Enabling real-world cancer care quality surveillance and analytics through a novel population-based statewide linked database.

545 Background: Population-based linked datasets are vital tools to generate real-world evidence (RWE) that can inform interventions and policies to improve cancer care quality and outcomes. The novel University of North Cancer Information & Population Health Resource (CIPHR) links statewide cancer registry data, public and private health insurance claims, and provider- and area-level data since 2003, representing more than 80% of North Carolina’s large, diverse cancer patient population. This scoping review included all articles that have used CIPHR data (N=44) to characterize the breadth of RWE generated and to identify further opportunities for population-based care quality surveillance. Methods: Articles published between 2012-2022 were categorized by cancer site(s) of focus, exposure variables, and outcomes examined across the cancer care continuum. For each article, notable results and conclusions were extracted and summarized, including statistically significant associations between patient-level factors (e.g., demographics, clinical variables, insurance type, distance to providers), provider-level factors (e.g., specialties, facility type, networks), system/policy-level factors and outcomes. Results: Of the 44 articles included, findings were reported across 23 unique cancer sites; 9 articles reported results aggregated across multiple cancer sites. Across the cancer care continuum, the majority of articles’ outcomes were categorized as focused on treatment and survivorship (n=25), with most examining treatment initiation and/or adherence (n=13). Other common outcomes included costs of care (n=8) and mortality/survival (n=8). Fewer articles focused on cancer screening (n=2), recurrence (n=1), long-term care use (n=1), or incidence (n=1). The cancer site most frequently examined was breast cancer (n=19), followed by colorectal (n=6), cervical (n=5), and uterine cancers (n=5). The majority of articles focused on racial/ethnic, rural/geographic, and socioeconomic inequities in care and outcomes, as well as multilevel predictors of observed trends. Conclusions: These findings demonstrate the value of creating and sustaining robust, longitudinal, population-based databases to facilitate the generation of RWE that can be used to monitor cancer care delivery trends, including cancer inequities that warrant intervention and policy attention. Lessons learned from more than a decade of analytics utilizing this unique data resource highlight opportunities to explore less frequently studied cancers and outcomes; motivate targeted implementation of equity-focused interventions and policies responding to trends; and inform development of similar resources in other states.