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New Survey Initiative For 2009 Announced
All currently accredited cancer programs being surveyed in 2009 will be participating in an educational chart review initiated by the Commission on Cancer. The review will use data submitted to the National Cancer Data Base. Surveyors will be confirming compliance with selected measures from the Cancer Program Practice Profile Reports (CP3R v2) on randomly selected measures and charts from 2006. The surveyor will specifically appraise the accuracy and completeness of tumor characteristics and adjuvant treatment information that is recorded within the cancer registry.
Three weeks prior to the survey, the cancer registrar will receive an e-mail generated from the Survey Application Record (SAR) advising him or her, to go to Standard 4.6 in the SAR and print the list of charts that will be reviewed by the surveyor. The maximum number of charts for this particular review is 25. The registrar should obtain these records or provide access to the electronic medical record and flag any pertinent documentation; a complete abstract should be printed for the surveyor to review.
At the conclusion of the survey day, the surveyor will comment on the results of this particular review and his or her findings. The findings do not affect the compliance rating for this standard.
Please keep in mind the fact that the surveyor will also be reviewing 30 abstracts from the last two completed years and the current year to establish a rating for Standard 3.3 (abstracting timeliness) and Standard 4.6 (CAP compliance). Only the condensed abstract and printed definitive pathology report are necessary for this review. Please assist in the process by highlighting the date of first contact and the date the record was abstracted.
The Commission on Cancer will be posting a Frequently Asked Question (FAQ) related to this new initiative on its Website in the near future. For questions or concerns regarding this new initiative or if you do not receive an e-mail three weeks prior to your survey date, please contact Lisa Landvogt at llandvogt@facs.org or (312) 202-5314.
Upcoming CoC Exhibits
The Commission on Cancer (CoC) will be exhibiting at the following meetings in May:
Oncology Nursing Society (ONS)
April 30 - May 5
Henry B. Gonzalez Convention Center
San Antonio, TX
Staff: Greer Gay
Association of Oncology Social Work (AOSW) 25th Anniversary
May 6 - 8
Hyatt Regency
Savannah, GA
Staff: Nina Miller
National Cancer Registrars Association (NCRA)
May 31 - June 3
Sheraton Hotel
New Orleans, LA
If you are attending these meetings, stop by the booths to speak with staff and see the new materials the CoC has to offer.
Have You Released FIPS 2007 Level II Data?
Thank you to the 370 facilities that have reviewed and released the 2007 FIPS Level II Data. There are still 975 facilities listed in draft form (data not reviewed).
Level II data are important:
Level II data are cancer cases diagnosed at your facility as submitted to the National Cancer Data Base (NCDB). These cases are categorized by site and stage and then displayed in the Facility Information Profile System (FIPS).
The FIPS program is a free tool for your facility to use in providing the public with data to aid in treatment decisions. This data-sharing project is exclusive to Commission on Cancer accredited facilities. Patients can access this data through the American Cancer Society (ACS) Hospital Locator.
To review and release Level II Data:
- Speak with your cancer committee about releasing this data.
- Enter FIPS through CoC Datalinks at https://web.facs.org/datalinks/.
- Click on the link titled “Level II: Cases Reported to the NCDB by Site and Stage.”
- Review the data table for accuracy.
- Indicate your facility’s decision by choosing one of the three buttons.
- Accurate Release to ACS
- Accurate Do Not Release to ACS
- Inaccurate Do Not Release to ACS
Remember, the deadline to review and release is June 30, 2009. Questions? Contact CoC@facs.org.
CoC FORUM for Cancer Registrars at NCRA
The CoC will host a FORUM for cancer registrars from CoC-accredited cancer programs on Sunday, May 31, 2009 from 4:30 PM to 6:30 PM. One registrar from each CoC-accredited cancer program has been invited to attend and participate in a dialogue and exchange of information and ideas about their facility’s participation in the CoC Accreditation Program. The registration deadline is May 15.
To register, go to: http://www.surveymonkey.com/s.aspx?sm=z0N6GqLXYs_2b3ArjeFtVWtw_3d_3d
Confirmations will be emailed within two weeks following registration. Questions can be directed to CoC@facs.org.
2009 SAR Instruction Guide Now Available
The “2009 SAR Instruction Guide” and “SAR Tips” sheet are now available online.
The new Instruction Guide is a screen-by-screen guide that provides instructions on how to complete the various fields throughout the Survey Application Record (SAR). It was written to correspond with the 2009 SAR. Click on the “SAR Instruction Guide” link and select from the informational front matter and/or from each of the chapters as listed in the Survey Application Record and the Cancer Program Standards 2009, Revised Edition.
The “2009 SAR Tips” sheet is an informational document that provides clarifications, definitions, maximum line and/or text entry, etc. to assist you in understanding what information is needed to complete the specific fields throughout the SAR. The “Chapter 4 Definition” sheet provides definitions for the treatment services that are recorded in Chapter 4. These definitions assist with completing and understanding the various fields throughout this chapter and were previously included in the SAR Training Guide.
The guide, tip sheet, and definition sheet can all be found at http://www.facs.org/cancer/coc/surveyresources.html. They are also available through the CoC Datalinks Activity Menu and the SAR menu (password-protected sections).
Looking Ahead Toward Next Fall’s NCDB Call For Data
Next fall’s NCDB Call for Data will begin on September 1. The submission years covered are 2008, 2003, 1998, 1993 and 1988. The deadline for initial submission of cases will be November 1 and the deadline for resubmitting cleaned cases for 2003 and 2008 will be June 1, 2010. A formal announcement will be sent to programs in August. A Webinar, “Preparing for This Year’s Call for Data”, is scheduled for August 12; for details see: http://www.facs.org/cancer/coc/coceduc.html.
Standard 3.7 was revised in 2008 for implementation in 2009 to read “Annually, cases that were diagnosed in 2003 or more recently meet the established quality criteria and resubmission deadline specified in the annual Call for Data.” Standard 3.7 applies specifically to cases submitted for the Call for Data, not to cases submitted as updates to CP3R or other NCDB applications. This year, cases diagnosed in 2003 and 2008 – including cases diagnosed prior to 2008 but not seen until 2008 – must be cleaned. Both data years must be clean at initial submission to qualify for commendation on Standard 3.7. The standard was revised because cases diagnosed in 2003 were subject to the 3.7 requirements when they were initially submitted in 2004; the revised standard ensures that the quality of those data is maintained at the program level and in NCDB.
Over the past few weeks, the NCDB held conference calls with registry software providers to provide them with the information they need to prepare for data submission this fall. NCDB’s submission edit metafile was distributed at that time to provide them with maximal time to include it with their routine software updates. The edits and all submission instructions will be available for registrar use in June on the NCDB’s data submission Web site: http://www.facs.org/cancer/ncdb/datasubmission.html.
Programs that are not already using the current NAACCR Hospital standard edits to clean cases as they are abstracted can prepare their cases now by using the edit sets described at http://www.facs.org/cancer/ncdb/newlyabstracted.html.
These edits are what will be used for the Call for Data.
A new transmission layout will be used to submit cases to NCDB in 2010. It will be distributed to programs by software providers around the end of the year. NCDB will accept either the current layout (version 11.3) or the 2010 version (12.0) for resubmissions from January 1, 2010, through June 1, 2010. Programs should not delay their 2010 software conversions if they have outstanding cases to clean and resubmit.
Two Helpful Registry Manual Resources Now Available
Two registry resources updated for 2009 are available for download now: the full FORDS Revised for 2009 and Registry Plus Online Help.
1. The full pdf version of the FORDS document is enabled for editing, therefore you may add electronic sticky notes, highlight, and write comments – just as someone might in a paper document. Its Bookmarks section is hyperlinked for instant access to any portion of the book. As with any electronic document, it is also possible to search for key terms. Of course, for those who prefer to use a paper document, it can be printed. No paper manuals will be distributed for FORDS Revised for 2009. Individual sections designed primarily for ease of printing are available. They are not enabled for editing like the full document. Some minor editing changes have been made to them since they were originally posted in December. Those changes are included in the full FORDS document.
Download FORDS Revised for 2009 or its individual sections at http://www.facs.org/cancer/coc/fordsmanual.html.
FORDS Revised for 2007 has been relocated to http://www.facs.org/cancer/coc/fordsmanualolder.html.
2. The incredibly useful Registry Plus Online Help tool has been updated to include material from FORDS Revised for 2009 and the current versions of all other cancer coding manuals, plus descriptions of all current standard edits. This free application is produced and distributed by the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC). The free-standing version is easy to download and install, and no registrar should be without it. Online Help works like the Bookmarks section of the full FORDS Revised for 2009, and it has hyperlinks connecting related pages of the various cancer manuals for easy reference. It also has search capabilities. Its descriptions of current standard edits are not readily available in any other publication, and in this tool they are hyperlinked to relevant material in the coding manuals.
To download Registry Plus Online Help, go to http://www.cdc.gov/cancer/npcr/tools/registryplus/.
Select “Online Help” under “Registry Components”, then select “Technical Information and Installation”.
With this great tool at your fingertips, you will be ready to interpret all of the most current edits when you abstract your cases. For information on which edits to use as you abstract, see http://www.facs.org/cancer/ncdb/newlyabstracted.html.
Web Page Updates For Current Edits
The standard edits for use with newly-accessioned cancer cases were updated in January, and the web page that describes them was modified recently. These are the edits that NCDB will use to form its submission edit metafile next fall. Most registries can expect that these edits will be incorporated into their next software updates. They also can be downloaded for use with GenEDITS Plus.
See http://www.facs.org/cancer/ncdb/newlyabstracted.html.
New edits most likely to affect CoC Accredited programs are described below. See “NAACCR 11.3A Metafile Changes” under “Current Metafiles” at
http://www.naaccr.org/index.asp?Col_SectionKey=7&Col_ContentID=136
Primary Site, Morphology-Type,Beh ICDO3(COC)
Edits site/histology/behavior fit instead of just site/histology; will be used by CoC for 2009 and later diagnoses. A version of this edit is already being applied in some population registries. The former site/histology edit will continue in use for cases diagnosed prior to 2009.
CS Extension, Brain Schema (CS)
If Primary Site = C71.1-C71.5 (supratentorial), then CS Extension must not = 11, 12, 20, or 51 (infratentorial tumors); if Primary Site = C71.6-C71.7 (infratentorial), then CS Extension must not = 10 or 50 (supratentorial tumors)
CS Extension, Mycosis Fungoides Schema (CS)
For the Mycosis Fungoides and Sezary Disease schema, per Note 2 for CS Extension: Use code 25 when skin involvement is present but only a general location/site is mentioned (i.e., face, legs, torso, arms). Use code 30 when there is skin involvement with no mention of location/site.
CS Lymph Nodes, SSF3, Nodes Eval, Melanoma (CS)
Compares CS Lymph Nodes, CS Site-Specific Factor 3 (Clinical Status of Lymph Node Mets), and CS Reg Nodes Eval for the Melanoma of Skin schema.
CS Mets at DX, Lung, Laterality (CS)
Verifies that, for bilateral lung cases, CS Mets at DX is coded to bilateral as well.
CS Reg Nodes Eval, Lymph Nodes, Breast Schema(CS)
Checks that, for Breast Schema cases, CS Lymph Nodes and CS Reg Nodes Eval are coded consistently per Note 3 under CS Lymph Nodes.
CS SSF 6, Tumor Size, Breast Schema (CS)
For the Breast Schema, checks that Site-Specific Factor 6 (Size of Tumor – Invasive Component) and CS Tumor Size are coded consistently. (1) If CS Site-Specific Factor 6 = 020, 030, 040, or 050, then CS Tumor Size must not = 999; (2) If CS Site-Specific Factor 6 = 060, then CS Tumor Size must = 999; (3) If CS Tumor Size = 990, then CS Site-Specific 6 must = 020.
CS TS/Ext Eval, Surgery, Bladder Schema (CS)
For the CS Bladder schema, if RX Summ--Surg Prim Site = 10-27, then the CS Tumor Size/Ext Eval must not = 3, 5, 6, or 8.
Derived SS2000, Behavior ICDO3 (CS)
(1) If Behavior Code ICD-O-3 = 0 or 1, then Derived SS2000 must be 8; (2) If Behavior Code ICD-O-3 = 2, then Derived SS2000 must be 0; (3) If Behavior Code ICD-O-3 = 3, then Derived SS2000 must not be 0. Edit may apply if Behavior or a CS input item is changed but the CS algorithm is not rerun.
Do You Still Have NCDB Cases to Correct?
Now is the time to take care of any NCDB data-cleaning you need to do before the June 1, 2009, deadline arrives. All rejected records and all 2007 cases with edit problems must be corrected and resubmitted by that date for compliance with Standard 3.7. If you have not done so already, double-check that everything went smoothly in your latest submission and take care of anyremaining problems.
Only submissions and resubmissions made by June 1 will be included in next Fall’s updates to the Benchmark and Survival reports and to the CP3R tool. Those reports are run from a static copy of the database created after cases submitted by June 1 have been completely processed and cannot be updated subsequently.
Finally, if any corrections are needed for your 2007 FIPS Level II tables, those also must be submitted by June 1. The FIPS Level II tables will be rerun once after all cases have been processed.
Remember: June 1 … or do it NOW!
New ACS-CAN Partnership Information
New documents on the Commission on Cancer-American Cancer Society Cancer Action Network (ACS CAN) landing page located at www.acscan.org/coc offer a brief outline of the mission of the ACS CAN, its relation to the Commission on Cancer (CoC), and how the two can work in partnership to achieve their common goal of defeating cancer.
Documents cover the following topics:
- The background, function, and organizational goals of ACS CAN
- A sample e-mail text drafted as a basic solicitation to join ACS CAN to forward to colleagues, friends, or family to draw support and advocacy involvement
- An ACS CAN membership form tailored for CoC members
- A FAQ sheet for CoC members answering basic questions about ACS CAN's purpose, its membership program, and how involvement with ACS CAN could help further the mission of the CoC
- An ACS CAN/CoC PowerPoint presentation describing how involvement with ACS CAN furthers the mission of the CoC by reviewing CAN goals, successes, and benefits as a membership organization
- ACS CAN's top federal priorities for 2009, giving an overview of what we are fighting for in Congress given today's political environment and the current state of key legislation
- A health care reform background sheet summarizing why health care reform has become a major goal, what we hope to achieve with our efforts, and how we plan to do so
- A health care reform one-pager that offers some direction to new members and advocates on what they can do to proactively support health care reform—a series of simple activities that can make a huge impact in lawmakers' decisions
- The ACS CAN 2007 Accomplishments Report, a comprehensive overview of the organization's 2007 goals, advocacy events, awards, state-specific victories, and the names of our major personal and corporate donors over the year
The 2008 Accomplishments Report will be posted soon. The above items can serve as a thorough introduction to ACS CAN and its mission, and showcases the positive impact of the ACS CAN and CoC partnership.
New 2009 CoC Educational Webinars Now Available
In April, the CoC launched the 2009 CoC Online Education Portal where individuals can participate in both live and archived Webinars. Register and view all new topics at: http://www.facs.org/cancer/coc/coceduc.html.
The next Webinar, "Standard 4.3: Stage and Treatment Planning", will take place on Wednesday, June 17 at 10:00AM Central.
NAPBC Announces Accredited Centers, Receives Local Media Attention
The National Accreditation Program for Breast Centers (NAPBC) announced on April 7, 2009, the inaugural group of centers it has accredited, and the announcement has attracted media attention across the country. The inaugural group consists of 23 centers from 13 states, many of which celebrated their NAPBC accreditation by hosting press conferences to inform their communities of this accomplishment.
The Virginia Hospital Center in Arlington, VA, was among the first to receive NAPBC accreditation. David P. Winchester, MD, FACS, NAPBC chair, was invited to the hospital’s press event, and in an interview with WMAL News in Arlington he said: “Accreditation by the NAPBC means that the center has all the specialists and processes in place that ensure streamlined, state-of-the-art evaluation and management of patients with diseases of the breast, particularly breast cancer.”
Since announcing this accreditation program to the public via the distribution of a national press release on April 7, the NAPBC has heard from more than 900 centers in the United States interested in pursuing NAPBC accreditation. To read the NAPBC press release, visit http://www.accreditedbreastcenters.org/news/news.html.
For more information and to see a complete list of the NAPBC-accredited centers, visit http://www.accreditedbreastcenters.org/.
Upcoming NAPBC Exhibits
The National Accreditation Program for Breast Centers (NAPBC) will be exhibiting at the following meeting in May:
National Cancer Registrars Association (NCRA)
May 31 - June 3
Sheraton Hotel
New Orleans, LA
If you are attending this meeting, stop by the NAPBC booth to speak with Cindy Burgin and see the new materials the NAPBC has to offer.
SAVE-THE-DATE – The AJCC Prepares for Personalized Medicine: Molecular Markers Meet Anatomic Staging
Founded in 1959, the AJCC maintains clinically relevant staging systems used worldwide. Cancer staging is evolving into the molecular era. While anatomic extent of disease will remain a key component of cancer staging, increasingly non-anatomic factors, including molecular markers of prognosis and response to therapy, will be identified that must be incorporated into clinical practice and staging.
As part of its 50th Anniversary celebration, the AJCC will host an annual state-of-the-science conference on September 11-12, 2009, at the Marriott Baltimore Waterfront Hotel in Baltimore, MD.
Keynote speaker Francis Collins, MD, PhD, former director of the National Human Genome Research Institute (NHGRI) at the National Institutes of Health (NIH), will set the stage for the conference featuring leaders in the science who will:
Intended audience - Cancer researchers and scientists, oncologists, statisticians, surveillance professionals, cancer registry professionals, and clinical trial professionals.
Registration opens June 1.
Visit www.cancerstaging.org for additional details.
A Sneak Peek Into The AJCC 7th Edition
April showers bring May flowers, and just like the many colored blooms that will be popping up, the AJCC 7th Edition will have a fresh new look with a full-color interior.
A new section, “Staging At-A-Glance”, will be found at the beginning of each chapter and will make a handy reference for the specific chapter. It will also include the applicable ICD-O-3 topography codes and histology code ranges for each disease site. The elements of T, N, and M will be color coded consistently throughout the text of the manual and the newly designed staging form. A "summary of changes" for each chapter will highlight major changes to the staging. Finally, the staging form has been newly designed based on input from a user survey conducted in 2008.
The 7th Edition will be published in August 2009. Pre-order your copy at www.springer.com, www.Amazon.com or www.barnesandnoble.com.
Upcoming AJCC Exhibits
The American Joint Committee on Cancer (AJCC) will be exhibiting at the following meeting in May:
National Cancer Registrars Association (NCRA)
May 31 - June 3
Sheraton Hotel
New Orleans, LA
If you are attending this meeting, stop by the booth to speak with staff and see the new materials the AJCC has to offer.
2009 Oncology Update To Be Held in June
The American College of Oncology Administrators (ACOA), a specialty group of the American Academy of Medical Administrators, is proud to announce the 2009 Oncology Update:
Innovative Approaches in Chaotic Times
June 17 - 19, 2009
Chicago, IL
Co-hosted by the American College of Surgeons Commission on Cancer
Whatever the size, structure, setting or location of your oncology program, you strive to meet the needs of your patients and community. To ensure your program continues to meet high standards and stay viable, you can’t depend on business as usual. So where do you turn for innovative solutions in these chaotic times?
Designed by colleagues who face the same turmoil you face, this conference brings you inventive ideas and creative strategies in a small-group environment. Hear from the experts on proven methods in operations and clinical practice. From quality and excellence to accreditation to survivorship programs, you’ll take home information you can incorporate immediately. Network with your peers to enhance the learning experience and make ACOA connections you can rely on for years to come.
Visit our website for additional conference details, online conference registration and hotel reservations: www.aameda.org or feel free to call AAMA headquarters at 847/759-8601.
May SEER Workshop
The 2009 SEER Workshop is being held in conjunction with the National Cancer Registrars Association Annual Conference on May 31, 2009 in New Orleans, LA. Registration for the one-day workshop, which provides an overview of cancer statistics for registrars, is open to all registrars. Federal funds are paying for the SEER Workshop so there is no charge to registrants. To receive additional details and to register, access the SEER Web site at http://www.blsmeetings.net/2009SEERWorkshop.
SEER Training Website Has New Look
The SEER Training website has a fresh new look and feel, including site structure, design, and navigation. Changes were made to improve the overall user experience making the Website more accessible to all users, regardless of special needs. The site is designed to be compatible with screen readers and other assistive devices. The content of the training site has not been changed. SEER will begin a comprehensive review and update of the content this year. The modules with the most urgent need for updating will be revised first.
Visit the website at http://www.training.seer.cancer.gov/.
June Conference: The Changing Role of Surgeons in Cancer Diagnostics and Therapy
Jointly Sponsored by the Duke University School of Medicine and the American College of Surgeons Oncology Group
Location: Hyatt Bonaventure, Weston, FL.
Dates: June 18–20, 2009
Meeting website: http://dcri.org/research/meetings/acosog
New imaging technologies and genomic and proteomic methodologies for the treatment of cancer are significantly changing the role of surgeons. Surgeons are working closely with laboratory scientists, medical oncologists, and radiation oncologists to further develop:
- new laboratory and imaging diagnostics
- novel therapeutics that target specific cell growth pathways expressed in a primary tumor
- neoadjuvant treatments for resectable primary tumors
- diagnostics that lead to personalized cancer treatment
This activity will provide surgeons with a greater understanding of their changing role in cancer imaging and diagnostics that will lead to new therapeutics.
This activity will also provide education for practicing surgeons. Topics include current treatment of breast, gastrointestinal, and thoracic resectable disease and how practicing surgeons can position their practice for improvement in cancer care.
Details about the activity will be coming soon. Please visit our meeting website for updated information.
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