title: Using the National Cancer Database for Outcomes Research: A Review.
abstract: The National Cancer Database (NCDB), a joint quality improvement initiative of the American College of Surgeons Commission on Cancer and the American Cancer Society, has created a shared research file that has changed the study of cancer care in the United States. A thorough understanding of the nuances, strengths, and limitations of the database by both readers and investigators is of critical importance. This review describes the use of the NCDB to study cancer care, with a focus on the advantages of using the database and important considerations that affect the interpretation of NCDB studies.
  
  
  
  The NCDB is one of the largest cancer registries in the world and has rapidly become one of the most commonly used data resources to study the care of cancer in the United States. The NCDB paints a comprehensive picture of cancer care, including a number of less commonly available details that enable subtle nuances of treatment to be studied. On the other hand, several potentially important patient and treatment attributes are not collected in the NCDB, which may affect the extent to which comparisons can be adjusted. Finally, the NCDB has undergone several significant changes during the past decade that may affect its completeness and the types of available data.
  
  
  
  The NCDB offers a critically important perspective on cancer care in the United States. To capitalize on its strengths and adjust for its limitations, investigators and their audiences should familiarize themselves with the advantages and shortcomings of the NCDB, as well as its evolution over time.
authors.affiliation: Section of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Boffa
authors.affiliation: Section of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Rosen
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Katherine
authors.initials: K
authors.lastname: Mallin
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Ashley
authors.initials: A
authors.lastname: Loomis
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Greer
authors.initials: G
authors.lastname: Gay
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Bryan
authors.initials: B
authors.lastname: Palis
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Kathleen
authors.initials: K
authors.lastname: Thoburn
authors.affiliation: American Joint Committee on Cancer, Chicago, Illinois
authors.forename: Donna
authors.initials: D
authors.lastname: Gress
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Daniel P
authors.initials: DP
authors.lastname: McKellar
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois|Department of Surgery, University of Pennsylvania, Philadelphia
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Shulman
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Facktor
authors.affiliation: American College of Surgeons, National Cancer Database, Commission on Cancer, Chicago, Illinois|Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois
authors.forename: David P
authors.initials: DP
authors.lastname: Winchester
mesh_terms: D000570:American Cancer Society; D016208:Databases, Factual; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D018426:SEER Program; D012955:Societies, Medical; D059039:Standard of Care; D014481:United States