DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Center for Health and Environmental Data THE COLORADO CENTRAL CANCER REGISTRY 6 CCR 1009-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Adopted by the Board of Health on May 17, 2023. Effective July 15, 2023.

I. General Purpose.

The purpose of this regulation is to establish a statewide cancer registry in the Colorado Department of Public Health and Environment and to provide for the reporting of information relating to Colorado cancer cases to the Department by hospitals, diagnostic and/or treatment clinics, pathology laboratories and diagnosing physicians or other health care practitioners.

II. Cancer Registry Established.

The Colorado Department of Public Health and Environment shall establish and maintain a statewide cancer registry pursuant to Section 25-1.5-101(q)(l), Colorado Revised Statutes. The function of the registry shall be to collect and compile reports of cancer and related data; to make data available upon proper request for release to the medical profession, persons or institutions engaged in treating cancer patients, research studies and other lawful purposes; and to analyze and disseminate appropriate information regarding incidence, diagnosis, treatment, and end results and any other data designed to provide more effective cancer control for the citizens of Colorado.

III. Reporting Required.

The following Colorado health care entities shall report all cases of cancer to the Colorado Department of Public Health and Environment:

1. a) Hospitals (except as noted below)
2. b) Free-standing diagnostic and/or treatment clinics c) Pathology laboratories d) Diagnosing and/or treating physicians or other health care practitioners (except as noted below)

Health care entities shall report information concerning all data, methods of treatment, physician names, and any other required data as determined by the Department Colorado patients diagnosed as having cancer in the form and format as determined by the Colorado Department of Public Health and Environment. Reports shall be in standard electronic format and include the name and address of the patient, demographic information, medical history, environmental factors, date and method of diagnosis, primary site, stage of disease, tissue diagnosis, laboratory. Reporting entities shall submit case reports no later than six months from the date in which the reporting entity first has contact with a patient who has a definitive diagnosis of cancer (clinical or pathologic). 1 CODE OF COLORADO REGULATIONS 6 CCR 1009-3 Center for Health and Environmental Data In lieu of actively reporting cancer cases, Colorado hospitals licensed for fewer than 50 beds and independent from a larger hospital system shall provide authorized Colorado Department of Public Health and Environment personnel 1) electronic medical record indices (or equivalent) of patients with cancer diagnosis codes for the purpose of case finding. Hospitals shall provide the medical record indices in a structured file format to be determined by each hospital in conjunction with CDPHE staff; and 2) access to any medical record or report pertaining to the diagnosis and/or treatment of cancer patients. Colorado hospitals shall allow secure remote access to electronic records. Physicians and other health care practitioners are exempted from actively reporting a new incident cancer case when the cancer patient has been admitted to a Colorado hospital or other Colorado diagnostic or treatment facility for further diagnosis or treatment, or the physician or other health care practitioner has an agreement with a Colorado hospital to report all cancer cases on his/her behalf.

IV. Confidentiality and Release of Reports and Registry Data. All reports of cancer cases received by the Colorado Department of Public Health and Environment, in connection with the registry, from hospitals and the other designated sources shall be and remain strictly privileged and confidential as “medical records AND reports” within the purview and intent of Section 25- 1-122(4), Colorado Revised Statutes.

Such reports and records shall not be released, shared with any agency or institution, or made public upon subpoena, search warrant, discovery proceedings, or otherwise, except under any of the following circumstances:

1. a) Release may be made of medical and epidemiological information in a manner such that no individual person can be identified.
2. b) Release may be made of medical and epidemiological information to the extent necessary for the treatment, control, investigation, and prevention of cancer; except that every effort shall be made to limit disclosure of personal identifying information to the minimal amount necessary.
3. c) Release may be made to the person who is the subject of a medical record or report with written authorization from such person.

The Department may exchange personal data with the National Cancer Institute, the Centers for Disease Control and Prevention, the North American Association of Central Cancer Registries, and any other governmental agency or contractual designee for the purpose of medical or scientific research, provided such entity, governmental agency, or contractual designee shall not further disclose information that is confidential under this section.

The Department is further authorized to acquire cancer data concerning Colorado residents from other states, and, in return, to provide those states with data relating to their residents. _________________________________________________________________________ Editor’s Notes History Entire rule eff. 06/14/2016.

Entire rule eff. 07/15/2023.

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