CoC to Host FORUM for Accredited Cancer Programs during NCRA

The CoC will host a FORUM for cancer registrars from CoC-accredited cancer programs on Sunday, May 31, 2009 from 4:30 to 6:30pm. One registrar from each CoC-accredited cancer program will be invited to attend and participate in a dialogue and exchange of information and ideas about their facility’s participation in the CoC Approvals Program. An e-mail invitation with registration information will be distributed in April.

2008 CoC Year in Review Publication

The 2008 CoC Year in Review publication was recently mailed to Cancer Liaison Physicians in CoC-accredited cancer programs, and to CoC members, state chairs, surveyors and consultants. This publication highlights accomplishments and initiatives from the past year and includes a month-by-month retrospective review of the programs and services provided by the Commission to improve the quality of cancer care at the national, state, and local levels. Copies can be accessed from the CoC Web site at http://www.facs.org/cancer/cannews.html.

American Recovery and Reinvestment Act of 2009

The American College of Surgeons submitted a comment letter to The Honorable Nancy Pelosi, Speaker of the House of Representatives, and The Honorable Harry Reid, Majority Leader of the Senate, on February 13, 2009 on the American Recovery and Reinvestment Act of 2009. The letter referenced the fact that the surgical community is ready to work with the administration on reforming our health care system and references the College’s Statement on Health System Reform which can be accessed from the College Web site at www.facs.org.

In addition, the letter makes reference to the Commission on Cancer and its network of accredited programs in response to the inclusion of $10 billion for vital research being conducted at the National Institutes of Health to cure the disease. The letter can be accessed from the College Web site at http://www.facs.org/ahp/views/rract09.pdf.

Reintroduction of Ovarian Cancer Biomarker Bill

As a member of One Voice Against Cancer (OVAC), the American College of Surgeons and Commission on Cancer had signed on to the Ovarian Cancer Biomarker Research legislation last year, and has been asked to serve as a co-sponsor again this year to help in the fight against this devastating disease. According to the National Cancer Institute (NCI), there are expected to be 21,000 new cases of ovarian cancer this year and 15,000 deaths from ovarian cancer in the United States in 2008. Ovarian cancer ranks fifth in cancer deaths among women and causes more deaths than any other cancer of the female reproductive system.

The Ovarian Cancer Biomarker Research Act of 2009, supported by Harold Berman and Ralph Hall as Members of Congress, would authorize the National Cancer Institute to make grants to public or nonprofit entities to establish research centers focused on ovarian cancer biomarkers. Biomarkers are biochemical features within the body that may be used to determine the presence and extent of and/or predict response to therapy and ultimate prognosis. The bill also establishes a national clinical trial that will enroll at-risk women in a study to determine the clinical utility of using these validated ovarian cancer biomarkers. The need for increased research and funding for ovarian cancer is critical to the realization of improved survivorship rates from this disease. Between FY2003 and FY2006, funding for the National Cancer Institute increased by $211 million, while gynecologic cancer research funding decreased.  With the lifetime risk of ovarian cancer at one out of every 72 women, we must increase the resources to fight this cancer.  

Upcoming CoC Exhibits

The Commission on Cancer (CoC) will be exhibiting at the following meetings in March:

Society of Surgical Oncology (SSO)
March 5-8
Phoenix Convention Center
Phoenix, AZ
CoC Staff: Jerri Linn Phillips

Association of Community Cancer Centers (ACCC)
March 18-2
Gaylord National Resort & Convention Center
National Harbor, MD
CoC Staff: Karen Stachon

If you are attending these meetings, stop by the CoC booths to speak with staff and see the new materials the CoC has to offer.

Is your organization applying for CoC Accreditation?

Is your organization applying for CoC Accreditation and need more guidance?

Then the one day workshop, A Foundation for Success: Building Your CoC-accredited Program is just what you need! The workshop is designed especially for staff of facilities taking their first steps to establish their cancer programs and seek CoC Accreditation.

This workshop is taking place on Monday, March 30, 2009 in Denver, CO, preceding the Commission on Cancer workshop Survey Savvy: Improving Patient Care through CoC Standards. We encourage you to attend both workshops which will provide you with an understanding of the CoC standards and better equip you to implement them in your program.

This workshop will feature step-by-step direction in

• Eligibility requirements
• Registry management basics
• Identification of key participants in your cancer program
• Choosing your Cancer Liaison Physician
• The role of the National Cancer Data Base (NCDB)
• Choosing a consultant

This is a great opportunity to get your questions answered!

All registration forms are due by March 9 as space is limited.

Registration information and forms can be found at: http://www.facs.org/cancer/coc/coceduc.html.

We look forward to seeing you in Denver to review this important information!  

See What’s NEW on the Best Practice Repository

Additional tools and examples have been added to the Best Practice Repository

• 2.6, 2.7, and 2.8 Clinical Cancer Conference Policy
• 2.8 Case Summary with Stage and Treatment Plan
• 2.10 Quality of Cancer Registry Data
• 4.3 AJCC TNM Staging Policy
• Clinical Staging Policy

Check out these best practices at our web site, located at http://www.facs.org/cancer/coc/bestpractices.html.

These resources are designed to help cancer programs meet the CoC Cancer Program Standards. Watch for more Best Practice examples to be posted in the future.

Tip of the Month: Selecting charts for quality control review

To meet the requirements for Standard 2.10, a 10% random sample of cases from the last completed year of abstracting are selected and reviewed to ensure the quality of abstracted data. The new standard 4.3 requires the cancer committee to select and review a sample of at least 10% of cases from the 5 major sites of cancer that are also drawn from the last completed year of abstracting.

Though the cases selected for each review may overlap, most programs are reporting that two different groups of cases are selected for the review. This has almost doubled the quality control workload in many programs. The Committee on Approvals did not intend that the changes to standard 4.3 should have this affect.

As a result, we recommend that the sample of cases from the 5 major sites of cancer that are used to meet the requirements for standard 4.3 also be used to meet the quality control review activities for standard 2.10.  

If this change is adopted by the cancer committee in your program, make sure to update the cancer registry policy and procedure manual as well as the policy and procedure for standard 2.10 and 4.3.

Do You Still Have NCDB Cases to Correct?

June 1 still seems a long time away, but now is the time to take care of any NCDB data-cleaning you need to do before that deadline arrives. All rejected records and all 2007 cases with edit problems must be corrected and resubmitted by that date for compliance with Standard 3.6. Now is the time to double-check that everything went smoothly in your latest submission, and take care of any remaining problems.

In addition, 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 can not 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!

Use the Most Current Edits for Newly Abstracted Cancer Cases

The standard edits for use with newly-accessioned cancer cases have been updated. 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 for details.  

New edits most likely to affect CoC approved 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 for a complete list of all new and changed standard edits.

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.

Nominate Your Cancer Liaison Physician – Deadline March 31

Administered by the Committee on Cancer Liaison, the Cancer Liaison Physician (CLP) Awards Program serves to recognize outstanding clinical champions who go above and beyond to make a positive impact on their cancer program and/or the community. The Commission on Cancer (CoC) is accepting nominations for outstanding CLP performance exhibited during the calendar year 2008. Nominations must be received no later than March 31, 2009

Cancer program staff, State Chairs, Surveyors, and American Cancer Society staff may nominate a CLP for excellence in one or more of the following areas in 2008

• Developed and/or implemented an idea(s) that improved quality of care at his/her facility.
• Significantly contributed to the approval status of the cancer program.
• Worked above and beyond normal CLP expectations to strengthen the cancer program.
• Demonstrated leadership and support for cancer control activities in the community and with the ACS.
• Served as a role model for other staff and exhibited characteristics that truly make him/her a physician champion for the cancer program.

All nominations must be verified and supported by the cancer committee chair of the CoC-approved facility.

For more information and to submit a nomination form, please log onto our Web site at http://www.facs.org/cancer/coc/physresource.html.

Should you have any questions, please contact Carolyn Jones, Cancer Liaison Program Coordinator, at 312-202-5183 or cjones@facs.org.

Commission on Cancer Paper Competition – Abstracts are due March 31

The Commission on Cancer (CoC) has announced its 2009 Paper Competition. Surgical residents and oncology fellows are encouraged to submit abstracts describing original research in cancer care including basic laboratory research, clinical investigation, and quality of care/health services research.   Don’t miss this opportunity for presentation, visibility, and networking for residents and fellows. 

This competition has been funded by the CoC and through a memorial gift from Mrs. A. Lee Campione in honor of her late husband, Matthew P. Campione, MD, FACS. The first place awardee will receive $1000 and have the opportunity to present at the Commission on Cancer Annual Meeting during Clinical Congress in October. Second and third place winners will be granted a $500 award and the opportunity to present a poster.  

For detailed information, please log onto our Web site at http://www.facs.org/cancer/cannews.html or contact the CoC Office at 312-202-5183 or cjones@facs.org.

Welcome New State Chairs!

The American College of Surgeons and the Commission on Cancer would like to announce the appointment of three new State Chairs:

• James Spellman, MD, FACS – Bebe Medical Center, Rehoboth Beach, DE
• Constantine V. Godellas, MD, FACS – Rush University Medical Center, Chicago, IL
• Thomas Broughan, MD, FACS – St. John Medical Center, Tulsa, OK

Exhibit at Survey Savvy 2009!

Applications are now available to exhibit at the upcoming CoC workshop Survey Savvy 2009 being held in Denver, CO on Tuesday, March 31 & Wednesday, April 1, 2009.

Survey Savvy, a two-day workshop, is designed to train cancer program teams on survey standards. Up to 250 participants are expected and will include: Cancer Committee Chairs, Cancer Liaison Physicians, Cancer Registrars, Oncology Nurses, and Cancer Program Administrators.

Applications and fees are due by March 9, 2009. Please click here for more information http://www.facs.org/cancer/schedules/meetcon.html.

Survey Savvy 2009 Registration Is Now Open!

Register now for Survey Savvy 2009, a two-day workshop held in Denver, CO on March 31 & April 1, 2009.  A special one-day preworkshop, scheduled for March 30, is open to new cancer programs seeking CoC accreditation. The registration deadline is Monday, March 9, 2009.

Registration information is available at http://www.facs.org/cancer/schedules/meetcon.html.

2008 CoC Web Conference Series Available Online

The CoC’s Web conference series offers one hour programs to support the educational needs of cancer program team members in both CoC-accredited and non-accredited programs. The following web conferences, presented live in 2008, are currently available as archived sessions:

• Collaborative Staging: Stay on Top of the Latest Changes
• Navigating and Interpreting the NCDB Survival Reports
• Resolving Issues of Case Eligibility
• Comparative Reporting: Quality of Care Measures for Breast and Colorectal Cancers
• Preparing for 2009: Understanding and Implementing Changes to the Cancer Program Standards

Visit this link for more information: http://www.register123.com/event/profile/web/index.cfm?PKwebID=0x104653884b

The 2009 topic offerings will be listed in the next issue of the Flash.

A Sneak Peek into the AJCC 7th Edition

Any journey is easier with a clear road map! And, if it included all the rules of the road in one place, it would be even easier! The AJCC has created a clear, easy-to-use "rules of the road" in the newly revised chapter, The Purposes and Principles of Staging, for the 7th Edition Cancer Staging Manual.

Major "roadwork" has been done on the staging rules and the other information in Chapter 1. The rules are more clearly defined and appear in an easy-to-read format to provide a quick reference of the highlights of the text.  

While Chapter 1 has been built out and expanded, other rules have been clarified and trimmed back. A major step forward has been accomplished with the elimination of MX throughout the 7th Edition. M category choices will be M0 or M1. In the past, the use of MX has precluded assignment of a stage group and use in data analysis. The M category will now reflect more accurate information related to metastatic workup.  

We are pleased with the new "rules of the road" and think you will be too!

Watch for another Sneak Peek into the 7th Edition next month!

SEER Workshop Being Held in May

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 

The Changing Role of Surgeons in Cancer Diagnostics and Therapy

Save the Date: 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.

Struggles and Successes of an Academic Surgeon

Bimal C. Ghosh, MD, FACS, a former Captain in the United States Navy and a licensed surgeon in New York State, Illinois, Maryland, and California, has published a book titled Struggles and Successes of an Academic Surgeon. This book is the empowering story of a young boy who grew up underprivileged only to eventually become a highly successful academic surgeon. Readers will receive a warm and inspiring story within the pages of this entertaining and enlightening memoir. Dr. Ghosh is a former member of the Commission on Cancer and was a state chair in New York. To purchase the book, contact Vantage Press order department at 1-800-882-3273.    

Upcoming NAPBC Exhibits

The National Accreditation Program for Breast Centers (NAPBC) will be exhibiting at the following meeting in March:

Miami Breast Cancer Conference (MBCC)
March 4-7
Fontainebleau Hilton Resort & Towers
Miami Beach, FL

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.