After identifying a potential case for the registry from a casefinding source, the registrar assesses whether the case is reportable, is already reported (and is already in the registry database), or could potentially be recorded in a file of non-reportable cases.
The suspense file contains information on cases that are potentially reportable. The suspense file can be maintained in at least two ways:
- By entering the case into a computerized registry database, which has a suspense file designed into it
- By filling out brief identifying information on a paper abstract, and filing it in alphabetical order.
The suspense file should be reviewed periodically to ensure that cases are completed promptly. Cases entered into the suspense file but later determined not to be reportable are moved to the history file of non-reportable cases. Reportable cases are eventually moved to the master patient index file.
When entering a case into the suspense file, registry personnel should include data elements required by the governing body. Hospitals participating in the approvals process by the Commission on Cancer of the American College of Surgeons must include the patient name, patient identifier, date of diagnosis, and primary site. Another option is to also include an identifier to indicate the location of the source document. This enables the registrar to more accurately record necessary identifying information in the suspense file as the patient moves through various hospital departments and is identified in multiple casefinding sources.
During the review of source document information, the registrar may discover that the patient is already in the registry's patient index file for the same primary cancer. If the source document indicates that this is a new primary, the case should be added to the suspense file so that the patient's health record can be reviewed to complete the documentation on the newly identified subsequent primary.
If, after review of the health record documentation, the registrar determines a case to be either a history case (i.e., no active disease or treatment) or a non-reportable case (for example, if the health record does not support the malignant disease code found on the hospital's disease index), the case should be maintained in the file of non-reportable cases to prevent repeated pulling and review of the same health record.
Registries that cannot maintain the file of non-reportable cases in their computerized registry system can use a separate database, spreadsheet, or word-processing program. These programs should allow the registrar to search the file by name, health record number, or social security number.