Casefinding Methods

There are two types of casefinding methods used by cancer registries: active and passive.

• Active casefinding involves cancer registry personnel retrieving all source documents (such as disease indices, pathology reports, radiation oncology, chemotherapy, surgery, endoscopy, radiology, etc.). These documents are then screened to identify reportable cases. The benefit of active casefinding procedures is that this method is more thorough and accurate than passive casefinding. Cancer registry personnel have knowledge of criteria and terminology to recognize reportable cases. Review of each casefinding source requires additional processing time by the cancer registry staff. The cancer registry may lack the staff and financial resources necessary to allow cancer registry personnel to actively review all potential casefinding sources.
  
  
• Passive casefinding occurs when other departments notify the cancer registrar of potentially reportable cases. A concern with passive casefinding is that non-registry staff are not as familiar with reporting criteria and terminology, so potential cases may be missed or incomplete casefinding may occur. For example, non-registry staff could miss the collection of cases with diagnostic terms that may not sound cancerous (such as linitis plastica or Waldenstrom's macroglobulinemia, or even leukemias and lymphomas).
  
  

A combination of active and passive casefinding is a commonly used system in registries today. The registrar must identify the critical casefinding sources that require active review by the registrar, and decide the amount of passive case identification that should be performed. The registrar can then determine which departments can provide high quality casefinding information. An effective combination of active and passive reporting methods ensures more complete cases and reduces labor costs of the registry.

Rapid Case Ascertainment

Efficient casefinding should be an electronic download process of eligible cancer cases into the cancer registry's reporting software. This should be supplemented by a review of source documentation. Timely reporting of tumor information is an important goal for a central registry. Epidemiology, cancer control, and clinical users benefit from speedy access to the most current information.

Automated Casefinding

Recent shifts from hospital settings toward ambulatory health care settings for cancer treatment are increasing the importance of reviewing non-hospital health care providers’ data for cancer surveillance. As health care providers adopt modern Electronic Health Record (EHR) systems, the opportunity to automate cancer registry reporting from health care provider settings also is increasing and becoming more feasible. Certified EHR technology can improve the process by identifying reportable cancer cases and treatments to the provider and facilitating electronic reporting either automatically or upon provider verification [2].

Updated: December 12, 2023