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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

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Breast Cancer Surveillance Consortium (BCSC): sponsored by the National Cancer InstituteCancer 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


Flashback to pre bcsc
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


Breast Cancer Screening Process

PROCESS SURVEILLANCE

OUTCOME SURVEILLANCE

Patient Factors

Screening Examinations

Diagnostic Evaluations

Intermediate Outcome

Treatment

Long-term Outcome

Surveillance Systems for Routine Clinical Practice


Screening registries should be
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


The cornerstone infrastructure common data elements
The Cornerstone:Infrastructure & Common Data Elements

GHRI

Reporting

Data Management /

Warehouse

SFMR

SCC Consolidated Data

CMR

Map

NHMN

Data

Analysis

VBCSS


Registry data collection methods
Registry Data Collection Methods

Pathology

Reports

(abstracted)

Women’s

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



Foundation for infrastructure
Foundation for Infrastructure

Women

Facilities

Providers


Fostering participation
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


Data collection innovations
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


Built in reporting
Built-in Reporting

From: Geller B.


Confidentiality legal infrastructure
Confidentiality & Legal Infrastructure

  • Federal Certificate of Confidentiality

    • strongest protection

    • tested in court

    • protects providers and patients


Screening in cancer control
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_figures.html

Improved Breast Cancer Screening

Practices


Expanding the Utility of the BCSC

Medicare

Claims

Ovarian

Cancers

New Technologies


Thank You to the

National Cancer Institute


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