Abstract
Cancer registrars, including Oncology Data Specialists (ODSs), must interpret complex and frequently updated coding and staging standards. We developed CRISS (Cancer Registry Intelligent Support System), a retrieval-augmented generation (RAG) conversational assistant that provides rapid, citation-supported access to registry guidance. This study evaluated whether CRISS could (1) support accurate and citation-supported responses, (2) improve access to and interpretation of relevant guidance, and (3) support training/helpdesk use while preserving human oversight of final abstraction decisions. We built a domain-specific knowledge base from national cancer registry standards, segmented into metadata-tagged passages and indexed as dense embeddings. Retrieved passages were used to generate citation-grounded responses through a large language model (LLM). Open-weight, proprietary, and non-RAG baseline models across Gemini and GPT families were evaluated on easy, medium, and hard registry questions using an LLM-as-a-Judge protocols. RAG configurations consistently outperformed non-RAG approaches, especially as question difficulty increased. Mean grounding scores for RAG were 0.62/0.56/0.59 across easy/medium/hard tiers versus 0.29/0.26/0.29 for non-RAG. RAG models also achieved higher semantic-similarity scores overall. Proprietary RAG models performed strongest on easy and medium questions, while local RAG models ranked highest on hard questions and proprietary models were generally more cautious. Domain-specific RAG improved evidence grounding and response quality for cancer registry questions while enabling citation-supported assistance across complexity levels. CRISS demonstrates the potential of human-centered, citation-grounded AI to support cancer registrars while preserving human oversight for final coding decisions.
Abstract (translated)
URL
https://arxiv.org/abs/2609.29075
