June 2002
Highlights for the month:
Collaborative Stage (CS) Data Set Implementation
A decision has been made by the CS Task Force and sponsoring organizations to delay the implementation of the CS Data Set until January 1, 2004. The CS Data Set is a completely new approach to data collection and collaboration among the major standard-setting organizations, and the delayed implementation will allow for the production of a high-quality product. This additional time will also enable us to fully proof the disease-site data sets against the AJCC Sixth Edition, to produce and publish a coding manual, to complete and test the computer algorithm, to incorporate CS into registry software, and to prepare for training in multiple mediums including on-site presentations, video conferences, and on the Internet. The delay of CS will not impact the January 1, 2003 implementation date for the Commission on Cancer's Facility Oncology Registry Data Standards (FORDS) or the AJCC Cancer Staging Manual, Sixth Edition. Questions and comments can be directed to Valerie J. Vesich, AJCC Technical Administrator, at (312) 202-5435 or by e-mail at vvesich@facs.org.
Highlights
Deadline Past for Proposed Standards Comments
The Commission would like to thank everyone who reviewed our proposed standards revisions and completed the questionnaire. The response was extraordinary. Your comments are invaluable to this project and will be shared with the Committee on Approvals.
Highlights
FORDS Winners from NCRA
Congratulations! The CoC is pleased to announce the names of the four lucky individuals who will each receive a complimentary hard copy of FORDS upon publication. The winners are:
- Wendy Drechsel, Norton Hospital Cancer Registry, Louisville, KY
- Frances Turner, John D. Archbold Memorial Hospital, Thomasville, GA
- Paula Carr, St. Louis University Hospital, St. Louis, MO
- Johanne Castonguay, Royal Victoria Hospital, Montreal, Canada
Highlights
FIPS - Are You Participating?
More than 54 percent of all CoC-approved cancer programs share their data with the American Cancer Society (ACS) through the Facility Information Profile System (FIPS). If your program participates, we urge you to continually update FIPS with any changes to your cancer program's resources and services. In addition, the NCDB has processed year 2000 data submissions. Please review your Level II-Annual caseload data 2000 on FIPS, and release the data to the American Cancer Society.
In order to continually improve and enhance FIPS and the data-sharing project, we need your feedback. Please e-mail comments, questions, and suggestions to FIPS@facs.org. And don't forget to tell your patients about the CoC Hospital Locator on the ACS Web site at http://www.cancer.org/, so they can review all that your cancer program has to offer.
Highlights
ACoS Appointments to National Programs
The American College of Surgeons recently joined the National Quality Forum (NQF) to ensure that surgeons actively participate in the development and implementation of proposed clinical quality and outcomes measures that would be shared throughout the nation. Alfred M. Cohen, MD, FACS, Chair of the CoC, was appointed to membership on the NQF Steering Committee which will establish the general framework for a core set of quality measures for cancer care. The Steering Committee will meet this summer.
The American College of Surgeons has also become a collaborating partner in the National Dialogue on Cancer. David P. Winchester, MD, FACS, Medical Director of Cancer Programs, serves as the ACoS representative. The NDC is a forum in which key leaders from public, private, and not-for-profit sectors can discuss critical issues facing the cancer community. Dr. Winchester participates in the activities of two NDC teams, Access to High Quality Cancer Care and State Cancer Plans.
Highlights
Reference Dates
A cancer program can request a change in its reference date by submitting a letter from the Cancer Committee Chair which asks for a new reference date and states the reason for the change. The new date must be approved by the Cancer Committee prior to sending the request to the CoC. You must also maintain at least five years of data in your registry database. A request for a change in reference date may be made every five years.
When a reference date is changed, the new date is the beginning of the registry. All eligible, analytic cases should reflect the new reference date. Case numbers prior to the new date are not changed and do not need to be followed. This provision includes recurrences and subsequent treatments. Cases accessioned prior to the new date may be deleted or the registry may choose to archive this data for historical purposes. The sequence number which is based on the number of primary tumors the person experiences in their lifetime, regardless of where these are diagnosed, is not affected by the date change.
The disadvantage to changing a reference date is that patient data gathered prior to the new reference date would be considered non-analytic or historical. The advantage, however, is that the registry's lost to follow-up rate should improve dramatically.
Examples:
- When a patient is diagnosed prior to a change in a facility's reference date and then comes in after the new reference date with recurrence or metastasis, abstract as Class of Case 4, utilizing the year of recurrence as the accession year. The Date First Seen for This Primary would be the date the primary was initially diagnosed. It can be before the reference date since it is Class of Case 4.
- If a patient comes in following a reference date change with a diagnosis of a second primary, reaccession the patient with a new number from the year they were diagnosed, a sequence number of A02", and as Class of Case 1.
Send requests for new reference dates to Nancy Etzold, Cancer Program Specialist, American College of Surgeons, 633 North Saint Clair Street, Chicago, IL 60611. For additional information regarding reference dates, please check the I&R System. Search under Approvals; Key Words: reference date.
Highlights
Helpful Hints for Using the Inquiry and Response System (I&R)
The purpose of the I&R System is to provide constituents with consistent, accurate, and timely answers related to approvals and data standards and TNM staging. To enter I&R, simply go to the CoC Web page at http://www.facs.org/dept/cancer/index.html, and click on the I&R icon.
Before submitting questions to the I & R team:
- Check handy references such as Standards of the Commission on Cancer Volumes I and II (ROADS), the AJCC Cancer Staging Manual Fifth Edition, SEER EOD, SEER Summary Stage 2000, and ICD-O Third Edition.
- Make use of important local resources such as the managing physician, pathologist, or physician advisor. Keep in mind that developing a positive, professional relationship with staff physicians, cancer committee members, and the physician advisor is crucial to gaining accurate and complete information for the cancer registry database.
- Review the I & R System. Questions relating to your topic may have already been answered.
- Be patient. Please do not resubmit questions. The average turn around time for an answer is two weeks.
Highlights
AJCC Cancer Staging Manual, Sixth Edition on Sale Now
The AJCC Cancer Staging Manual, Sixth Edition published last month and its TNM staging will go into effect with cancer cases diagnosed beginning January 1, 2003. The Sixth Edition manual and handbook can be ordered directly from Springer-Verlag at www.cancerstaging.net. Special prices and discounts are currently available from the publisher, but are subject to change.
For volume discounts available to hospitals and registries, contact Charisse Wilburn, Assistant Manager, Corporate Sales, Springer-Verlag New York, Inc. at (212) 460-1594 or www.springer-ny.com.
Highlights
NCDB to Present Findings In BCS Study
Members of the National Cancer Data Base will present a poster session titled "Are Variations in Breast Conservation Surgery (BCS) Related to Race?" during the Academy for Health Services Research meeting on June 23 in Washington, DC. Data used in the analyses were Stage 0 and Stage I breast cancer cases submitted to the National Cancer Data Base in 1993 (n=59,459) and 1998 (n=68,092). Despite the fact that five-year survival rates are essentially the same for women surgically treated with breast-conserving surgery and mastectomy, there are large variations in the use of BCS when comparing different regions of the United States and by contrasting rural/urban patient demographics. Researchers have ruled out the possibility that the type of surgery was directly associated with patient race. However, other possible factors that contribute to whether a woman gets BCS or a mastectomy remain undetermined, but may include the availability of adjuvant radiation treatment facilities or travel distance for the patient. The NCDB has concluded that this important issue will require further examination.
Highlights
Benefit of Being An Approved Program
Your cancer program will be recognized by other national health care organizations, including the JCAHO, as having established performance measures for high-quality cancer care.
Highlights
To Subscribe to CoC Flash
CoC Flash is e-mailed automatically each month to individuals for whom the Commission on Cancer of the American College of Surgeons has an e-mail address. If you wish to continue to receive the newsletter on a monthly basis, you need do nothing. You can discontinue your subscription by writing to coc@facs.org and requesting that your name be deleted from the database. Individuals not currently receiving the newsletter may subscribe to the publication by sending an e-mail containing your name, address, telephone and fax numbers to coc@facs.org, and asking to be added to our electronic distribution database.
To Submit Information
CoC Flash will accept submissions received by the third week of each month. However, the CoC reserves the right to decide whether or not the materials are appropriate for inclusion. Information for CoC Flash should be timely, newsworthy, brief, and of use and interest to the constituents of the Commission, which include cancer registrars, liaison physicians, cancer committee chairs, and other cancer-oriented health care professionals. To submit material, send it to coc@facs.org.
The Commission on Cancer is a consortium of professional organizations dedicated to reducing the morbidity and mortality of cancer through education, standard setting, and the monitoring of quality care. CoC Flash is a monthly news service for constituents of the CoC provided by the Commission and the Cancer Program of the American College of Surgeons.
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