One of the challenges to the existing cancer surveillance system is the amount of time and resources needed to identify reportable cancers/tumors and to collect the required information. One part of this challenge is the cancer surveillance system reliance on manual retrieval of information from the medical records (paper-based or electronic), containing the pathology and radiology reports, and the manual entry (or re-entry) of the salient information into the cancer registry database (another software system). The readiness and ability of cancer registry systems to capture information on new diagnostic (e.g. molecular markers) and treatment tools and protocols is also impacted by the over-reliance on this manual process.
An additional challenge that has not been mentioned as frequently is the amount of time cancer registrars spend reviewing and adjudicating information found within reports. A difference in documentation between radiology and pathology reports requires close attention to the rules for collecting the related data item and frequently requires a follow-up to both departments to clarify the discrepancy or ambiguity.