Breast Cancer Surveillance Consortium (BCSC): sponsored by the National Cancer Institute Cancer Screening Surveillance in Clinical Practice

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Breast Cancer Surveillance Consortium (BCSC)
sponsored by the National Cancer Institute
Cancer Screening Surveillance in Clinical
Practice
Tracy Onega, PhD Director, NH Mammography
Network, Assistant Professor of Community
Family Medicine Dartmouth Medical School the
Norris Cotton Cancer Center
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Flashback to pre-BCSC..

• Circa early-mid 1990s.
• No understanding of screening mammography
  process or quality
• MQSA passed to ensure standardized delivery of
  quality mammography services
• NCI responded to legislative mandate by
  establishing surveillance system to provide
  reliable and comprehensive performance data

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Breast Cancer Screening Process
Patient Factors
Screening Examinations
Diagnostic Evaluations
Intermediate Outcome
Long-term Outcome
Treatment
Surveillance Systems for Routine Clinical
Practice
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Screening Registries Should Be..

• Integral to clinical care processes
• Population based / part of consortia
• Interdisciplinary
• Longitudinal
• Informing and Improving
• Patients lives
• Provider care
• Evidence-based guidelines
• Tailored screening approaches
• Research

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The CornerstoneInfrastructure Common Data
Elements
GHRI
Reporting
Data Management / Warehouse
SFMR
SCC Consolidated Data
CMR
Map
NHMN
Data Analysis
VBCSS
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Registry Data Collection Methods
Pathology Reports (abstracted)
Womens Questionnaire (filled out at time of
mammogram)
State Cancer Registry
Radiologist/ Rad Tech Form (filled out at time
of mammogram)
Vital Status (DHHS)
Radiologist Info
Facility Info
Registry Database
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Cancer Care Continuum BCSC Resources
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Foundation for Infrastructure
Women
Facilities
Providers
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Fostering Participation

• Voluntary registries how to develop maintain
  buy-in?

MQSA, quality measures, benchmarking
Facilities Clinicians Patients
Performance feedback Relationships
Disseminating findings, Electronic data
capture, Rad tech support
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Data Collection Innovations

• Software for clinical data collection
• Tablet PCs
• Integration with electronic health records
• Continuous breast density
• Digital image collection
• Standardized data elements for new modalities
• Built-in reporting

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Built-in Reporting
From Geller B.
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Confidentiality Legal Infrastructure

• Federal Certificate of Confidentiality
• strongest protection
• tested in court
• protects providers and patients

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Screening in Cancer Control
Concept Map Showing Priority and Thematic Areas
of Research for the Applied Cancer Screening
Research Branch at NCI

• http//cancercontrol.cancer.gov/acsrb/priorities_f
  igures.html

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Expanding the Utility of the BCSC
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Thank You to the National Cancer Institute