The Missouri Cancer Registry and Research Center (MCR-ARC) collects demographic, tumor and treatment information on more than 30,000 new cases of invasive cancer diagnosed among Missouri residents annually. Currently, the MCR-ARC database contains nearly 560,000 invasive Missouri cases diagnosed from 1996 through 2014 (including nearly 30,000 in situ cases) plus more than 300,000 invasive cases diagnosed before 1996. To ensure complete reporting of new cases, MCR-ARC has data exchange agreements with all eight bordering states and 11 other states and conducts linkages with other databases (e.g., Missouri Vital Records, DHSS’s Patient Abstract System (Missouri’s hospital discharge database, Social Security Death Index (SSDI) and the National Death Index (NDI) to capture missed cases and obtain additional information on previously-reported cases.