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

Integrated Network Cancer Programs

What Is an INCP?

The Integrated Network Cancer Program (INCP) category is defined as "an organization that owns, operates, leases, or is part of a joint venture with multiple facilities providing integrated cancer care and comprehensive services." At least one facility in the category is a hospital and must be a CoC-accredited cancer programs. Generally, INCPs are characterized by a unified cancer committee, standardized registry operations with a uniform data repository, and coordinated service locations and practitioners. Each entity of the INCP meets performance expectations for the quality measures under the umbrella of the integrated program. The INCP participates in cancer-related clinical research either by enrolling patients in cancer-related clinical trials or by referring patients for enrollment at another facility or through a physician’s office. Participation in the training of resident physicians is optional, and there is no minimum caseload requirement for this category.

Necessary Steps to Become an INCP

Each program seeking to be part of an INCP is required to:

  • Have at least one facility in the category must be CoC accredited
  • All CoC-accredited programs seeking network accreditation must be in good standing, which is defined as:
    • Accredited with no unresolved deficiencies

Additionally, programs seeking to form network accreditation must:

  • Submit a completed application with application fee by September 30, so individual programs due for survey in 2017 can be put on hold pending a network survey
  • Name an INCP Cancer Program Administrator
  • Name an INCP Cancer Liaison Physician
  • Sign a Business Associate Agreement (BAA) with the American College of Surgeons
  • Maintain compliance with INCP-specific requirements as outlined in the current edition of the Cancer Program Standards from the time of the category change through survey
  • Continue to submit data as required for the National Cancer Database (NCDB) Call for Data and, if applicable, to the Rapid Quality Reporting System (RQRS)  as individual programs (the individual program Facility Identification number [FIN] is reported in data element “Reporting Facility [#540]”)
  • Be surveyed as part of the network within 18–24 months of category change confirmation

If your program meets the above requirements and is interested in forming an INCP, please review and complete the Network Application Form (please note: we recommend that you right-click this link and save the associated file to your local drive in order to access the interactive application form PDF). Please submit your completed application form to Karen Stachon. Questions regarding the Guidelines for Integrated Network Cancer Programs may also be directed to Karen Stachon.

Network Checklist

The following checklist is provided to ensure successful network formation and a smooth transition between your facility and the CoC.

    Access and complete the online Network Application via Datalinks.

    Remit application fee to: American College of Surgeons, ATTN: Karen Stachon, 633 N. Saint Clair St, Chicago, IL 60611.

    Coordinate cancer registry data collection and reporting in preparation for network registry operations.

    Review and sign the HIPAA BAA for network.

    Receive e-mail confirmation from CoC with new INCP FIN and category.

    Complete INCP Survey Application Record (SAR) in preparation for survey.

    Comply with standards specific to the INCP category for at least 18 months.

    Schedule an INCP survey within 24 months of network application submission.

Cancer Program Identification

Programs meeting the requirements for the formation of an INCP are assigned a Network FIN. An automated letter will be sent to the CEO, network cancer program administrator, cancer committee chair, Cancer Liaison Physician (CLP), and cancer registrars confirming the following:

  • Category change
  • Network FIN
  • Participating individual cancer programs and their FINs
  • Reference date
  • Preliminary survey date

Individual programs should continue to make submissions to the NCDB as required by the Call for Data schedule, and to RQRS if applicable. Additionally, the INCP will maintain compliance with INCP-specific requirements as outlined in the most current edition of the Cancer Program Standards.

Cancer Liaison Physician

A single CLP should be appointed to serve the network facility. In most cases, a cancer liaison physician currently in place at one of the campuses will be selected to fill this role by the network cancer program; however, new networks may optionally select an entirely new cancer liaison physician. If a new liaison is selected, complete the CLP Appointment Application or contact Carolyn Jones.

Reference Date

A reference date for the network will be established by the CoC.  This reference date will be the earliest reference date of the individual programs in the network.  Once the network is established, a reference date change may be requested. 

To request a reference date change for your network, please use the Registry Reference Date Change request available on the CoC website.

Cancer Registry Operations and Database Management

Program access to CoC Datalinks for the individual facilities and for the network will be accomplished through the new network FIN, once the network has been accredited. Prior to accreditation of the network, access will be available only through the individual facility-specific FINs.

Each individual facility in the network must maintain its facility-specific FIN for NCDB (RQRS if participating) submissions. Although the individual submitting data for the network will log into CoC Datalinks under the new network FIN, the facility-specific FIN must be reported in both the Reporting Facility [#540] and Archive FIN [#3100] data items in the submitted data file(s).  The Network FIN should not be recorded in submitted records.  The NCDB will combine cases from facilities and provide aggregate reports for the network.  Any individual designated as a registrar or co-registrar for any individual facility in the network program (or software provider specified by that individual) is authorized to submit data to the NCDB for any facility in the network.

Previously CoC-accredited programs are required to submit data to the NCDB from the time of the network reference date forward, as applicable, in accordance with the Call for Data specifications. Facilities (or campuses) that were not previously accredited are required to submit NCDB data from the date of network accreditation forward, but earlier cases may be submitted at the program’s discretion.

All the information for submitting data can be found on the NCDB web page. Facility staff should contact the NCDB at if clarification of submission guidelines is necessary.

A network may request CoC Datalinks access for additional members of the cancer program and/or medical staff. These additional users must be added by an existing Datalinks user with access to the network. Adding a user may be completed using the Manage Staff Contact link located on the Activity Menu in Datalinks.  It is at the discretion of the network to designate the additional users and to notify the CoC of these users.

Health Insurance Portability and Accountability Act (HIPAA)

The American College of Surgeon’s CoC serves as the recognized accrediting body for your program. In that capacity, the College serves as a Business Associate to your program.  Although, a BA/DUA has been individually signed by each CoC-accredited facility involved in the network, to comply with the HIPAA privacy regulations, the network program will need to electronically sign the Business Associate and Data Use Agreement as well.

The network program can view and electronically sign the Business Associate and Data Use Agreement with the American College of Surgeons. The American College of Surgeons ACS has developed a standard Business Associate and Data Use Agreement for all of the quality improvement programs administered by the College. The new agreement includes the new HIPAA security rule requirements. Instructions to sign the BAA can be found on our website.

NCDB Statistical Tools

Once the new network has been accredited, it will have access to the NCDB Hospital Comparison Reports and the NCDB Survival Reports. However, the Cancer Program Practice Profile Reports (CP3R) and Cancer Quality Improvement Program Annual Reports (CQIP) are updated annually and data for these reports will be released for the new network at the same time these reports are released for all CoC-accredited programs. Extensive documentation for these reporting tools is available online, providing an overview of the NCDB statistical tools.

Program Activity Report/Survey Application Record (PAR/SAR)

The PAR/SAR is a web-based tool that provides the framework for detailing your network’s activity as it relates to compliance with the most current CoC Cancer Program Standards.

After your application has been accepted, your program will be given access to a single PAR/SAR for the network through the Datalinks Activity Menu.  Cancer programs participating in CoC accreditation are required to complete the PAR/SAR in preparation for survey. 

For questions regarding the PAR/SAR, e-mail