I am the sole tumor registrar at a small Commission on Cancer (CoC) accredited facility in the state of Vermont. I have been employed there for over five years. Because I am the only registrar, I am responsible for all the tasks that are involved in maintaining the tumor registry.
When I first started here, I worked 2.5 days at a hospital location and 2 days remotely from my home office. Since the pandemic, I have been working full-time from home. At this time, I can go into the cancer center whenever there is work that needs to be done onsite.
Below are the duties that I perform as the sole tumor registrar:
Case finding/Abstracting: Back in August 2019, I was abstracting at 4-6 months. In December of that same year, I started doing concurrent abstracting. Years ago, when they first started talking about concurrent abstracting, I thought no way. How did they think that was going to happen? Now, I think it is great. When I get the pathology reports each morning, I start an abstract and fill in as much of the information that I can at that time. I have constructed an Excel spreadsheet where I add the patient’s name, medical record number, and site. I go back to it from time to time to add further information to update the case.
Tumor Board: I am responsible for putting the tumor board list together each week. When I go through the daily pathology reports, I select all the reportable new cases and add them to the tumor board list. When I finish the pathology reports from Thursday, I will then send the list to the cancer committee chair at the cancer center. He will then select and/or add cases to the list and send it back to me. I will then send the list out to those on the distribution list. Tumor board is held at 8:00 am on Tuesday morning. I attend the meeting, keep attendance and notes on each of the patients discussed.
Data submission: Monthly I submit our data to the state of Vermont and RCRS. I take care of all corrections and resubmissions of data. Since the change over from RQRS to RCRS, it has taken me some time to figure out the new system. Because I am submitting my data to them concurrently, I get quite a few things that pop up with missing data items. I will then review the patient’s medical record and add any new information that is currently available.
Follow up: This is one of my least favorite tasks. I’m glad that the powers that be decided that we don’t have to follow up on cases before 2004. It makes this task a little bit easier. This is one of the most boring, repetitive tasks I do. It can take me anywhere from one and a half to almost three days to complete. Most months I just do current follow-up. But once a quarter, I will go through some of the older cases to see if there is any recent follow-up.
I have obtained and kept our follow-up rate well above the standard set by the CoC. Another method of follow-up that I use is looking at the weekly obituaries from our local newspaper. And I also get a monthly death list from the state of Vermont.
Cancer Committee: I am a required member of the cancer committee. We meet quarterly. I am also the cancer conference coordinator. At the committee meeting, I give reports on follow-up, site totals and annually I give the cancer conference report.
Annual Report: We still do an annual report. I provide various graphs on the registry data as well as the tumor registry report.
Working in a small community cancer program is not for everyone. It takes a special type of person to thrive in such an isolating and under-resourced environment; I am one of those people. Working as a tumor registrar is challenging, but also very rewarding. My job is not always easy. Some may find it rewarding while others may find it very frustrating. My experience with tumor registries is unique not only because of the setting but also because it represents an area of cancer research that is often overlooked by the medical community at large. While I do not doubt that excellent tumor registrars can be found in large academic centers, working in a smaller program has its unique challenges, and it has been my pleasure to tackle them.