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

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.

Standard 4.2: Oncology Nursing Credentials

Standard 4.2 will be phased-in for 2021. Programs will be 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 CoC Datalinks, 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 30 days before the site visit.

Standard 4.8: Survivorship Program

Standard 4.8 will be phased-in for 2021. Programs will be 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.

Standards 5.3-5.8: Surgical Standards

Programs will be expected to comply with Standards 5.7: Total Mesorectal Excision and 5.8: Pulmonary Resection beginning January 1, 2021.

Standards 5.3 Breast Sentinel Node Biopsy, 5.4 Breast Axillary Dissection, 5.5 Primary Cutaneous Melanoma, and 5.6 Colon Resection will be phased in over three years, beginning in 2022.

More information on the Operative Standards implementation timeline and plan may be found on the Commission on Cancer Operative Standards website.

Resources including relevant excerpts from the Operative Standards for Cancer Surgery and an introductory webinar are now available.

Standard 6.2: Data Submission

This standard will be 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).

Standard 6.3: Data Accuracy

This standard will be retired beginning in 2021 as the NCDB works to develop new methods to measure data accuracy using the Rapid Cancer Reporting System (RCRS).

Standard 6.4: Rapid Quality Reporting System (RQRS) Participation

This standard will be 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 Standards Manual will be updated later this year to reflect the changes outlined for Standards 6.2, 6.3, and 6.4.

Standard 7.1: Accountability and Quality Improvement Measures

For 2020 and 2021, the program’s performance rate for this standard is expected to be equal to or greater than the expected rate specified by the CoC for the nine (9) selected measures. If the performance rate is not in compliance, the upper limit of the confidence interval computed by the NCDB, which is used to adjust for patient count, may be used to judge performance.

Standard 9.2: Commission on Cancer Special Studies

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

Information for Future Site Visits

Previous Site Visit Year

Original Accreditation Site Visit Year

New Accreditation Site Visit Date/Year

Years of Activity Reviewed at Site Visit

Standards Applicable to Site Visit



2020 through June 2021

2017, 2018, 2019

Cancer Program Standards: Ensuring Patient-Centered Care (2016 Edition)




2020, 2021

Optimal Resources for Cancer Care (2020 Standards)




2020, 2021, 2022

Optimal Resources for Cancer Care (2020 Standards)




2021, 2022, 2023

Optimal Resources for Cancer Care (2020 Standards)