Background: The National Cancer Database (NCDB) is a hospital-based cancer registry that includes diagnostic, staging, treatment, and outcomes data for newly diagnosed cancer patients in the United States. The NCDB data include 31 million records for patients diagnosed between 1985–2015. A Participant User File based on a subset of these data has been available to researchers at facilities accredited by the Commission on Cancer since 2010. This study aimed to compare the number of incident cancer cases in the NCDB with a national population cancer registry. Methods: Incident cancer cases in the NCDB in 2012–2014 were compared with the number of cancer cases in the United States Cancer Statistics data for the 2012–2014 diagnosis years. Comparisons were made by primary site and other factors. Results: In 2012–2014, the NCDB captured 72% of the cancer cases in the United States, which was slightly higher than the 67% and 69% reported respectively in two prior assessments. Among the top 10 major cancer sites, the highest coverage (80%) was found for breast cancer, and the lowest was found for melanoma of the skin (52%) and prostate (58%). Colon, bladder, and kidney and renal pelvis cancers had relatively high coverage of 71%, 70% and 78%, respectively, whereas lung and bronchus had slightly lower coverage (65%). Conclusions: The NCDB coverage of U.S. cancer cases has remained relatively high (72%), but differences remain by cancer site and other factors that should be taken into account by users of the NCDB data.
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