NPCR Standards

Background

All registries funded by CDC's National Program of Cancer Registries (NPCR) are expected to meet established standards. One of these standards requires that central cancer registries submit de-identified cancer data (data from which all information that could identify patients has been removed) to CDC annually.

These data are evaluated for quality, completeness, and timeliness according to the National Data Quality Standard for 23-month data and the Advanced National Data Quality Standard for 12-month data. Data also are evaluated according to the U.S. Cancer Statistics (USCS) Publication Criteria for inclusion in data products, including the Data Visualizations tool and public use databases.

National Data Quality Standard

Data being evaluated for the National Data Quality Standard must meet the following five data quality criteria:

• Data are 95% complete based on observed-to-expected cases computed by CDC.
• There are 3% or fewer death certificate-only cases.
• There is a 1 per 1,000 or fewer unresolved duplicate rate.^A
• The maximum percentage of missing critical data elements are:
  • 2% age
  • 2% sex
  • 3% race
  • 2% county
• 99% pass a CDC-prescribed set of standard computerized edits.^B

Advanced National Data Quality Standard

Data being evaluated for the Advanced National Data Quality Standard must meet the following four data quality criteria:

• Data are 90% complete based on observed-to-expected cases computed by CDC.
• There is a 2 per 1,000 or fewer unresolved duplicate rate.^A
• The maximum percentage of missing critical data elements are:
  • 3% age
  • 3% sex
  • 5% race
  • 3% county
• 97% pass a CDC-prescribed set of standard computerized edits.^B

US Cancer Statistics publication criteria

To be included in data products, central cancer registries' incidence data must meet the following five data quality criteria for all cancer sites combined:

• No more than 5% of cases are ascertained solely on the basis of a death certificate.
• No more than 3% of cases are missing information on age.
• No more than 3% of cases are missing information on sex.
• No more than 5% of cases are missing information on race.
• At least 97% of the registry's records pass a CDC-prescribed set of standard computerized edits.^B

Case ascertainment. After years of analyzing completeness of case ascertainment, CDC has determined that NPCR registries consistently deliver high-quality, complete data. Completeness of case ascertainment calculations were discontinued as a measure of eligibility for publication starting with the November 2016 submission data. Although the completeness estimate is no longer a criterion for USCS, CDC will continue to use it to monitor and evaluate progress in meeting NPCR standards.

See central cancer registries that met publication criteria.

Data are evaluated for the National Data Quality Standard and the USCS Publication Standard 23 to 24 months after the end of the diagnosis year. Data are evaluated for the Advanced National Data Quality Standard 12 to 13 months after the end of the diagnosis year.

Footnotes

^A Because some cancer patients receive diagnostic or treatment services at more than one reporting facility, cancer registries perform a procedure known as “unduplication” to ensure that each cancer case is counted only once.

^B Computerized edits are computer programs that test the validity and logic of data components. For example, if an 80-year-old patient was diagnosed with cancer in 2000, and the patient's year of birth was reported as 1980, a computerized edit could identify these facts as incompatible. The computerized edits applied to cancer statistics data were designed by the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program for use by registries. During the 1990s, these edits were expanded and incorporated into North American Association of Central Cancer Registries (NAACCR) standards and into CDC's EDITS software. Edits, and the accompanying software, are reviewed and updated routinely to maintain consistency with clinical practices and abstracting and coding standards.

^C Edits include single-field, inter-field, and inter-record edits.

^D For the NPCR National Data Quality Standard and the NPCR Advanced National Data Quality Standard, the measurement error for completeness of case ascertainment is 1.0%. The measurement error for records missing age, sex, race, or county is 0.4%.