by standardizing rules for timing, clinical and pathologic assessments, and compatibility across all of these systems for all cancer sites.
Collaborative Stage makes it possible for all registries to collect a unified data set and report to central agencies such as the National Cancer Data Base (NCDB) of the Commission on Cancer (COC), the SEER Program of the National Cancer Institute, and the National Program of Cancer Registries of the Centers for Disease Control and Prevention. Collaborative Staging system converts "objective" data into information that each agency can use in its own way.
The Commission on Cancer approvals program continues to require that the registrar record the stage as the physician has documented in the medical record. This will allow the CoC to assess the need for physician education in staging. It also requires less time for the registrar to abstract.