American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

November 2016 CoC Source

(HTML Version)

Thank You, Dr. McKellar for Your Leadership

The Commission on Cancer (CoC) expresses thanks to Daniel P. McKellar, MD, FACS, for his contributions and leadership as the CoC Chair from 2012-2016. Under his leadership the number of CoC-accredited programs increased and he was responsible for a number of new initiatives including but not limited to:

  • Strengthening the CoC/NCDB quality program by increasing the number of quality metrics -- now 20 in CP3R.
  • Introducing the Cancer Quality Improvement Program (CQIP) – a program-specific report that cancer programs use to conduct a retrospective review of the services they provide.
  • Promoting the introduction of Patient-Centered Standards – Patient Navigation Process, Psychosocial Distress Screening, and Survivorship Care Plan.
  • Expanding the Participant User Files (PUF) application process from annual to semi-annual.
  • Launching two new accreditation program pilots – the Oncology Medical Home (OMH) and the National Accreditation Program for Rectal Cancer (NAPRC).

Dr. McKellar will continue to work with the CoC as he assumes the role as chair of the CoC Nominating committee.

Lawrence N. Shulman, MD, FACP New Chair of the Commission on Cancer

During the CoC Annual Meeting on October 16, 2016 in Washington, DC, it was announced that Lawrence N. Shulman, MD, FACP would assume the role as chair of the CoC from 2016-2018. Prior to this position, Dr. Shulman served as the chair of the CoC’s Quality Integration Committee.

Dr. Shulman shared his vision for the CoC during his presentation at the Annual Meeting. He stated that as the Chair he plans to:

  • Identify priorities for the CoC and the National Cancer Database
  • Explore areas where cancer care and outcomes vary at the national level
  • Determine where to drive change to improve outcomes in cancer care nationally
  • Continue to have the CoC viewed as the organization that drives cancer care quality in the US
  • Enhance the relationship between the CoC and its accredited hospital programs

Currently Dr. Shulman is the the deputy director for clinical services of the Abramson Cancer Center at the University of Pennsylvania, and director of their newly formed Center for Global Cancer Medicine. He has a leadership role in the strategic development of cancer services for the Cancer Center and its affiliated hospitals. He also leads the Cancer Quality program for the University of Pennsylvania’s Health System and five hospitals.

CoC News

CoC Annual Meeting Keynote Addresses Cancer Moonshot: Data are the Holy Grail of Cancer Care

Greg Simon, executive director of the White House Moonshot Initiative, delivered the keynote address at the CoC's Annual Fall Meeting on October 16, 2016. The initiative, led by Vice-President Joe Biden—focuses on prevention, early detection, and accessible therapies. The current Information Age offers society computing ability beyond our imagination, yet we don’t share our information. Data are the Holy Grail, and sharing information does not diminish the research, said Mr. Simon, noting that the purpose of research is to benefit the general well-being. Access the full article from the Clinical Congress News.

Schilsky Addresses Clinical & Real-World Evidence in Oncology Lecture at Clinical Congress

Richard L. Schilsky, MD, FACS, FASCO was the CoC Oncology Lecturer on October 19 during the American College of Surgeons Clinical Congress in Washington, DC. Dr. Schilsky spoke about the explosion of data in cancer care and explained how we can build our knowledge base.

In cancer there are two types of evidence – clinical evidence, derived from clinical trial data, and real-world evidence. Both, Dr. Schilsky said, are necessary to advance our understanding of cancer. While clinical trial evidence can provide specific information in a randomized and controlled environment, real-world evidence provides a broader and more faithful representation of how a medicine or treatment may work.

National Cancer Database News

CQIP Update

The National Cancer Database (NCDB) staff is preparing Cancer Quality Improvement Program (CQIP) 2016 reports. The reports will also include estimated performance rates (EPRs) for cases diagnosed in 2014 for all measures reported in the Cancer Program Practice Profile Reports (CP3R). EPRs from CP3R will be frozen as of December 9, 2016, to be reported in CQIP 2016.

It is recommended that programs prioritize review efforts in CP3R to focus on 2014 cases with incomplete or nonconcordant case status. Doing so will help to ensure that the EPRs reported in CQIP reflect the most current information available.

Completeness and Default Overuse Reports

The Completeness and Default Overuse Reports will be released concurrently with CQIP 2016 reports.

Questions or concerns? Please contact the NCDB at

Resources for Cancer Liaison Physicians

State Chair Outstanding Performance Award

The CoC recognized three State Chairs on Sunday, October 16 for their outstanding performance in 2015 during the State Chair Town Hall meeting at Clinical Congress. The State Chair Outstanding Performance Award was presented to Ted James, MD, FACS, Vermont State Chair; Sharon Lum, MD, FACS, California State Chair; and Richard Zera, MD, FACS, Minnesota State Chair.

The State Chair Outstanding Performance Award recognizes individuals who have exhibited outstanding leadership and innovation and who have made significant contributions to the improvement of cancer care in their state or region. They are collaborators, innovators, and experts working with cancer programs, professionals, and state coalitions to improve the quality of cancer care. This honor is awarded based on excellence in service on behalf of the CoC.

News from Cancer Programs


Cancer Staging Manual, Eighth Edition, Just Released by American Joint Committee on Cancer (AJCC)

Newest edition’s precision medicine-based approach focuses on more individualized treatment for cancer patients

The American Joint Committee on Cancer (AJCC) TNM Cancer Staging Manual, Eighth Edition, draws on newer understanding of cancer biology concepts and emphasizes a more contemporary individualized approach to cancer classification and treatment, building on its four decade-long traditional population-based approach.

Read the full news release and download the PDF version.

Abstracting Edit Issues

All registrars need to be aware of the issues with the NAACCR Edit file. There are many TNM edits that will not allow a case to be completed, even though the AJCC stage is assigned accurately. It is critical to report these so the issues can be corrected. Stage must be assigned according to AJCC rules, and not changed to pass the edits.

The process for reporting suspected abstracting edit problems:

  • If a hospital registrar suspects there is a problem with an edit, they should report that problem to their central registry. Do not report suspected edit problems to the CAnswer Forum or SEER Sinq.
  • Central registries should contact with suspected edit problems.
  • Jim will work with the Edits WG to resolve the issue.
    • If it is a problem with the edit, we will fix it and release the corrected edit with the next metafile release.
    • If it is a coding issue, we will work with the standard setters to resolve the issue and send a coding recommendation back to the central registry.

NAACCR usually does not release an updated metafile so soon after the previous release (last release was 10/6/16). However, we identified problems in the v16b metafile that would not allow abstractors to abstract cases correctly. The NAACCR Edits WG which includes representatives from central registries, NCRA, SEER, NPCR, CoC, and software vendors felt that it was best to release a corrected metafile immediately.

The NAACCR v16c metafile has been posted to the NAACCR Edits page. A spreadsheet showing the changes to the v16B and v16C metafile has been posted. The changes from v16B to V16C are highlighted in teal (dark blue).

Changes to the v16c metafile include:

  • Critical updates to 5 edits. Registrars will not be able to enter correct codes into an abstract unless these edits are updated. These edits cover common sites such as colon, melanoma, and breast.
  • Minor updates to 2 edits. These include updates to edit description, error messages, etc.
  • 1 edit was added to the CoC and NPCR edit sets. This edit had been incorrectly removed from these edit sets in v16b. It is important that central registries monitor changes to standard setters edit sets. If edits are added/removed from standard setter edit sets, central registries should consider adding or removing them from their edit sets. These changes are documented in the spreadsheet.

AJCC Disease Site Webinars Based on AJCC Seventh Edition

The AJCC held five disease site webinars during the summer and early fall this year. The webinars, provided at no cost, provide highlights of the five most common site chapters for AJCC Seventh Edition staging and include Melanoma, Lung, Breast, Colorectum, and Prostate. Pre- and posteducation quizzes are included to serve as a self-assessment for the information learned. The webinars provide information on the uniqueness, differences, exceptions, or special concerns for the disease sites.

Each lecture contains the following topics:

  • Overview and Learning Objectives
  • Anatomy Affecting Stage
  • Classification Issues
  • Assigning T, N, M Stage Group
  • Information and Questions on AJCC Staging and Summary

All five webinar recordings for Melanoma, Lung, Breast, Colorectum, and Prostate are available now on the AJCC website.

Visit the AJCC website to learn more about the Disease Site webinars and stay informed.


Updated Accreditation Web Pages
For the latest information on initial accreditation and reaccreditation processes with timelines, annual accreditation fee information, and updated center resources, visit the National Accreditation Program for Breast Centers (NAPBC) Accreditation Web page.

New NAPBC Center Portal
The NAPBC is pleased to announce the release of its new center portal and Survey Application Record (SAR) platform. The first round of surveys in the new system will be conducted this fall and winter. Access to the new center portal and SAR is being granted on a very specific timeline. You will be notified via e-mail when you have access to the new center portal. You can still access the legacy system (old portal) via a link on the new center portal landing page.

NAPBC Standards Manual
The NAPBC Accreditation and Standards Committee is hard at work developing the 2017 edition of the NAPBC Standards Manual. The updated manual will be released early next year and will be announced via e-mail and on our website.

NAPBC Workshop Postponed
The November 12, 2016 NAPBC Accreditation Workshop, Pursuing Excellence through NAPBC Accreditation, has been postponed until mid-2017. As soon as a date is secured, we will post information on the website and send an e-mail notification to all on our distribution list. Please check the website periodically and watch your inbox for more details.

News from the Oncology Community


Learn More about RQRS with NCRA’s Three-Part Webinar Series

The National Cancer Registrar Association (NCRA) is offering a three-part, live webinar series on the Rapid Quality Reporting System (RQRS), including “RQRS: Overview, Objectives, and Implementation” with Lisa Landvogt, BA, CTR, on November 2; “RQRS: Performance Measures Depth and Detail” with Sharmen Dye, CTR, on November 16; and “RQRS: Tools and Data Reports” with Melissa Smith, RHIT, CTR, on December 7. All webinars begin at 2:00 pm ET. Earn one CE credit for each webinar. Learn more and register at

December 8: Deadline for Chufar Annual Conference Scholarship

The Danielle Chufar Memorial Annual Conference Scholarship provides financial support to help an active NCRA member with no available funding to attend the NCRA’s Annual Conference. Applicants must complete the application and submit a 500- to 750-word essay. The 2017 theme is The Future of Auto Populating the Cancer Registry Database and How It Will Affect the Cancer Registry Profession: Outline the Advantages and Disadvantages. The deadline to apply is December 8, 2016. Learn more and download the application at

Now Available! Three New Informational Abstracts

NCRA has posted three new Informational Abstracts: Kidney, Pancreas, and Renal/Pelvis/Ureter. NCRA’s Education Committee created these site-specific abstracts to provide an outline to follow when determining what text to include. Download the 12 Informational Abstracts for free. Take the Informational Abstract quizzes to earn CE credits. Go to

Learn More about NCRA’s Professional Liability Insurance Program

NCRA has partnered with CPH & Associates to provide a professional liability insurance program. This new benefit offers NCRA members discounted rates for coverage, with limits of $1,000,000 each occurrence/$6,000,000 aggregate. Members can get an instant quote for coverage online and save five percent by applying online. To learn more about NCRA’s new professional liability insurance program, including details on how to get started, go to