healthcare providers, and public policymakers use to
combat a common enemy: cancer.
some, her job title sounds scary. But cancer registrar
Suzanna Hoyler does vital work. She compiles information
about cancer cases at the Washington Hospital Center in
Washington, DC. She gathers data that
Suzanna directs the efforts of a small team of cancer
registrars. Their core duties involve case finding,
abstracting, and followup. "With case finding,"
Suzanna says, "we look at every diagnosis of cancer—and
certain benign tumors—and we read pathology reports and
medical records to decide whether a case is suitable for
the registry." Cancer registrars working in a
hospital make registry entries only for patients who were
diagnosed or received a first course of treatment at that
Next, there’s abstracting cases," she says. "That’s
the main job of summarizing the patient’s medical
records. You’re taking English-language medical jargon
and translating it into a coded structure that’s
standard across the country. For example, the code for
lung cancer is C34."
In abstracting a case, a multitude of these specialized
cancer-registry codes are assigned to record demographic information for the patient, type and location of the
cancer, stage of the disease, details and dates of
treatment, and treatment outcomes.
is given in many places,"
Suzanna says, "so a patient might have a biopsy done
in a physician’s office, go somewhere else for a CAT
scan, and then come to us for surgery. We’re required to
get all of that information."
|Cancer diagnosis and treatment involves several
procedures, which often are done at numerous locations.
The cancer registrar obtains information on treatment
provided to a patient at these other medical facilities,
as well. "Medical care
The third component, following up, happens once a year
with every patient who has a record in the registry.
"We do followup," Suzanna says, "by
checking our records to see if patients have been back to
the hospital, by surveying doctors who were active on
cases, and by writing to the patients and asking them how
Hospitals and other healthcare providers must submit
their registry data to be compiled in comprehensive State
cancer registries. The followup information that Suzanna
and other cancer registrars collect about patients allows
State health departments to calculate survival rates for
Other registry data allow public health officials to identify
geographic areas with a high incidence of potentially
screenable cancers diagnosed at a late stage. Based on
such information, screening programs can be developed for
the populations identified so that cancers may be caught
earlier, when they are easier to treat.
Registry data also support cancer research in various
ways. The hospital might be asked to participate in a
study involving clinical trials for treating a specific
type of cancer. "One of the ways we use the
data," Suzanna says, "is to answer the question:
Do we have enough patients that meet the criteria for a
clinical trial?" To find a quick answer, Suzanna
queries the registry data. "This might save
researchers from having to review the medical charts of 400
patients to identify the 20 patients for a study,"
to treat that cancer. This promotes efficiency in
allocating healthcare resources.
Large medical facilities like Washington Hospital
Center also use registry data for business purposes. For
example, Suzanna looks at the data to identify trends in
services provided. If the hospital is increasingly
treating a certain type of cancer, hospital administrators
may decide to invest in expensive medical equipment
The occupation of cancer registrar is a specialty
within the broader occupation of medical records and
health information technician. Suzanna believes cancer
registrars may balance more varied duties and apply more
in-depth knowledge than do medical records and health
information technicians in general.
not always sitting there coding all day," she says of
cancer registry work. "You might do some case
finding, you might do quality control by reviewing
information abstracted by other registrars, you might work
on a special study or report, or you might be abstracting
cases or doing followup. Everything has to get done at a
certain time, but you decide how to manage your
when you read about what tissue the cancer has affected, you can code the stage of disease."
|Suzanna enjoys applying medical knowledge in her job.
She knows which drugs are used to treat cancer and which
others are given to control side effects; she codes the
former in the registry, but not the latter. "You also
really have to understand a pathology report,"
Most people entering the occupation come from among the
ranks of medical records and health information
technicians. They have related work experience and often
have an associate degree in health information management.
These technicians—and sometimes other allied health
workers—learn the specialized knowledge and skills of a
cancer registrar through on-the-job training. A smaller
share of workers attend 2-year programs specifically
designed to train cancer registrars. Eleven schools
currently offer cancer registrar programs approved by the
National Cancer Registrars Association.
Like most cancer registrars, Suzanna has professional
certification, which she gained after passing an exam
given by the association. Candidates must meet minimum
education or experience requirements to sit for the exam.
In addition, registrars must earn 20 hours of continuing
education credits every 2 years to keep their credential.
does not publish employment and
earnings data for cancer registrars.
to the association, Suzanna is 1 of about 3,400
credentialed cancer registrars in the United States. The
Association estimates median earnings for cancer
registrars at between $30,000 and $35,000 per
Bureau of Labor Statistics
Suzanna enjoys her job because, as she says, "I
love data." And she thinks the occupation has a lot
to offer. "For someone who’s detail oriented, self
motivated, and likes a challenge, this work can be very
rewarding," she says, "and I don’t think you
ever stop learning."
Original photos courtesy of