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MCR MINI-UPDATE NOVEMBER 2014
Fellow Registrars,
We should be very proud of the top-notch MOKA regional meeting co-ordinated by MoSTRA
and our Oklahoma, Kansas and Arkansas neighbors. Arrangements and program were
outstanding! I was touched to have our own Angela Martin installed as President. I know she
will do a great job. MCR is proud to support and work with MoSTRA on many projects. All
registrars in the state benefit when both central registry and state tumor registrars
associations work together.
Due Dates
Large hospitals (>500 cases/yr.) are to report April 2014 cases by November 15 and smaller facilities
(<300 cases /yr.) report the 2nd Quarter of 2014 by January 15. If you are behind, please make every
effort to bring your registry into compliance as soon as is possible.
Educational Opportunities - November
NAACCR Webinars – Get 3 CEs By Viewing Recorded Webinars. Request Access Now! Check out our
Education and Training page to find out how you can receive access to the recorded NAACCR Webinars.
November 6, 2014 – Hematopoietic and Lymphoid Neoplasms
Live Meetings - Visit our Education and Training page to listen to previous Live Meetings. They are
available to listen to for one year after they are presented. Registration will be accepted through the
Monday before the Live Meeting.
November 12, 2014 – Review of NPCR Audits – What it Means for You
To register for any of our educational opportunities, call 1-866-240-8809 or contact Shari Ackerman at
[email protected].
CancerCare: Connect Education workshop - These workshops are free – no phone charges apply. You
can listen to leading experts in oncology provide the most up-to-date information on the telephone or
via live streaming. Please feel free to forward to your colleagues or anyone affected by cancer.
These workshops will be taking place from 1:30 p.m. to 2:30 p.m. EST:
November 4, 2014 – Advances in the Treatment of Lung Cancer
November 5, 2014 – Progress in the Treatment of Myeloproliferative Neoplams
November 6, 2014 – Update on Mantle Cell Lymphoma
For more information and to register, visit the CancerCare Website or call 1-800-813-HOPE (4673).
MCR News
LM Recordings – listen now before they are gone!
Live Meeting has been made available to us via a CDC account. Microsoft is no longer supporting that
software and it will not be available to us in 2015. We are exploring alternative ways to get educational
sessions to your desktop. In the meantime, please take advantage of any sessions you missed by
listening to the recordings posted on our website, http://mcr.umh.edu/mcr-livemeeting.php.
Unfortunately, in 2015 you will no longer have access to these previous recordings. If you missed our
Live Meeting last month on the Value of the Cancer Registry, you might want to listen to the recording
to learn how you can make your registry more valuable to your facility. Its format is meant to educate
and encourage your Administrators to appreciate your data and learn how it can enhance hospital
operations, so please share the link with them as well!
Facility Reporter Survey Results Summary
We sent out 102 surveys and had 33 responders. Thank you for everyone who participated in our
survey. We found that all appreciate the work that we are doing to provide information that you
need. You said that you appreciate the Monthly Update as well as the Live Meeting trainings. There
were also suggestions on how to improve our website as well as other topics of interest for educational
trainings. As always, we appreciate any and all suggestions that you have. We continue to work to
provide you with access to the necessary information to make your job easier.
Navigating the MCR Website
The survey indicated that our website can be hard to negotiate. Until we can incorporate your
suggestions, I thought it might be useful to review the location of helpful resources. A topical list of
pages is found on the left column of the MCR-ARC web site home page http://mcr.umh.edu/index.php.
We’ve put the link to the Web Plus login screen at the top for your convenience. Registrars will find
much of what they need for data submissions on our Hospitals page: reporting calendar, edits
information, list of required fields, and MCR Abstract Code Manual. This is also the spot to find change
of information, hospital directory update and transmittal forms. The Abstracting Resources page has
links to county code lists, recommended abbreviations, ICD-10 codes, etc. The Education page is the
place to find details on training that we offer as well as links to some of the standard setter training
materials. The Data page is your first stop in finding our compiled Missouri data as well as links to
national cancer statistics. Past issues of this Monthly Update are archived on the Publications page. The
menu bars across the top of the home page show links to many standard setter websites. The Contact
Us tab brings you to a list of MCR staff and photos. You can stay up to date with additions or
improvements to the web site via the What’s New tab. And if you get lost, the Site Map may help you
find what you want. Or, as always, you can call us at 1-800-392-2829.
Abstracting Tips
Coding Breast Biopsies and Surgery
The Sept 2014 edition of the COC Flash contained an explanation of an issue that had come forward on
the CA Forum thread “Biopsy Removing All Breast Cancer”. If your cancer program is accredited and
your registry needs to always track breast core needle biopsies in the Surgical, Diagnostic and Staging
Procedure field for quality measure; that is acceptable for MCR. In the rare situation where the
treatment surgery (e.g., lumpectomy) shows no residual cancer, also continue to code the date of
surgery (Date of 1st Surgical Procedure (RX Date – Surgery) as the date the tumor was first removed,
i.e., the date the biopsy removing the tumor was done. In this example the code for the lumpectomy is
the most definitive treatment surgery and is still coded in the Rx Summ -Surgery of Primary Site field, as
it has been in the past. Your text should explain that a biopsy was done and that there was no residual
tumor found on the more definitive surgery specimen.
Grade Reminder
Several grades for prostate have changed, effective with cases diagnosed January 1, 2014 and
later. Gleason Scores 5 and 6 convert to Grade Code 1 and Gleason Score 7 converts to Grade Code
2. Refer to the new 2014 Grade Codes for prostate located in the table on page 51 of the MCR Manual
or in the 2014 SEER Manual, page 86.
Date of First Contact
For analytic cases, the date of first contact is the date the patient was first eligible for the assigned Class
of Case indicating why the case was reported by your facility. For Example: Patient diagnosed elsewhere,
came into to your facility for consult with RT Doctor on 05/01/14 and RT was recommended. Patient
started RT 06/01/14. The Date of First Contact would be 06/01/14, the day the patient started their
radiation (not the consult date). The date the patient started RT is the date that made the case analytic
and determined that your facility needed to pick up the case.
Hematopoietic Manual Appendices
This manual has two excellent appendices as a resource to assist with coding obsolete terms and
determining reportability for certain hematopoietic and lymphoid neoplasms. Appendix E lists all
obsolete codes effective 01/01/2010, with their current descriptions and codes. Be sure to familiarize
yourself with the terms because the code assignment for the current terms is different. Appendix F is a
listing of commonly seen non-reportable terms and includes NOS terms for diagnoses that are only
reportable if certain additional modifying terms are present. For example: myelofibrosis alone is not
reportable - it must be stated as 'primary' myelofibrosis or one of the alternate names listed in the HP
DB for primary myelofibrosis.
Standard Setter News
CS Transition Newsletter for October is attached to this email. Please note the significant revision to
one sentence regarding an upcoming letter you can give to your boss.
SEER Summary 2000
You might want to make a new year’s resolution to download the complete SEER Summary Staging
Manual - 2000 (SS00) http://seer.cancer.gov/tools/ssm/SSSM2000-122012.pdf You will be required to
direct code SS00 values when abstracting 2015 cases, so we recommend that you review pages 1-15 and
have the resource handy to look up applicable codes for particular sites when it is time to abstract those
cases. If you were not a registrar before 2004, this may be entirely new to you. If you have used it in the
past, you might benefit from a refresher. Listen to the October NAACCR webinar recording to learn
more about SEER Summary 2000 and as well as AJCC TNM Staging which will MCR will require of all
facilities in 2016. http://mcr.umh.edu/mcr-education.php
SEER Rx
Important Update: SEER*Rx has a new look! SEER*Rx now has a new and improved search engine that does
faster and more intelligent full text searching of all fields, with a sortable results table and a new relevance
column so you can tell how relevant each search result is to your entered search string. Additionally, each
drug and regimen is now displayed in its own page so that you can bookmark specific entries. For specific
Summary of Changes related to the September 30, 2014 release please click on (details) located at:
http://seer.cancer.gov/tools/seerrx/
SEER Educate
SEER has announced an expansion of the free training and continuing education series in SEER*Educate.
Anatomy and Physiology has been released as a new module in General Knowledge Site-specific
modules for MP/H training have also been added. They include 5 practice case scenarios with answers
and rationales to help registrars learn how to use the 2007 MP/H Rules for the following sites:

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Benign and Borderline Brain/CNS
Breast
Colon
Head and Neck
Kidney
Lung
Malignant Brain/CNS
Melanoma
Other Sites
Urinary
This new content is available from the Training Menu in the Practical Application section. One of the
best ways to learn cancer registry work is by doing cancer registry work. A primary goal of SEER*Educate
is to provide access to free practical application exercises to learn how code and apply guidelines
associated with various aspects of a registrar’s responsibility. They have applied to the National Cancer
Registrars Association (NCRA) for continuing education credits for this entire series:
https://educate.fhcrc.org/LandingPage.aspx.
Planned coding rule revisions
MP/H Rule revision is tentatively planned for 1/1/2016. Hematopoietic and Lymphoid Neoplasm
Database and Coding Manual revision is tentatively planned for 1/1/2015.
From NAACCR: 3 min. video celebrating cancer registries
Every day registry staff capture data on patients diagnosed with cancer that physicians, researchers,
health care administrators and standard setters rely on. To celebrate and highlight the work of so many
dedicated individuals, NAACCR proudly presents a new tool to inform the public about the important
role cancer registries play in preventing and treating cancer. This short explainer video, which was
developed in cooperation with the Communications Steering Committee and NAACCR staff, can be
accessed via the NAACCR website or through NAACCR's Youtube channel here. Take a moment to watch
it and share it with your friends, family and colleagues.
Thank you for all that you do. Your efforts to gather and support vital information that is used to
develop programs to prevent cancer, detect it earlier, and improve survival, make the world a better
place.
Save the Date: Dec 8, 2014 Massachusetts Cancer Registry Annual Workshop Webcast
I’ll provide the link in my December Monthly Update. This will be an all-day workshop with topics that
include: quality control program/Commission on Cancer, data warehouses and cancer surveillance, AJCC
breast cancer staging, esophageal cancer overview, radiation oncology, and quality control efforts on
breast and colorectal cancer treatment data. The workshop will be webcast free-of-charge.
Registry to Research
State Cancer Profiles Updated (SEER/NPCR)
http://statecancerprofiles.cancer.gov/quick-profiles/index.php?statename=missouri
2014 CBTRUS Published
The Central Brain Tumor Registry of the United States (CBTRUS) announces the publication by Oxford
University Press of its latest report, CBTRUS Statistical Report: Primary Brain and Central Nervous
System Tumors Diagnosed in the United States in 2007-2011. It is currently available online at
www.cbtrus.org by clicking on Reports and Tables. Data collected by CDC’s National Program of Cancer
Registries and NCI’s Surveillance Epidemiology and End Results program were analyzed resulting in an
incidence rate of 21.42 cases per 100,000 for all primary brain & central nervous system tumors
diagnosed in 2007-2011. The efforts of hospital tumor registrars, central cancer registries, and staff from
NPCR and SEER to collect accurate and complete data have contributed to making this report possible.
A limited number of printed booklets (November 2014) may be requested by contacting
[email protected] <mailto:[email protected] .
Lynch Syndrome screening under performed in high-risk patients
http://www.practiceupdate.com/News/6234/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4
MTE1NjYS1&lid=10332481
Treatment of lung cancer in the elderly
http://archsurg.jamanetwork.com/article.aspx?articleid=1915585
Use of and mortality after bilateral mastectomy in California
http://jama.jamanetwork.com/article.aspx?articleid=1900512
Racial disparities found in head and neck cancer outcomes
http://www.sciencedirect.com/science/article/pii/S1368837514002656
Resources
Killing cancer at MU
http://munews.missouri.edu/news-releases/2014/0924-bacterial-%E2%80%9Ccommunicationsystem%E2%80%9D-could-be-used-to-stop-spreading-and-kill-cancer-cells-mu-studyfinds/index.php?&utm_medium=website&utm_campaign=atMizzouOct14
Long-term Impact of SLN surgery
http://www.ejso.com/article/S0748-7983%2814%2901051-8/abstract
Receptor status change after neoadjuvant chemotherapy - survival analysis
http://www.sciencedirect.com/science/article/pii/S1526820914001980
Registry Note: Per CS coding rules, priority is given to coding receptor values prior to any adjuvant
treatment.
Role of re-excision for close and positive margins in breast conserving surgery
http://www.sciencedirect.com/science/article/pii/S0960977614001775
Which breast cancer patients are at higher risk for supraclavicular fossa recurrence?
http://www.sciencedirect.com/science/article/pii/S0960977614001374
Public misunderstandings of metastatic breast cancer
http://www.medicalnewstoday.com/releases/283754.php?tw
Proposal for molecular testing (EGFR and ALK) of lung cancer patients
http://jco.ascopubs.org/content/early/2014/10/14/JCO.2014.57.3055
Scientists find trail to explain how melanoma spreads
http://www.medicalnewstoday.com/releases/283872.php?tw
FDA approves Ibrutinib for CLL
http://www.practiceupdate.com/News/5723/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4
MTE1NjYS1&lid=10332481
Thyroid cancer markers of aggressive tumors
http://medicalxpress.com/news/2014-10-thyroid-cancer-genome-analysis-markers.html?sf32915316=1
Thanks for the work you do every day!
Nancy H. Rold, CTR
Operations Manager
Missouri Cancer Registry and Research Center