Cancer Record Support Unit

Collecting and reporting the data on patients with cancer are required for correctly identifying the greatness and features of cancer which varies geographically, in each country. The widespread computer usage has enabled these systems to be developed easily and worldwide standard recording systems to be established. In our country, difficulties exist in operating recording systems rather than installing them, and even in hospital-based activities, the cancer records are lower than expected. These difficulties result from the differences of data collecting orders between the different sections within the hospital and the procedure of filling form is not included within the procedures when each patient comes. Reaching the collected data in different sections by cancer record staff who are trained especially for this purpose, controlling the data with computer network and completing the deficiencies, transferring the collected data to the cancer record system in certain intervals will considerably eliminate these problems.

Cancer Record Systems, are the systems developed for the data of cancer patients to be collected, saved, analyzed, interpreted and notified systematically. It is unquestionable that a regular cancer record system will have a big contribution to any kind of researches on cancer cases. Especially in prospective researches, when the losses in unacceptable ranges in patient follow up phase in developing countries are taken into account, even the contributions on following up shows that the cancer record systems are significant requirements. Furthermore, in our time that the health care policies gain importance, the reliable databases have made great contribution on planning health care services. The activities which the computer usage is put into service in hospital administration to the best advantage, exist in the literature. Cancer record systems are separated into two: hospital-based and population-based. Hospital-based cancer record systems are constituted at hospitals and includes only the information related with the cancer patients that are examined in that hospital. Their purpose is to contribute to the hospital services by enabling easy access the data such as treatments applied for patients with cancer and the results of treatments. Population-based cancer record systems collect the data related with all patients with cancer among an identified population. Population-based cancer record systems offer service especially on epidemiology and public health, through enabling the presentation of incidence and mortality rates.

Population-Based Cancer Record Systems

This kind of systems should distinguish the natives and non-natives of a certain region. They should also contain sufficient data on each case, to prevent multiple records to exist on the same case. All health care sections and health care personnel to have collaboration is a significant element for a well-functioning cancer record system. Obtaining reliable and prevailing information will be possible only with such a collaboration. Since the population-based cancer record systems concern about each new cancer case and it use it to define the population under risk, censuses that present age and gender information for the region correctly are necessary.

The dataflow to population-based cancer record systems arise from the following sources:
• Data obtained from treatment services; cancer centers, large hospitals, private clinics, nursing homes, practitioners.
• Data obtained from diagnosis centers; especially pathology laboratories, hematology, biochemistry and immunology laboratories.
• Death certificates and death record systems.

Information is obtained from these sources with two methods. Active Collection: In this record system, collection is performed by relevant personnel to visit data sources regularly and to collect the required data on related forms. Passive Notification: It is performed by healthcare services personnel to fill the forms that are developed and delivered by record system or to send the copies of patient epicrises to the record center. The data collected with both methods are used in record systems. Medical Record Sections at hospitals are also among the important record sources.

A different "cancer record number" is given by record system for each case. If a patient has more than one primary tumor, different record numbers for each tumor should be registered. Name-surname, gender, age and address are the important basic information. Address is particularly important for the purpose of determining the conditions of living place and following up. Age is a valuable determinant for defining the cancer incidence. The date that the cancer exists, should be considered as the date that the patient's first apply to hospital due to cancer or the date that the consultation is requested, thus the data should be able to be controlled when needed.

If this information cannot be obtained only following dates can be used as the date of existence: diagnosis date, date of first pathology report, death date if the cancer is firstly realized with death certificate or autopsy. Asking the prevailing diagnosis method enables evaluating the reliability of incidence rates. At least whether the diagnosis is made microscopically should be recorded. It is necessary to define the localization and the morphology of the tumor in accordance with the ICD-O (International Classification of Diseases - Oncology) classification. The location of the primary tumor in tumor localization should be stated. This data is the most significant information that is recorded and it constitutes the base of cancer record system data classification. The morphology code used in ICD-O classification defined the histological type and behavior of the tumor.

How much the disease spreads before treatment, treatment methods and various follow up criteria are among the items that are optional to be recorded in the database. A detailed code list about the source that the data is obtained should be in each cancer record system.

Population-based cancer record systems should publish the obtained indications and results in cancer incidence reports, certain private reports and scientific journals as articles and should convey the collected information to users. These reports should contain the features of cancer record system, record methods, definitions of included population and residential area, statistical methods and indications. The data should be presented with tables and graphic methods.

The epidemiological researches in each line are able to obtain support of the data of cancer record systems, in terms of their definitions.

Hospital-based Cancer Record Systems

Hospital-cased cancer record systems and Medical Record Sections are the basic elements of hospital-based data systems, which are commonly benefited in establishing and evaluating the needed cancer services at hospitals. One of the most important sources of well-operating population-based cancer record systems are also hospital-based data systems. The Medical Record Sections among them, are the sections that should be present at each hospital are established in all developed countries to be used for preserving all hospital records, for reapplying and for analyzing. In developing countries, these sections are quite restricted and generally they are stores in where bulks of printed records are kept. The necessity of the centers in where the hospitals records are kept in preplanned, reliable and coded manner, are also felt in our country. Furthermore, these sections create significant resources for other privatized systems, such as hospital-based cancer records systems.

Hospital-based cancer record systems offer services for the hospital administration, cancer program of the hospital and the cancer patients. It is also one of the sources of population-based cancer record systems.

Hospital-based cancer record systems give information on the localization of cancer types, incidence age, phase distribution, treatment methods, responses to treatments, paces of life by creating reports on the cancers observed within the year. These data are used in determination of prospective treatment, material and personnel requirements. It has also considerable contributions to cancer researches in clinic and patient follow ups.

In addition, hospital-based cancer record systems set a good model for population-based systems in determining, summarizing, coding and analyzing activities of cases. Establishing standard systems will enable the cancer information to be compared by hospitals in different regions.

The patient records of below mentioned departments are aimed in Hacettepe University Cancer Record System.
• Neurosurgery
• Dermatology
• Adult Hematology
• General Surgery
• Chest Diseases
• Chest Surgery
• Ophthalmology
• Gynecology and Obstetrics
• Cardiovascular Surgery
• Otorhinolaryngology
• Medical Oncology
• Nuclear Medicine
• Orthopedics and Traumatology
• Pathology
• Pediatric Surgery
• Pediatric Hematology
• Pediatric Oncology
• Pediatric Pathology
• Plastic and Reconstructive Surgery
• Radiation Oncology
• Urology