The American College of Surgeons Commission on Cancer: CoC Flash Newsletter

The CoC Welcomes New Staff

The Commission on Cancer welcomes the following new staff members:

Brenda Williams, Education and Promotion Assistant, started with the Commission in December 2008 and is responsible for coordinating Commission meetings, workshops, conferences, and online education programming. Brenda also manages the CoC Web site. Brenda can be reached at bwilliams@facs.org.

Nina Miller, Manager for the Cancer Liaison Program, started with the Commission this month and is responsible for managing the activities of the Commission’s Committee on Cancer Liaison and the Cancer Liaison Program. Her responsibilities include managing the activities of the Commission’s State Chairs and Cancer Liaison Physicians, maintaining and enhancing the Commission’s relationship with the American Cancer Society, and with the National Partnership for Comprehensive Cancer Control. Nina can be reached at nmiller@facs.org.

Steffanye Hawbaker, Customer Relations Assistant, started with the Commission this month and is responsible for providing support to Cancer Programs staff. She provides customer service to the CoC’s constituents via the phone and the CoC e-mailbox, and manages user access to the Commission’s password-protected portal – CoC Datalinks. Steffanye also manages the Facility Information Profile System. Steffanye can be reached at shawbaker@facs.org.

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 mid-March.

CoC’s Role in One Voice Against Cancer

As a member of One Voice Against Cancer (OVAC), the Commission on Cancer is supporting the OVAC campaign to support investments in cancer research. The Commission signed on to a letter dated January 9, 2009, addressed to the Obama transition team requesting that a special emphasis be placed on efforts to reduce cancer incidence and mortality as part of the national health care agenda. The letter outlines the need for increased funding for cancer research at the National Institutes of Health (NIH) and the National Cancer Institute (NCI).

Visit the OVAC Web site to learn more about its agenda at http://www.ovaconline.org

Pre-Survey Documentation: What is Required?

The following cancer committee/leadership body documentation of cancer program activity must be provided to the surveyor in advance of the on-site visit so that the surveyor can review the information and be adequately prepared for the evaluation. In general, the following documentation is provided to the surveyor a minimum of 2 weeks (14 days) in advance of the on-site visit:

A printed copy of the completed SAR.
A copy of the certificate of accreditation or letter from the accrediting body.
Copies of all cancer committee/leadership body minutes (including any attachments that apply to the standards) from the previous 2 complete calendar years and the current year through the survey date. * Cancer committee/leadership body minutes are a primary resource for documenting program organization and operation, as well as monitoring programmatic activity.
Results of the outcomes analysis(es) and methods of dissemination for the last 2 complete calendar years, as well as the current calendar year, if the outcome analysis is completed by the time of the survey.
A copy of the published annual report for the last 2 calendar years, if an annual report is published.
An accession list for the last complete abstracting year that identifies the major sites of cancer and surgical resections performed.

Please do not send more than what is required to the surveyor before survey. The surveyor will review any additional information at the facility on the day of survey.

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.

Now Accepting Nominations for Outstanding CLP Award

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 are due March 31, 2009.

For detailed information 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 cjones@facs.org or 312.202.5183.

Start your nomination form now!

2009 Call for Abstracts: Commission on Cancer Paper Competition

On January 9th, the Commission on Cancer (CoC) announced its 2009 Paper Competition. We encourage you to share this information with your surgical residents and oncology fellows. This is an opportunity for presentation, visibility, and networking that your residents don’t want to miss!

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.

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 College is pleased to announce the appointment of new Commission on Cancer State Chairs:

Steven Hochwald, MD, FACS, Shands at the University of Florida, Gainesville, FL
Katherine Morris, MD, Portland, OR
Valeriy Moysaenko, MD, FACS, Upper Valley Medical Center, Albany, OH (Co-Chair)

Role of the CLP Web Conference

Do you find yourself asking, “What are the duties of the CLP”? Join us on the next “Role of the Cancer Liaison Physician” Web conference to better understand what is expected of the CLP. This Web conference serves as a guide for the new CLP or as a refresher for the veteran CLP. Facility staff and American Cancer Society representatives are also welcome to participate

Date: Thursday, February 12, 2009
Time: 4:00 pm CST
Facilitator: Lynn Dyess, MD, FACS, Alabama State Chair

This is a free resource from the Commission on Cancer. Registration is NOT necessary. For further instructions, visit our Web site at http://www.facs.org/cancer/coc/clpwebconferences.html.

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

Survey Savvy 2009 Registration Is Now Open!

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:

1) Collaborative Staging: Stay on Top of the Latest Changes

2) Navigating and Interpreting the NCDB Survival Reports

3) Resolving Issues of Case Eligibility

4) Comparative Reporting: Quality of Care Measures for Breast and Colorectal Cancers

5) Preparing for 2009: Understanding and Implementing Changes to the Cancer Program Standards

More information is available online.

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

Join the National Accreditation Program for Breast Centers Today!

The newly launched National Accreditation Program for Breast Centers (NAPBC) has received enthusiastic support from hundreds of breast centers across the United States. Since the formal program launch in early September 2008, the NAPBC has received 100 completed applications and requests for survey, along with phone calls and emails from hundreds of additional centers in the process of evaluating their program in preparation for applying for accreditation. The NAPBC currently maintains a list of approximately 850 breast centers across the United States that have expressed interest in participating in this comprehensive, multidisciplinary, quality improvement breast care program.

The NAPBC Application process includes completing a short pre-application confirming that all program components are in place. Once approved, the center is released for survey and an NAPBC Surveyor is assigned to contact the center to schedule an on-site visit. Centers are encouraged to complete the accreditation process within six months of application or apply for NAPBC Provisional Accreditation, which requires the center to provide specific information in the electronic Survey Application Record (SAR) for review until an NAPBC Survey can be scheduled to inspect the center. The Provisional Accreditation process is outlined in the NAPBC Standards Manual. The fee for survey is $3,500, and accreditation is for a three-year period.

If you would like to learn more about the NAPBC, please visit the NAPBC Web site at http://www.accreditedbreastcenters.org, where you will find a copy of the NAPBC Standards Manual. The manual provides a comprehensive outline of the program, a listing of the required program components, and the NAPBC Standards, as well as directions on how to apply for NAPBC Accreditation. You may also email the NAPBC Administrative Office at napbc@facs.org to request an Information Kit.

NAPBC to Exhibit in Florida in February

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

Multidisciplinary Symposium on Breast Disease (MSBD)
February 12-15
Ritz-Carlton
Amelia Island, 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.

A Sneak Peek into the AJCC 7th Edition

It's hard to believe that the first month of the New Year is drawing to a close! Soon our calendar entries will be "Spring", "NCRA Annual Conference", "publication of the 7th Edition AJCC Cancer Staging Manual". The work of the 7th Edition has served to illustrate the increasing role prognostic data items play in the care of the cancer patient and the role of the registrar. These prognostic data items will be defined as new Site-Specific Factors (SSFs) in Collaborative Staging and, for the first time, they will be incorporated into the 7th Edition AJCC staging system. The 7th Edition Manual will emphasize the importance of the data collection effort of registrars. Two changes have been made to the 7th Edition that will facilitate better data collection, and ultimately better care of the cancer patient.

First, each chapter will list all the site-specific factors (SSFs). Those that are used in the Collaborating Staging algorithm and necessary for the derivation of the AJCC TNM staging elements or stage grouping will be highlighted. This approach will serve to clarify the data necessary to complete the staging.

The second improvement is the histology lists. In the 6th Edition these lists were described as a "guide" to be utilized in determining the cases to be staged using the AJCC classification. The histology lists in the 7th edition have been revised and will be an exhaustive, inclusive list of all histologies that can be staged using the AJCC classification, thus removing any doubt as to whether a case can be staged using the criteria. We feel these are great enhancements to facilitate data collection!

Next month, watch for a Sneak Peek into Chapter 1, The Purposes and Principles of Staging. You've sent us your suggestions and your feedback and we've incorporated them into a "rules of the road" we think you'll like!

NCRA Issues Call for Volunteers

As a member-based organization, the NCRA relies on its membership for committee leadership and expertise. Interested in becoming a volunteer of an NCRA Committee? To be considered as a candidate for any posted position, a candidate profile must be completed and submitted to the Executive Office. Deadline: Postmarked or faxed no later than February 2, 2009.

NCRA Danielle Chufar Scholarship- 2009

The Danielle Chufar Memorial Annual Conference Scholarship is named in memory of the NCRA staff member who passed away in February 2004 from cancer. Danielle was a new RHIT professional who was preparing to take her CTR exam. Funded by individual donations, speakers’ returned honoraria, and the annual state basket raffle, this scholarship has been made available to NCRA members. Each year since 2004 NCRA has committed to funding the expenses associated with travel; lodging and registration for the members awarded the Danielle Chufar Memorial Scholarship.

The purpose of the scholarship is to provide financial assistance to members who may not otherwise have the opportunity to attend our Annual Conference. Specifically, the scholarship covers the full conference registration fee, round-trip coach airfare, and hotel for three nights at the conference hotel. More than one scholarship may be awarded, depending upon the amount of money available in the fund.

Eligibility: To be eligible, members must complete an application and write a 500 to 750 word essay on the theme based on the committee’s Foundation statement.

Deadline: The postmark deadline for applications and essays is February 28, 2009.

Download an application today.

CTR Exam Prep Workshop Scheduled

CTR Exam Prep Workshop
February 7-8, 2009 in Baltimore, MD

This special two-day workshop, taught by instructors Donna Gress, RHIT, CTR and Louise Schuman, MA, CTR, is designed to prepare candidates for the Certified Tumor Registrars Exam (CTR Exam). Our panel of knowledgeable and experienced instructors has developed an agenda that provides comprehensive and thorough review of all exam topics, including the new multiple primary and histology rules, as well as designated time throughout the program to address attendees' questions and concerns.

The workshop will cover the following topics:

Registry Organization and Operation
Concepts of Abstracting Coding and Follow-up
Data Analysis and Interpretation
Application of Coding and Staging Principles

Download the Workshop Registration Form.

C-Change Cancer Core Competency Initiative Addresses Workforce Shortage+

In an effort to address shortages in the cancer workforce, C-Change developed competency standards and tools for strengthening the cancer knowledge and skills of non-oncology health professionals. C-Change is a not-for-profit organization that assembles cancer leaders from the public, private, and not-for-profit sectors,

These standards and tools were tested at 4 diverse pilot sites including Audrain Medical Center (Mexico, MO), California University of Pennsylvania (California, PA), Marshall University School of Medicine (Huntington, WV), and the University of Pittsburgh Medical Center (Pittsburgh, PA). All pilot sites yielded very promising results in terms of ability to quantitatively impact professional knowledge, skills, and attitudes among non-oncology health professionals as well as to qualitatively benefit the course faculty, institution, and community. Improvements in all pilot sites from pre to post-test scores ranged between 20%-177%.

The results demonstrated the utility and flexibility of the standards and tools in diverse training and care settings, among different disciplines, and with different cancer education topics. A complete report of the pilot phase methods and findings can be found at:

http://c-changetogether.org/pubs/cccpp.asp

For additional information regarding the C-Change Cancer Core Competency Initiative please contact Sabrina Tyus at styus@c-changetogether.org or 202-756-1345.

Activities of the National Partnership for Comprehensive Cancer Control

As a member of the National Partnership for Comprehensive Cancer Control, the Commission on Cancer participated in the Comprehensive Cancer Control (CCC) Policy and Practice Summit sponsored by the Partnership and hosted by C-Change in May of 2008.

The Summit was attended by representatives from all 50 state cancer plan coalitions with the goal of engaging in a dialogue about CCC areas and potential policy approaches to address those areas, share and discuss experiences, strategies, challenges, and new approaches to affect policy change, identify policy approaches that for consideration, and identify policy approaches for the National Partners to support and or address at the national level.

The Symposium Report is available for download from the C-Change Web site at http://www.c-changetogether.org/pubs/default.asp and includes the Summit proceedings, and key suggestions for action that address the capacity building roles in which the National Partners can engage, and potential roles for the National Partners in terms of national agendas and approaches.

In addition, the National Partners have published The Comprehensive Cancer Control Movement: 10 Years of Success. The report is available for download from the C-Change Web site at http://www.c-changetogether.org/pubs/default.asp and highlights the evolution of the CCC movement. A decade ago there were only a handful of states that had a strategic plan for addressing cancer, and mostly those plans focused on government actions. Then, a different vision emerged in which organizations from across country came together with a united approach for addressing cancer in their communities. A decade later, that vision is reality. Fifty states, several American Indian and Alaska Native tribes and tribal organizations, territories and Pacific Island jurisdictions have developed data and evidenced-based CCC plans that are now being implemented.

Revised March 30, 2010

CoC Flash

Commission on Cancer