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MCR MINI-UPDATE APRIL 2015 Fellow Registrars, I want to re-affirm how blessed I feel to work with such a professional and dedicated group of registrars across Missouri. You keep the light burning in the cancer surveillance lighthouse even when the storm clouds of change threaten. Please know that you are appreciated! I hope that you find a way to celebrate National Cancer Registrars Week April 6-10. If you are in the Columbia area, let Shari know If you would like to join MCR for lunch on April 7 at 11:30 at Arris Pizza. Due Dates Large hospitals (>500 cases/yr.) are to report Sept 2014 cases by April 15 and smaller facilities (<300 cases /yr.) report the 3nd Quarter of 2014 by April 15. Education 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. April 2, 2015 – Collecting Cancer Data: Stomach and Esophagus (Live webcast at MCR) GoToMeeting - There are only 25 lines available so it will be a first come, first serve on the day of the meeting. We recommend that if there are several of you from one facility that want to participate in a meeting you call in as a group. For those of you not familiar with GoToMeeting, you can listen via your computer speakers or headphones and ask questions via a microphone or type a chat message within GoToMeeting. If you have to call in to listen you will be charged for a long distance call. April 8, 2015 – SEER Summary Stage: Colon Fundamentals of Abstracting Workshop – This day and a half workshop will focus on the MCR Abstract Code Manual and will give you an opportunity to abstract practices cases. This is a great workshop for those new to abstracting as well as those that need a refresher course. April 2-3, 2015 at the Missouri Cancer Registry and Research Center 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 1:30pm to 2:30pm EST: April 2, 2015 - Progress in the Treatment of Multiple Myeloma April 15, 2015 - Emerging Therapies in Hodgkin and T-Cell Lymphomas April 21, 2015 - Precision Medicine: Implications for the Treatment of Prostate Cancer April 28, 2015 - Medical Update on Ovarian Cancer April 29, 2015 - Updates in the Treatment of HER2 Positive Breast Cancer Part I of Living with Breast Cancer For more information and to register, visit the CancerCare Website or call 1-800-813-HOPE (4673). MCR News 2015 Case Reporting We won’t be able to accept 2015 cases until after we upgrade our systems to NAACCR v15, which is planned for mid-August. Facilities should hold any 2015 cases until then. If you abstract them while your hospital software is still in v14, then you may have to touch them again in v15 to clear edits and complete the newly required field, “Date of Most Definitive Surgery” or its date flag. New Edits for 2015 Several new edits will be included in your v15 software. Edits will: check for blanks in the referred to and referred from fields for applicable classes of case check for inappropriate site and histology 8050 pairing check that grade for C80.9 solid tumor cases equals 9 check Gleasons score vs. grade and flag cases dx’d 2014+ that need correction The Missouri Edits metafile for 2015 cases is due to be sent to vendors this week for incorporation in your v15 software conversion. MCR/NPCR vs. SEER Reportability Rules The fact that the 2015 SEER Manual was recently published has raised some questions from hospital registrars about discrepancies in casefinding and reportability instructions compared to past MCR requirements. MCR is not a SEER state, so we do not necessarily follow them. I raised your questions with our governing body, NPCR, and they are meeting soon to consider whether they will require the same types of cases. I will email you as soon as I know more because I know you are well into your 2015 casefinding. In the meantime, I do want to remind you that, as I reported in the April 2014 Monthly Update, there were some changes made to ICD-O-3 at that time that do affect 2015 cases. I am re-issuing this reminder and have highlighted the pertinent section below. Carcinoid of the appendix becomes reportable because of the NAACCR adoption of the change of its behavior to /3. Please continue to use Tables 1 and 2 in the link below along with your ICD-O-3 Manual when checking casefinding. There have been no further NAACCR guidelines published on this topic since 4/15/14. From April 2014 Monthly Update: ICD-O-3 Update In Sept. 2011 the WHO published Updates to ICD-O-3 to modernize some terminology. Many of the updates were not implemented immediately in the US to allow a NAACCR work group time to evaluate the impact on registries. Their step-wise recommendations for 2014-15 were just approved. The full implementation guidelines with tables are available from NAACCR at http://www.naaccr.org/LinkClick.aspx?fileticket=u7d3sB71t5w%3d&tabid=126&mid=466. Your existing copy of the third edition of ICD-O-3 will continue to be useful when accompanied by Tables1 & 2 from the implementation guidelines. For implementation with 2014 diagnoses there are 36 new terms for 22 reportable conditions (Table 1). They are synonymous with existing terms. For 2015 reporting, 11 more new terms with new codes will be added (Table 2). Most are rare or very site-specific. If these terms show up on pathology reports while CSv2.05 is in effect, Table 2 shows which existing codes to use. All carcinoids of the appendix will also become reportable (/3) then. Enteroglucagonoma histology code will shift from 8157 to 8152. The work group is still evaluating complex issues surrounding many dysplasias and what the impact might be if any were to be required at some future date. Also under consideration are new terms that are expected for bronchiolo-alveolar carcinoma, and interpretation of GIST risk categories. Abstracting Tips Diagnostic Confirmation: the code for hematopoietic primaries diagnosed from peripheral blood is 1 – Positive Histology. Diagnostic Confirmation code 2 – Positive Cytology is INCORRECT when the diagnosis is based on results of the peripheral blood smear. See page 14 of the Hematopoietic and Lymphoid Neoplasm Coding Manual. Date of 1st Course Treatment: Record the earliest date on which treatment for the reported cancer began, including active surveillance only, or the date the decision was made not to treat (watchful waiting or refusal by patient). See page 66 of the MCR Manual. Unknown treatment: When treatment is truly unknown, code: Treatment status: 9 Date of first course treatment flag: 10 Various treatments: at least one must = 9 or 99, and the remaining should indicate either unknown if tx 9/99 or no tx (00 or 7-8, or 80-88) Treatment text should state that you have no information as to whether or not treatment was given. Standard Setter News SEER Completes Hematopoietic Conversion Documents for 2015 reporting The conversion to NAACCR version 15 includes conversion of some hematopoietic codes. Please see the SEER documentation at: http://seer.cancer.gov/tools/heme/conversion.html NCRA Announces a New Complimentary Resource: Informational Abstracts To assist registrars in preparing abstracts, NCRA's Education Committee has created a series of informational abstracts. These site-specific abstracts provide an outline to follow when determining what text to include. The sites include: bladder, breast, colon, lung, melanoma, and prostate. The outline has a specific sequence designed to maximize efficiency. Check out this complimentary resource! New CS Transition Newsletter http://www.ncra-usa.org/files/public/CSTransitionNewsletterIssue(March2015).pdf Now Available! Second Module of the AJCC Curriculum for Registrars AJCC Curriculum for Registrars are presentations designed to provide education in a step-wise learning environment complete with additional resources to reinforce the information and webinars with interactive quizzes to prompt discussion and serve as a self-assessment for the information learned. Second module is now available CAnswer Form Redesigned Get an overview and tips on navigating it here: http://newsmanager.commpartners.com/acscoc/issues/2015-03-02/3.html Cancer Trends Progress Reports redesigned The National Cancer Institute is pleased to announce the launch of the newly redesigned Cancer Trends Progress Report. After 14 years, they have given the website a new look and feel to better serve those looking for national trend data across a spectrum of cancer control measures. From prevention to end of life, the site offers trends by sex and age, race and ethnicity, and income and education level, and displays them in relation to Healthy People 2020 targets, where they are available. Visit the site to see new measures in HPV immunization; cancer survivorship as it relates to physical activity and obesity; and four new environmental exposures, including arsenic, benzene, cadmium, and nitrate. Please visit www.progressreport.cancer.gov. Registry to Research International trends and variations in renal cell carcinoma incidence and mortality (GLOBOCAN data) http://www.europeanurology.com/article/S0302-2838%2814%2901010-0/fulltext/internationalvariations-and-trends-in-renal-cell-carcinoma-incidence-and-mortality Invasive Cancer Incidence and Survival (NPCR and SEER data) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6409a1.htm?s_cid=mm6409a1_w http://www.christiantimes.com/article/cancer.survival.rates.2.in.3.cancer.patients.survive.5.years.or.m ore.prostrate.cancer.patients.have.best.survival.rate.of.97.c.d.c/51561.htm Cancer Survival in Asian Americans (SEER data) http://www.medicalnewstoday.com/releases/291413.php?tw Inequalities in premature death from colorectal cancer by state (CDC data) http://jco.ascopubs.org/content/33/8/829.full Colorectal cancer death rates by sex (CDC data) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a6.htm?s_cid=mm6411a6_w Death rates rising for liver cancer, falling for colorectal (SEER data) http://www.practiceupdate.com/c/22367/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4 MTE1NjYS1&lid=10332481 Hormone receptor status and survival in bilateral breast cancer (SEER data) http://www.thebreastonline.com/article/S0960-9776(14)00220-3/abstract After breast cancer diagnosis, risk of thyroid cancer goes up (SEER data) http://www.medicalnewstoday.com/releases/290575.php?tw Survival benefit from adjuvant RT in minor salivary gland tumors (SEER data) http://www.oraloncology.com/article/S1368-8375(15)00127-X/abstract Intermediate and high-risk prostate cancers on rise since PSA screening changes (NODA data) http://www.asco.org/press-center/early-evidence-increase-higher-risk-prostate-cancers-2011-2013 Resources 250 Years of Advances Against Cancer (timeline) http://www.cancer.gov/researchandfunding/progress/250-yearsadvances?utm_content=sf36598755&utm_medium=spredfast&utm_source=twitter&utm_campaign=N ational+Cancer+Institute&cid=sf36598755 Early vocal cord cancer treatment options – laser vs. RT http://bastianmedicalmedia.com/early-vocal-fold-cancer-remove-laser-radiate/ Colon cancer Infographic http://www.cdc.gov/cancer/colorectal/basic_info/screening/infographic.htm Tumor Location Portends CRC Survival http://dx.doi.org/doi:10.1093/jnci/dju427 New Oncology Drugs Approved in 2014 Solid Tumors http://www.practiceupdate.com/c/21002/3/0/?elsca1=emc_enews_top10&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4MT E1NjYS1&lid=10332481 Hematologic disease http://www.practiceupdate.com/c/21003/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4 MTE1NjYS1&lid=10332481 Ki-67 predicts CNS relapse in mantle cell lymphoma http://annonc.oxfordjournals.org/content/early/2015/02/22/annonc.mdv074.abstract Bladder cancer “no longer one single disease” http://www.practiceupdate.com/c/22549/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4 MTE1NjYS1&lid=10332481 Targeting gastric cancer http://www.curetoday.com/articles/targeting-gastric-cancer-recent-advances-generate-fresh-hopesafter-many-frustrations/1 Can B-ALL cells be reprogrammed to become harmless? http://www.medicalnewstoday.com/articles/291115.php?tw Predicting cancers http://www.medicalnewstoday.com/releases/291020.php?tw Tobacco epidemic Atlas http://www.tobaccoatlas.org/ Use of tampons in endometrial cancer screening http://www.medicalnewstoday.com/releases/291420.php?tw Thanks again for all you do! Nancy H. Rold, CTR Operations Manager Missouri Cancer Registry and Research Center