Information Technology as Tools for Cancer Registry and Regional Cancer Network Integration

Background. With the publication of large studies from different health systems comparing survival probabilities, cancer registries are increasingly involved in clinical evaluation research. The changing role of registries strictly depends on the integration between the oncology system and proper information technology (IT) tools. IT is fundamental to improving validity and timeliness of data diffusion when both the number of sources linked and the number of variables registered are on the rise. Aims. In this paper, we present a modern web-based management system that allows to integrate different sources, validate and elaborate data thus providing a new evaluation system for the oncology network based on cancer registries. Materials and methods. We developed a Web 2.0 management system for the Umbria Cancer Registry (S.G.RTUP) based on AMPAX technology (Apache, Mysql, PHP, Ajax and XML) and object-oriented programming. ISO/IEC 27001:2005 standard is followed to ensure security access to the information. The S.G.RTUP architecture is modular and extensible and information consistency is guaranteed by entity-relationship principles. Cancer sites, topology, morphology, and behavior are coded according to the International Classification of Diseases. Classical epidemiological indices for a cancer registry are implemented: incidence, mortality, years of potential life lost, and cumulative risk. S.G.RTUP has tools to prepare data for trend analysis and relative survival analysis. Geographical analysis is also implemented. Results. S.G.RTUP is integrated with the Oncology Network and gives timely epidemiological indices for evaluation of oncological activities. The registration system that we developed can effectively manage different data sources. Automatic importing of routinely available data from pathology archives, screening services, and hospital discharge records will reduce the time needed to produce data and will also allow the expansion of registered information. Several services for data visualization and statistical analysis are implemented. A geographic information system based on Google maps API is used for geolocalization of cases and map plotting of incidence and mortality rates. We implemented Besag York and Mollie's algorithm for real-time smoothed maps. All services can be dynamically performed over a subset of data that the user can select through an innovative filtering system. Discussion and conclusion. IT contributed to shortening all phases of cancer registration, including linkage with external sources, coding, quality control, data management and analysis and publication of results. Integration in the oncology network and secure Web access allowed us to design with clinicians innovative population-based collaborative studies. Our geographic analysis system enables us to develop sophisticated dynamic geostatistic tools.