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

The Brief: February 13, 2020

ACS Cancer Programs Updates

Register today for April accreditation conference

Registration is for the American College of Surgeons (ACS) Cancer Accreditation Programs: New Content for a New Decade conference. Learn about the new Commission on Cancer (CoC) Standards for 2020, as well as best practices and common deficiencies for the National Accreditation Program for Breast Centers (NAPBC). Join us on April 22–24, 2020, at the Loews Chicago O’Hare Hotel in Rosemont, IL.

Three consecutive days of live programming will cover the following:

  • CoC Educational Summit—April 22
  • National Cancer Database (NCDB) Half-Day Workshop—April 23 (morning)
  • NAPBC Quality Makes a Difference—April 23 (afternoon) and all day April 24

All members of the multidisciplinary care team at health care facilities that treat patients with cancer are invited to attend, including, but not limited to:

  • Cancer committee members
  • Genetics professionals
  • Navigators
  • Nurses
  • Physicians (Cancer Liaison Physicians)
  • Program leadership (cancer program administrators, breast program directors, breast program leaders)
  • Registrars
  • Social workers

Please note, registration is limited to the first 200 participants. To learn more about the programs, please visit the event website.

Deadline to submit CAnswer Forum LIVE questions is April 21

Registration is now open for the next CAnswer Forum LIVE webinar from 12:00 noon to 1:00 pm CST on Wednesday, May 6, 2020. In this webinar we will address the new 2020 Commission on Cancer (CoC) Standards and answer questions from cancer programs throughout the United States. Please submit your questions for this free session by 12:00 pm CST on Tuesday, April 21, 2020.

The American College of Surgeons (ACS) Cancer Programs is offering one continuing education credit from the National Cancer Registrars Association (NCRA) for each of the 2020 CAnswer Forum LIVE webinars. If you missed previous CAnswer Forum LIVE sessions, visit our website to read about the NCRA continuing education credits and to view the recordings and download the slides.

Save the Dates — CAnswer Forum Live Upcoming Webinars

  • CAnswer Forum LIVE — June 10, 2020
  • CAnswer Forum LIVE — August 5, 2020
  • CAnswer Forum LIVE — October 14, 2020
  • CAnswer Forum LIVE — December 9, 2020

Cancer Programs featured in the Bulletin of the American College of Surgeons

The American College of Surgeons (ACS) Cancer Programs were featured in several articles in the February issue of the Bulletin of the American College of Surgeons.

Registration open for 2020 ACS Leadership & Advocacy Summit

Registration is open for the ninth annual American College of Surgeons (ACS) Leadership & Advocacy Summit, March 28–31 at the Renaissance Washington, DC Downtown Hotel. The Summit is a dual meeting offering comprehensive and specialized sessions that provide ACS members, leaders and advocates with information on effective surgeon leadership, as well as interactive advocacy training with coordinated visits to congressional offices. Additional information is available on the ACS website.

Enrollment OPEN for colorectal surgery enhanced recovery program

Enhanced recovery is one of the best ways to improve the short-term outcomes for colorectal cancer patients.

The Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR), a national collaborative focused on enhanced recovery implementation, is recruiting hospitals to join the new collaborative. As part of this program, hospitals will have access to evidence-based enhanced recovery pathways, coaching and content calls with experts in the field and continuous clinical and implementation support. The program aims to improve patient outcomes (for example, surgical site infections, venous thromboembolism, length of stay) through a collaborative, team-based approach.

Benefits of ISCR participation:

  • Recommended milestone goals but self-paced program
  • Personalized support
  • Bench-marked data reports
  • Assistance with staying up to date with evolving practices
  • Collaboration with like-minded people passionate about perioperative improvement

Participation is free to all U.S. hospitals.

If you are interested in joining or learning more about the surgery programs, register for an upcoming informational webinar or e-mail to begin the enrollment process.

New Cancer Genetics and Risk Assessment Certification program

In recent years, genetics has become an important variable in cancer care while the ability to test individuals has greatly expanded. Beyond surgical skills, knowledge of cancer genetics is necessary to comprehensively treat our patients. Accreditation bodies such as the Commission on Cancer (CoC) and the National Accreditation Program for Breast Centers (NAPBC) require competency in cancer genetics. The National Consortium for Breast Centers’ (NCBC) new certification program in Cancer Genetics and Risk Assessment (CGRA®) is now available to document competency in this field. Clinicians beyond genetic counselors, such as physicians, physician assistants, advanced practice nurses or other skilled professionals, must validate their skills, knowledge and abilities in cancer genetics.

This new rigorous CGRA Certification Exam will be offered on April 7, 2020, in Las Vegas, NV, during the 30th Annual Interdisciplinary Breast Center Conference. Examinees must be qualified to take the exam. Beyond being a licensed clinician experienced in the field of cancer care, one must have evidence of clinical training and/or educational courses in the field of cancer genetics, including breast cancer risk assessment to qualify for the examination. Although this certification is new, it is expected that those who achieve CGRA Certification will satisfy the CoC and NAPBC requirements as providers of cancer genetics and risk assessment services.

For further information, please contact NCBC’s Executive Director, Kimberly Bolin, at or visit the CGRA website.

2020 Jacobson Promising Investigator Award accepting submissions

The American College of Surgeons (ACS) is accepting nominations for the 16th Joan L. and Julius H. Jacobson II Promising Investigator Award to be conferred in 2020. This award has been established to recognize outstanding surgeons who are engaged in research that advances the art and science of surgery and who demonstrate early promise of significant contribution to the practice of surgery and the safety of surgical patients. The award is funded through a generous endowed fund established by the donors and administered by the ACS Surgical Research Committee (SRC).

To be considered for the 2020 award, applications must be submitted on or before February 21. 2020. Visit the award website to submit documentation and nomination materials. For additional information, please contact

Cracking the code to clinical trial enrollment: How to start and who can help

Are you a surgeon interested in participating in clinical trials but are unsure how to get started? A new webinar and resource deck developed through the American College of Surgeons Clinical Research Program (ACS CRP) was designed to help guide surgeons through the administrative and regulatory requirements needed to participate in clinical trials. This webinar will detail how to obtain a Cancer Therapy Evaluation Program (CTEP) Identity and Access Management (IAM) ID, how to register with the National Cancer Institute (NCI)’s Registration and Credential Repository (RCR) and how to complete enhanced training requirements such as Good Clinical Practice (GCP). The webinar will also provide information about the NCI Biosketch, Financial Disclosure Form and Agent Shipment Form.

ACS Cancer Programs now on Facebook, Twitter

The American College of Surgeons (ACS) Cancer Programs is now on Facebook and Twitter. Follow our new pages for the latest news and updates from all Cancer Programs, including the ACS Cancer Research Program (ACS CRP), American Joint Committee on Cancer (AJCC), Commission on Cancer (CoC), National Accreditation Program for Breast Centers (NAPBC), National Accreditation Program for Rectal Cancer (NAPRC) and National Cancer Database (NCDB).

ACS Cancer Programs offer career opportunities for CTRs

The American College of Surgeons Cancer Programs has two exciting career opportunities at its home office in Chicago, IL, for Certified Tumor Registrars (CTR) or CTR-eligible professionals with the American Joint Committee on Cancer (AJCC) and the National Cancer Database (NCDB).

For details, visit the American College of Surgeons website:

AJCC Technical Specialist

NCDB User Support Specialist

Interested candidates are encouraged to apply online; however, if you have questions, please contact Cindy McWilliams, Talent Manager, at 312-202-5492 or


CDC's Cancer Staging API transitions to AJCC

For the past several years, the Centers for Disease Control and Prevention (CDC) has created and maintained software in the form of a dynamic link library (DLL) to help cancer registries collect data on stage of disease for cancers according to the American Joint Committee on Cancer (AJCC) Cancer Staging System. Content from AJCC’s Cancer Staging System was licensed for use in the development of this software named the Cancer Staging API. This tool is made available by the National Program of Cancer Registries (NPCR) and licensed, through the AJCC, to cancer registry software companies to incorporate into their commercial products. The ownership and maintenance of this API will transition to the AJCC, a program of the American College of Surgeons, beginning January 2020. This transition will bring future development closer to the source of content as AJCC moves forward with updates to the Cancer Staging System.

The AJCC and CDC will continue to work closely together over the transition period. As a long-time partner of the AJCC, the CDC is committed to a smooth handover process and has already begun providing documentation, training and expertise to ensure a successful transition of the API.

Going forward, the Cancer Staging API developed by the CDC will be referred to as the AJCC Cancer Surveillance API. This change is both to indicate the new ownership and distinguish this tool from the AJCC API developed for clinical care that is licensed and used by electronic health record vendors at point of care. The AJCC Cancer Surveillance API will continue to include content to support collection of Summary Stage 2018 and EOD to provide vendors with a single tool for collection of stage data. Access to the API by and for NPCR registries will not change.

Please contact the AJCC at with questions or support requests for the API.


CoC Paper Competition accepting submissions through June 30

The Commission on Cancer (CoC) is currently accepting submissions for the Annual Cancer Research Paper Competition, which recognizes residents and fellows-in-training for their original research. The first-place winner will receive a $1,000 honorarium plus travel expenses to present the research at the CoC’s Annual Meeting on October 4, 2020, during the American College of Surgeons Clinical Congress in Chicago, IL. The entry will be considered for publication in the Journal of the American College of Surgeons. The authors of the second- and third-place winning abstracts will each receive a $500 cash award. Submissions are being accepted through June 30, 2020, at


Sentinel Lymph Node Biopsy information updated

As referenced in the STORE, page 3, because sentinel lymph node biopsies have been generally under-reported and the timing and results of sentinel lymph node biopsy procedures are used in multiple Commission on Cancer (CoC) Quality of Care Measures, the CoC developed six new data items for collection of more specific information on sentinel and regional nodes.

  • Date of Regional Lymph Node Dissection [682]
  • Date Regional Lymph Node Dissection Flag [683]
  • Date of Sentinel Lymph Node Biopsy (for breast and melanoma only) [832]
  • Date of Sentinel Lymph Node Biopsy Flag (for breast and melanoma only) [833]
  • Sentinel Lymph Nodes Examined (for breast and melanoma only) [834]
  • Sentinel Lymph Nodes Positive (for breast and melanoma only) [835]

In instances when only a sentinel lymph node biopsy is performed (no other regional lymph nodes examined and no regional lymph node dissection), the following data items are completed:

  • Sentinel Lymph Nodes Examined [834]
  • Sentinel Lymph Nodes Positive [835] Date of Sentinel Lymph Node Biopsy [832]
  • Regional Lymph Nodes Examined [830]*
  • Regional Lymph Nodes Positive [820]*
  • Date Regional Lymph Node Dissection [682] (blank)
  • Date Regional Lymph Node Dissection Flag [683] (11; no regional lymph node dissection performed)
  • Scope of Regional Lymph Node Surgery [1292] (code 2; cannot be codes 3 to 5)

*When only a sentinel lymph node biopsy is performed and there are no other regional lymph nodes examined, the number of Regional Lymph Nodes Examined [830] is equal to the number of Sentinel Lymph Nodes Examined [834], and the number of Regional Lymph Nodes Positive [820] is equal to the number of Sentinel Lymph Nodes Positive [835].

Case Scenario: A patient only has a sentinel lymph node biopsy on January 1, 2019, for breast cancer that reveals 0/2 sentinel lymph nodes positive.

The relevant data items are completed as follows:

  • Sentinel Lymph Nodes Examined [834] 02
  • Sentinel Lymph Nodes Positive [835] 00 Date of Sentinel Lymph Node Biopsy [832] 20190101
  • Date of Sentinel Lymph Node Biopsy Flag [833] blank
  • Regional Lymph Nodes Examined [830] 02
  • Regional Lymph Nodes Positive [820] 00
  • Date Regional Lymph Node Dissection [682] blank
  • Date Regional Lymph Node Dissection Flag [683] 11
  • Scope of Regional Lymph Node Surgery [1292] 2
  • NCDB updates Tumor Size Summary Addendum

    The last paragraph of the STORE Addendum on page 16 for Tumor Size Summary [756] was updated to:

    If no surgical resection, then largest measurement of the tumor from the imaging, physical exam, or other diagnostic procedures in this order of priority prior to any form of treatment (See Coding Rules), page 174, STORE. The next version of the STORE will be updated with the following information for Tumor Size Summary [756], Coding Rules #4: Information on size from imaging/radiographic techniques can be used to code the tumor size when there is no more specific size information from pathology or operative report. It should be taken as a lower priority, but over a physical exam.