J Public Health Manag Pract

ContextThe Centers for Disease Control and Prevention evaluated the economics of the National Program of Cancer Registries to provide the Centers for Disease Control and Prevention, the registries, and policy makers with the economic evidence-base to make optimal decisions about resource allocation. Cancer registry budgets are under increasing threat, and, therefore, systematic assessment of the cost will identify approaches to improve the efficiencies of this vital data collection operation and also justify the funding required to sustain registry operations.ObjectivesTo estimate the cost of cancer registry operations and to assess the factors affecting the cost per case reported by National Program of Cancer Registries\ue2\u20ac\u201cfunded central cancer registries.MethodsWe developed a Web-based cost assessment tool to collect 3 years of data (2009-2011) from each National Program of Cancer Registries\ue2\u20ac\u201cfunded registry for all actual expenditures for registry activities (including those funded by other sources) and factors affecting registry operations. We used a random-effects regression model to estimate the impact of various factors on cost per cancer case reported.ResultsThe cost of reporting a cancer case varied across the registries. Central cancer registries that receive high-quality data from reporting sources (as measured by the percentage of records passing automatic edits) and electronic data submissions, and those that collect and report on a large volume of cases had significantly lower cost per case. The volume of cases reported had a large effect, with low-volume registries experiencing much higher cost per case than medium- or high-volume registries.ConclusionsOur results suggest that registries operate with substantial fixed or semivariable costs. Therefore, sharing fixed costs among low-volume contiguous state registries, whenever possible, and centralization of certain processes can result in economies of scale. Approaches to improve quality of data submitted and increasing electronic reporting can also reduce cost.CC999999/Intramural CDC HHS/United States2017-09-01T00:00:00Z26642226PMC489299