Requirements of CoC / Governing Agencies

Governing agencies have different follow-up target rates and different timelines for considering a patient lost, but the principle of following all alive patients until they die remains critical for providing survival statistics.

The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) requires approved cancer programs to meet or exceed the target rate of 90 percent successful follow-up. SEER cancer registries must meet or exceed 95% successful follow-up. The follow-up rate is calculated on all eligible patients, both living and dead. The successful follow-up rate for eligible living patients is set by the CoC at 80 percent. The table below specifies cases that can be excluded from calculations.

Types of Cases Excluded from Calculations of CoC Follow-up Rates for Approved Cancer Programs:

  • Nonanalytic cases
  • Carcinoma in-situ of the cervix
  • Benign and borderline histologies
  • In-situ and localized basal and squamous cell carcinomas of the skin
  • Foreign residents
  • Patients whose age exceeds 100 years

The CoC considers a case to be delinquent if no follow-up information has been obtained within fifteen months after the date of last contact. An institution may request its registry to follow certain patients with various tumor types, sites, or stages more frequently than annually.

Names of patients who are lost to follow-up (delinquent) should remain in the follow-up system until follow-up is obtained. The follow-up system must be audited periodically to determine that all patients lost to follow-up remain in the system and are continually pursued for current follow-up.

The CoC requests follow-up statistics at the time of an institution survey; the follow-up calculations are part of the survey application. Most registry software systems have a programmed report for calculating these statistics. Click here to view the standard CoC Follow-up Calculations Table.