An accession register is the master index of cancer cases entering the registry. Each case is given a unique accession number when it is abstracted, and the register lists all cases in a chronological, sequential order—often annually—so the registry can track every reportable cancer it includes. This makes it easy to verify completeness, manage retrieval, and link the abstract to source information. It isn’t about patient insurance, hospital admissions, or laboratory test results—those are separate records used for different purposes.

Death clearance is the process of confirming a patient’s death and updating the registry’s records to reflect the correct vital status, usually by linking to external mortality data sources. This approach is a hallmark of population-based registries, where long-term survival data depends on accurate death information from external records. In hospital-based registries, the focus is on cancers diagnosed and treated within the hospital and on in-hospital outcomes. Because of narrower scope and limited resources, systematic, universal death clearance for all cases after discharge isn’t a standard requirement across hospital-based registries. Some institutions may perform it when feasible, but it isn’t routinely mandated for every hospital-based registry. That’s why describing death clearance as always or universally required in hospital-based registries would be incorrect.

Primary casefinding sources are the data sources used to identify new cancer cases based on evidence that a cancer diagnosis has occurred. The strongest of these is pathology reports, because they provide the definitive histology and confirmation of cancer, making them the standard starting point for casefinding. Surgery schedules and reports, while helpful for locating patients who had surgical treatment, do not by themselves confirm a cancer diagnosis. They can reflect procedures for noncancer conditions and, even when cancer surgery is performed, the diagnosis often relies on pathology results. Because of this, surgical schedules and reports are considered supplementary rather than a primary source for casefinding. Other sources like medical and radiation oncology logs and HIM disease indices play important supporting roles: oncology logs help identify treated cases and gather treatment details, while disease indices can aid in retrieving records through coded diagnoses. But they do not replace pathology as the primary, definitive source.

A hospital with an accreditation from the Commission on Cancer must maintain a cancer registry because the program’s credibility and quality improvement rely on complete, accurate cancer data. Accreditation standards require collecting and sustaining registry data for all eligible cancer cases, supporting staging, treatment, follow-up, and ongoing quality measures, and they align with submitting data to the National Cancer Database. So even if state laws touch on reporting, the CoC accreditation itself imposes the registry requirement as part of the program’s core operations.