title: The cost of cancer registry operations: Impact of volume on cost per case for core and enhanced registry activities.
abstract: BACKGROUND
  Cancer registration data is vital for creating evidence-based policies and interventions. Quantifying the resources needed for cancer registration activities and identifying potential efficiencies are critically important to ensure sustainability of cancer registry operations.
  
  
  METHODS
  Using a previously validated web-based cost assessment tool, we collected activity-based cost data and report findings using 3 years of data from 40 National Program of Cancer Registry grantees. We stratified registries by volume: low-volume included fewer than 10,000 cases, medium-volume included 10,000-50,000 cases, and high-volume included >50,000 cases.
  
  
  RESULTS
  Low-volume cancer registries incurred an average of $93.11 to report a case (without in-kind contributions) compared with $27.70 incurred by high-volume registries. Across all registries, the highest cost per case was incurred for data collection and abstraction ($8.33), management ($6.86), and administration ($4.99). Low- and medium-volume registries have higher costs than high-volume registries for all key activities.
  
  
  CONCLUSIONS
  Some cost differences by volume can be explained by the large fixed costs required for administering and performing registration activities, but other reasons may include the quality of the data initially submitted to the registries from reporting sources such as hospitals and pathology laboratories. Automation or efficiency improvements in data collection can potentially reduce overall costs.
authors.affiliation: RTI International, Waltham, MA, United States. Electronic address: ssubramanian@rti.org.
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.affiliation: RTI International, Waltham, MA, United States.
authors.forename: Maggie Cole
authors.initials: MC
authors.lastname: Beebe
authors.affiliation: RTI International, Waltham, MA, United States.
authors.forename: Diana
authors.initials: D
authors.lastname: Trebino
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Weir
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Frances
authors.initials: F
authors.lastname: Babcock
mesh_terms: D003625:Data Collection / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D020407:Internet; D009369:Neoplasms / Q000453:epidemiology*; D012042:Registries / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Cancer registry; Cost; Economics