Childhood cancers are rare diseases and a leading cause of mortality in children. The effective reuse of cancer-related real-world data can accelerate the pace of research discovery. This discussion describes the development of the National Childhood Cancer Registry (NCCR), a component of the National Cancer Institute (NCI) Childhood Cancer Data Initiative (CCDI) data ecosystem that integrates and harmonizes heterogeneous data from multiple sources, including central cancer registries and electronic health records, to augment cancer surveillance and research.

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