2020 CoC Standards Implementation Timelines

With a few exceptions, programs were expected to implement the Optimal Resources for Cancer Care (2020 Standards) beginning January 1, 2020. Optimal Resources for Cancer Care (2020 Standards) was updated in December 2024. A change log is available that details updates to the manual since its original publication.

Starting January 1, 2024, programs will be required to demonstrate accreditation for anatomic pathology by a recognized organization.

Programs were expected to comply with Standard 4.2 beginning January 1, 2021.

Resources to support implementation:

• Oncology Nursing Certification Corporation (ONCC) website for information on certification and continuing education (CE). The ONCC also provides an updated list of available free CE options.
• Oncology Nursing Society also provides information on continuing education for nurses, including free options.
• Oncology Nursing Credentials Frequently Asked Questions resource answers questions submitted by programs regarding all aspects of the standard.
• The Oncology Nursing Credentials Template, located in QPort, is a useful tool to track compliance throughout the accreditation cycle and can be used to demonstrate compliance with the standard. The template must be uploaded into the Pre-Review Questionnaire at least 60 days before the site visit.

If a program due for a site visit in 2023 or 2024 determines it is not currently capable of meeting compliance with Standard 4.2, the program is allowed to develop and implement an action plan to help achieve compliance.

The corrective action plan must outline the specific issue(s) affecting compliance and the interventions that will be implemented to achieve compliance. The specifics of the action plan must be documented in the cancer committee minutes. Successful documentation of a substantive action plan may result in a “deficient but resolved” rating during the 2023 or 2024 site visit.

Programs were expected to comply with Standard 4.8 beginning January 1, 2021. A Frequently Asked Questions document and a resource that provides compliance examples for a variety of programs are available in the Standards Resource Library.

The review of pathology reports during the site visit to evaluate that the required CAP elements are present in synoptic format was removed beginning January 1, 2023.

Standard 5.1’s measure of compliance has been replaced with a requirement to perform an internal audit of pathology reports. Programs are expected to comply with the updated requirements, as fully detailed in the Standards manual, by January 1, 2024.

The following implementation timeline is being utilized for Standard 5.3: Sentinel Node Biopsy for Breast Cancer; Standard 5.4: Axillary Lymph Node Dissection for Breast Cancer; Standard 5.5: Wide Local Excision for Primary Cutaneous Melanoma; Standard 5.6: Colon Resection; Standard 5.7: Total Mesorectal Excision; and Standard 5.8: Pulmonary Resection.

Standards 5.3-5.8 were republished with substantive updates in 2021 and 2023. Please review the most recent version of Optimal Resources for Cancer Care (2020 Standards) for updates. 

Resources to support implementation of the operative standards can also be found on the CoC Operative Standards page and Operative Standards Toolkit page.

For site visits occurring in 2024, 2025, or 2026, a site may meet CoC Standards 5.3-5.6 through an alternative compliance pathway by performing an internal audit of its compliance with Standards 5.3-5.6. If compliance is not met with any of these standards, an action plan must be developed, outlining the specific issue(s) affecting compliance and the interventions that will be implemented to achieve compliance. The results of the internal audit and the action plan must be documented in the cancer committee minutes. An action plan must be developed for each potentially non-compliant standard.

The internal audit must be conducted and the resulting action plan must be documented in cancer committee minutes from a meeting during the year before or the year of the site visit and must be from before the Site Reviewer selects the cases that will be reviewed during the site visit. For example, if the site visit is in 2026, then the internal audit/action plan must be documented in the minutes from a 2025 or 2026 cancer committee meeting.

During the site visit, the medical record review will be conducted. If the expected compliance percentage is not met, the site reviewer will evaluate the results of the site’s internal audit and action plan as documented in the cancer committee minutes. A “deficient but resolved” rating may then be given.

A site taking advantage of this alternative compliance pathway is expected to be fully compliant with Standards 5.3-5.6 at its next site visit.

This standard was retired beginning in 2021 as complete data for all requested analytic cases will be submitted to the National Cancer Database (NCDB) in accordance with the requirements for use of the new Rapid Cancer Reporting System (RCRS). Data accuracy will be evaluated under Standard 6.4: Rapid Cancer Reporting System: Data Submission.

In 2021, Standard 6.4 was renamed Rapid Cancer Reporting System (RCRS) Data Submission with the following requirements:

• All new and updated cancer cases are submitted at least once each calendar month.
• Submit all complete analytic cases for all disease sites via RCRS as specified by the annual Call for Data.
• Rapid Cancer Reporting System data and required quality measure performance rates are reviewed by the cancer committee at least twice each calendar year and documented in the cancer committee minutes.

The most recent version of Optimal Resources for Cancer Care (2020 Standards) reflects the updates to Standards 6.2, 6.3, and 6.4.

Starting January 1, 2022, Standard 6.5 requires a rolling 15-year requirement for long-term follow-up. Follow-up on cases older than 15 years from the most current year of completed cases will no longer be required for submission to the National Cancer Database. Updates are reflected in an updated version of Optimal Resources for Cancer Care (2020 Standards).

Due to ongoing upgrades, Standard 7.1 will not be evaluated during 2024 site visits. 2023 and 2024 cancer program activity for Standard 7.1 will also not be evaluated at future site visits.

For more information, please review the National Cancer Database Quality Measures webpage.

At this time, there are no studies planned in 2020, 2021, 2022, 2023, or 2024 for Standard 9.2: Commission on Cancer Special Studies.

Standards Specifications by Category

The Specifications by Category section of Optimal Resources for Cancer Care (2020 Standards) has updated standards requirements for Integrated Network Cancer Programs (INCP), NCI-Designated Network Cancer Programs (NCIN), and Pediatric Cancer Programs (PCP). Please review the Specifications by Category section for full details.