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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

Tangka, Florence K. L. PhD; Subramanian, Sujha PhD; Beebe, Maggie Cole PhD; Weir, Hannah K. PhD; Trebino, Diana MPH; Babcock, Frances CTR; Ewing, Jean MSW, MSHyg

Journal of Public Health Management and Practice: September/October 2016 - Volume 22 - Issue 5 - p 452–460
doi: 10.1097/PHH.0000000000000349
Original Articles
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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.

This study aims at estimating the cost of cancer registry operations and assessing the factors affecting the cost per case reported by National Program of Cancer Registries–funded central cancer registries.

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Tangka and Weir and Mss Babcock and Ewing); and RTI International, Waltham, Massachusetts (Drs Subramanian and Beebe and Ms Trebino). Ms Trebino is currently with Dana-Farber Cancer Institute, Boston, Massachusetts.

Correspondence: Florence K. L. Tangka, PhD, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, F76, Atlanta, GA 30341 (ftangka@cdc.gov).

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Funding support for Sujha Subramanian, Maggie Cole Beebe, and Diana Trebino was provided by the Centers for Disease Control and Prevention (Contract No. 200-2002-00575, Task order 009, to RTI International).

The authors declare no conflicts of interest.

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