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. 2016 Sep-Oct;22(5):452-60.
doi: 10.1097/PHH.0000000000000349.

Cost of Operating Central Cancer Registries and Factors That Affect Cost: Findings From an Economic Evaluation of Centers for Disease Control and Prevention National Program of Cancer Registries

Florence K L Tangka  1 , Sujha Subramanian, Maggie Cole Beebe, Hannah K Weir, Diana Trebino, Frances Babcock, Jean Ewing
Affiliations

Cost of Operating Central Cancer Registries and Factors That Affect Cost: Findings From an Economic Evaluation of Centers for Disease Control and Prevention National Program of Cancer Registries

Florence K L Tangka et al. J Public Health Manag Pract. 2016 Sep-Oct.

Abstract

Context: The Centers for Disease Control and Prevention (CDC) evaluated the economics of the National Program of Cancer Registries to provide the CDC, the registries, and policy makers with the economics evidence-base to make optimal decisions about resource allocation. Cancer registry budgets are under increasing threat, and, therefore, systematic assessment of the cost will identify approaches to improve the efficiencies of this vital data collection operation and also justify the funding required to sustain registry operations.

Objectives: To estimate the cost of cancer registry operations and to assess the factors affecting the cost per case reported by National Program of Cancer Registries-funded central cancer registries.

Methods: We developed a Web-based cost assessment tool to collect 3 years of data (2009-2011) from each National Program of Cancer Registries-funded registry for all actual expenditures for registry activities (including those funded by other sources) and factors affecting registry operations. We used a random-effects regression model to estimate the impact of various factors on cost per cancer case reported.

Results: The cost of reporting a cancer case varied across the registries. Central cancer registries that receive high-quality data from reporting sources (as measured by the percentage of records passing automatic edits) and electronic data submissions, and those that collect and report on a large volume of cases had significantly lower cost per case. The volume of cases reported had a large effect, with low-volume registries experiencing much higher cost per case than medium- or high-volume registries.

Conclusions: Our results suggest that registries operate with substantial fixed or semivariable costs. Therefore, sharing fixed costs among low-volume contiguous state registries, whenever possible, and centralization of certain processes can result in economies of scale. Approaches to improve quality of data submitted and increasing electronic reporting can also reduce cost.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Map of US Cancer Registries With Volume of Incident Cancer Cases Recorded by Cancer Registries by Statea
Abbreviation: NPCR, National Program of Cancer Registries. aOur analysis excludes Pacific Island Jurisdictions. The registry did not report cases diagnosed in 2006 and is still ramping up case reporting. Low case volume distorts cost per case calculations. We also exclude SEER (Connecticut, Hawaii, Iowa, New Mexico, and Utah), NPCR-SEER (Kentucky, Louisiana, New Jersey), NPCR states with SEER metro areas (Georgia, Michigan, and Washington), and NPCR states with SEER metro and regional coverage (California) from this study. Shading denotes case volume (low, medium, and high). Patterns denote federal funding sources in place at the time this study began (2009).
Figure 2
Figure 2
Cost Per Case by Volume of Incident Cancer Cases Reported by Cancer Registries, National Program of Cancer Registries (Years 2009, 2010, and 2011)
See this image and copyright information in PMC

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