The National Cancer Database Conforms to the Standardized Framework for Registry and Data Quality.

BACKGROUND: Standardization of procedures for data abstraction by cancer registries is fundamental for cancer surveillance, clinical and policy decision-making, hospital benchmarking, and research efforts. The objective of the current study was to evaluate adherence to the four components (completeness, comparability, timeliness, and validity) defined by Bray and Parkin that determine registries' ability to carry out these activities to the hospital-based National Cancer Database (NCDB). METHODS: Tbis study used data from U.S. Cancer Statistics, the official federal cancer statistics and joint effort between the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), which includes data from National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) to evaluate NCDB completeness between 2016 and 2020. The study evaluated comparability of case identification and coding procedures. It used Commission on Cancer (CoC) standards from 2022 to assess timeliness and validity. RESULTS: Completeness was demonstrated with a total of 6,828,507 cases identified within the NCDB, representing 73.7% of all cancer cases nationwide. Comparability was followed using standardized and international guidelines on coding and classification procedures. For timeliness, hospital compliance with timely data submission was 92.7%. Validity criteria for re-abstracting, recording, and reliability procedures across hospitals demonstrated 94.2% compliance. Additionally, data validity was shown by a 99.1% compliance with histologic verification standards, a 93.6% assessment of pathologic synoptic reporting, and a 99.1% internal consistency of staff credentials. CONCLUSION: The NCDB is characterized by a high level of case completeness and comparability with uniform standards for data collection, and by hospitals with high compliance, timely data submission, and high rates of compliance with validity standards for registry and data quality evaluation.

Programa de investigación de la calidad sanitaria de los alimentos (ICSA): 30 años de vigilancia sanitaria de los alimentos en Barcelona / The ICSA Program: 30 Years of Health Surveillance of Foods in Barcelona

La Agencia de Salud Pública de Barcelona (ASPB) dispone, desde 1984, del Programa de Investigación de la Calidad Sanitaria de los Alimentos (ICSA) como instrumento para la vigilancia de determinados parámetros químicos y microbiológicos relacionados con el estado sanitario de los alimentos comercializados en la ciudad. Este trabajo analiza la importancia de la vigilancia en salud, particularizando con el análisis de la utilidad y beneficios del programa ICSA. El objetivo principal del programa es valorar si, una vez en el mercado, los alimentos cumplen con la ausencia y/o niveles de tolerancia establecidos para determinados parámetros. No obstante, su carácter abierto permite incorporar o suprimir parámetros o alimentos reflejando nuevos peligros emergentes o intereses más allá de lo legislado. Además, el programa no solo obtiene una visión puntual de los parámetros estudiados en cada edición sino que la acumulación de datos en el tiempo permite evaluar riesgos, realizar cálculos de ingestas de contaminantes a través de la dieta, analizar tendencias, valorar la efectividad de las normativas para la reducción de contaminantes o ayudar en la planificación de programas de control. La información resultante se divulga local e internacionalmente, formando parte de los trabajos de recopilación de contaminantes de agencias de salud estatales y europeas, lo que muestra que es posible desarrollar un sistema de vigilancia a nivel local pero con alcance y objetivos globales y con información útil para gestores, administraciones, operadores económicos y consumidores (AU)

The Food Health Quality Research Program (Investigación de la Calidad Sanitaria de los Alimentos [ICSA]) of the Public Health Agency of Barcelona (Agencia de Salud Pública de Barcelona [ASPB]) was initiated in 1984 to carry out surveillance of certain chemical and microbiological parameters related to the sanitary and safety of foods sold in the city. The present article analyzes the importance of health surveillance and provides details of the uses of the ICSA program. The main aim of this program is to evaluate whether marketed foods comply with the absence and/or established tolerance levels of specific parameters. Nevertheless, the program is able to incorporate or suppress parameters or foods that pose emerging dangers or interests not represented in current legislation. Besides, the program not only obtains a view of the parameters studied at a specific time period in each report, but also accumulates data over time, allowing risk assessment, calculation of dietary intake of contaminants, analysis of tendencies, and evaluation of the effectiveness of regulations to reduce contaminants. The program can also help in the planning of food control programs. The information obtained is disseminated nationally and internationally and is included in dossiers of contaminants issued by national and European health agencies. This demonstrates that a locally-developed surveillance system can have a wider scope and broader objectives and can provide useful information for managers, administrations, economic operators and consumers (AU)

Plan de vigilancia de brotes epidémicos recientes de sarampión y rubeola en Cataluña / Surveillance plan on recent outbreak of measles and rubella in Catalonia, Spain

El sarampión y la rubeola son dos enfermedades inmunoprevenibles. En Cataluña, desde 1988, se administra a todos los niños y niñas dos dosis de vacuna antirubeola y antisarampión con altas coberturas vacunales. Desde 1990 se lleva a cabo el Programa de eliminación del sarampión en Cataluña que contempla alcanzar y mantener un nivel elevado de inmunidad en la población mediante coberturas vacunales altas, una vigilancia epidemiológica intensa y una respuesta inmediata ante la aparición de un caso o un brote. La tasa de sarampión se situó en 2014 en 1,9 casos/100.000 habitantes, destacando los brotes recientes de 2006, 2011, 2013 y 2014, que afectaron a 381, 289, 31 y 124 personas respectivamente. Todos los brotes fueron desencadenados por un caso importado. En el 2011 y 2014 el 6% y 5,5% de los afectados fueron profesionales de la salud. En todos los brotes se observó una amplia variedad genotípica. En el caso del Programa de eliminación de la rubeola, desde el 2002 ha habido 68 casos confirmados de rubeola postnatal y 5 casos de rubeola congénita confirmada. En la vigilancia y control del sarampión y la rubeola, además de reforzar las coberturas vacunales, es esencial la declaración urgente, antes de las 24 horas, de la sospecha y la confirmación por parte del laboratorio de los casos declarados. Respecto a las coberturas vacunales, destaca la necesidad de reforzar la vacunación en el grupo de profesionales de la salud al igual que en otros colectivos no vacunados. En este sentido se aconseja vacunar a todas las personas nacidas después de 1966 que no estén correctamente vacunadas con dos dosis de triple vírica. Asimismo es de destacar que el avance en el estudio de los genotipos aislados permite identificar diversas importaciones procedentes de otros países europeos con brotes activos, aspecto que facilita la vigilancia de estas enfermedades (AU)

Measles and rubella are two immuno-preventive illnesses. In Catalonia, since 1988 all children are given two doses of measles and rubella vaccine with high levels of vaccination coverage. The measles elimination programme has been carried out since 1990 in Catalonia. This programme includes achieving and keeping high immunization levels among population with high vaccination coverage, intense epidemiological surveillance and an immediate response to the appearance of a case or outbreak. In 2014, the measles incidence rate was 1.9 cases/ 100,000 inhabitants. There were 4 recent outbreaks in 2006, 2011, 2013 and 2014 that affected 381, 289, 31 and 124 people respectively. All outbreaks were triggered by an imported case. In 2011 and 2014 measles outbreaks, 6% and 5.5% of affected people were health care workers. All outbreaks presented a great variety of measles genotypes. Concerning rubella elimination programme, since 2002, 68 cases of postnatal rubella and 5 cases of congenital rubella were confirmed. Regarding measles and rubella surveillance and control, in addition to strengthen vaccination coverage, it is essential immediate notification, within the first 24 hours since suspicion and laboratory confirmation. In addition there is a need to enforce vaccination among health care workers as well as in other susceptible and unvaccinated people. It is recommended to vaccinate all people who were born after 1966 and who have not been vaccinated with two doses of trivalent measles-mumps-rubella vaccine. Furthermore, we have to emphasize that the progress concerning genotypes study allows identifying various imported cases from other European countries with active outbreaks, aspect that makes easier the surveillance of these illnesses (AU)

Validation of the prognostic value of new sub-stages within the AJCC 8th edition of non-small cell lung cancer

Background. The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for non-small cell lung cancer (NSCLC) has been released. The current study tried to validate the prognostic significance of the new system among patients registered within the surveillance, epidemiology and end results (SEER) database. Methods. SEER database (2010-2013) has been accessed through SEER*Stat program and AJCC 8th edition stages were reconstructed utilizing the collaborative stage descriptions. Overall and lung cancer-specific survival analyses according to both 7th and 8 th editions were conducted through Kaplan-Meier analysis and multivariate analysis was conducted through a Cox proportional hazard model. Results. A total of 127,096 patients with NSCLC were identified in the period from 2010 to 2013. For overall survival assessment according to the 8th edition, P values for all pair-wise comparisons among different stages were significant (<0.0001) except for the comparisons between stage IB and IIA (P = 0.146); stage IIA and IIB (P = 0.165). For lung cancer-specific survival according to the 8th edition, P values for all pair-wise comparisons among different stages were significant (<0.001). Among patients with stage I disease, multivariate analysis for factors affecting overall and lung cancer-specific survival among patients with stage I disease was conducted. The following factors were associated with worse overall and lung cancer-specific survival: age ≥70 years, more advanced stage, male gender, squamous histology, no surgery and no radiotherapy (P < 0.0001 for all factors). Conclusion. This SEER analysis supports the prognostic significance of the added sub-stages described within AJCC 8th edition stages I and III. Further work is needed to incorporate molecular markers and personalize the future editions of the AJCC staging system (AU)

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Prognosis of patients with thyroid cancer who do not undergo surgical treatment: a SEER database analysis

BACKGROUND: The treatment for thyroid cancer is surgical. However, some patients do not undergo operations because of comorbidities or other reasons. There is little information about the prognosis of these patients. The aim of the present study was to describe patients with well differentiated thyroid carcinoma who did not undergo surgical treatment and to identify differences in prognostic variables and survival compared with patients treated surgically. METHODS: We conducted a retrospective review of a prospective cohort collected by the National Cancer Institute obtained from the Surveillance, Epidemiology and End Results (SEER) Program. All patient files with a diagnosis of thyroid cancer were selected (38,493 cases). Finally, 12,416 cases were used for the analysis. Treatment was divided into surgical or nonsurgical groups. Five-year survival rates were estimated and classified by the SEER stage. RESULTS: Eighty-six patients did not receive surgical treatment. These patients were older, had more advanced tumours and their treatment was less associated with complementary radiotherapy. Five-year overall survival rates were 96.7% for surgical patients vs. 56.8% for nonsurgical patients (p<0.001). The overall survival in the nonsurgery group for localised tumours decreased 14.9%, for regional tumours decreased 49.9% and for distant tumours decreased 61.8%. DISCUSSION: The patients who did not undergo surgical treatment showed less than 5-year overall survival. The SEER database does not offer information about comorbidities that could explain these differences (AU)

Subregistro de las infecciones postoperatorias en el conjunto mínimo de datos básicos (CMBD) / Underregistration of postoperative infections in the Minimun Basic Data (MBDS)

Objetivos: El Conjunto Mínimo Básico de Datos (CMBD) se ha utilizado para estimar la complejidad de los pacientes y elaborar indicadores de calidad, no obstante, se han descrito problemas de calidad y exhaustividad en el mismo. El objetivo de este estudio es evaluar la calidad del registro de infecciones postoperatorias en el CMBD en un hospital de tercer nivel y analizar las variables relacionadas. Métodos: Se diseñó un estudio observacional retrospectivo, en el que se comparó la información disponible sobre infección postoperatoria en el CMBD con la de la base de datos del sistema de vigilancia activa del Servicio de Medicina Preventiva, que se consideró sistema de referencia (gold standard). Se incluyeron todos los episodios de hospitalización en los que el Servicio de Medicina Preventiva encontró una infección postoperatoria. Las infecciones se clasificaron en Infección Superficial de la Herida (ISH), Infección Profunda de la Herida (IPH) e Infección de Órgano/Espacio (IOE). Los criterios diagnósticos utilizados fueron los establecdos por los Centers for Disease Control. Por medio de un modelo de regresión logística, se analizó la asociación entre variables relacionadas con el paciente y el episodio de ingreso, y el registro o no de la infección postoperatoria en el CMBD. Resultados: El sistema de vigilancia registró 300 casos de infección postoperatoria, con una incidencia acumulada anual de 2,8 por ciento. De ellas 219 correspondían a IHS, 27 a IPH y 54 a IOE. En 172 casos (57,3 por ciento) no aparece el código de "infección postoperatoria" en el CMBD. Esta proporción es el 57,5 por ciento en la ISH, el 44,4 por ciento en la IPH y el 63 por ciento en las IOE. En el modelo de regresión logística incluimos el servicio que da el alta y el tipo de infección. Conclusiones: Existe un importante subrregistro en el CMBD de las complicaciones infecciosas asociadas a la cirugía. No encontramos ninguna variable claramente relacionada con el registro de la infección postoperatoria. El diseño de estrategias de intervención nos llevarían a mejorar la calidad de los informes médicos y el correcto registro de las complicaciones infecciosas. Estas estrategias deberían estar dirigidas a los servicios con mayor margen de mejora en el índice de case-mix y peor calidad de información clínica recogida en el CMBD (AU)