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MCR MINI-UPDATE APRIL 2016 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 give your hearts to providing cancer statistics to your facilities, to epidemiologists, public health policy-makers and researchers. Please know that our appreciation of you is also very heartfelt! I hope that you find a way to celebrate National Cancer Registrars Week April 11-15. If you are in the Columbia area, let Shari Ackerman ([email protected]) know if you would like to join MCR for lunch on April 13 at 11:30am at Arris’ Pizza, 1020 East Green Meadows, Suite 102, (Kohl's Shopping Center), Columbia, MO. DUE DATES Large hospitals (>500 cases/yr.) are to report Sept 2015 cases by April 15 and smaller facilities (<300 cases /yr.) report the 3nd Quarter of 2015 by April 15. EDUCATION NAACCR Webinars Live: April 7, 2016, 8-11 am, Collecting Cancer Data: Ovary (broadcast to MCR classroom in Columbia) To register for the live event in Columbia, use this online link: http://www.signupgenius.com/go/30e0e49a4a82caafa7-naaccr3 Recordings: Earn 3 CEs by viewing recorded webinars. Check out our Education and Training page to find out how you can receive access to the recorded NAACCR Webinars. GoToMeeting Live: The Q&A session scheduled for April 13, 2016, 10-11 a.m., has been cancelled due to low enrollment and lack of questions submitted for discussion. Apparently the excellent recorded video training by Florida’s Steve Peace is a sufficient introduction to how the AJCC Cancer Staging Manual is organized. If you have not viewed it, the recording is still available on the MCR education page (video and slides). Should you have future questions about using the manual, our staff is available to assist you at 1-800-392-2829. Recordings: of previous GoToMeeting sessions are available on the MCR website. Check out the offerings at: http://mcr.umh.edu/mcr-gotomeeting.php Fundamentals of Abstracting Workshop The Fundamentals of Abstracting Workshop is a day and a half course held in Columbia, MO at the offices of the Missouri Cancer Registry and Research Center. The next class will be held April 25-26, 2016. This free class is geared toward inexperienced abstractors who would like to become more proficient with the abstracting process. Students use Abstract Plus software to work through cases using the MCR-ARC Abstract Code Manual. For those not familiar with abstracting and the MCR-ARC required fields, this hands-on training is a great place to start. Register at: http://www.signupgenius.com/go/30e0e49a4a82caafa7-fundamentals 1 MCR MINI-UPDATE APRIL 2016 How to use Sign Up Genius to register for all educational events Click on any “signupgenius” link provided above. Click the check box for the listed event and then click the button that says “Submit and Sign Up”. You do not need to create an account; just fill in the boxes with your name, email, number of registrants and any needed ADA accommodations. That information will not be made public. Click the “Sign Up Now” button to complete your registration. You can also go back later and change your reservation. You will get a confirmation email that allows you to put the webinar on your Outlook, Mac or Google calendar. MCR Help-Line 1-800-392-2829 is available during business hours or leave a message and a member of our QA staff will try to get back to you within a day. Save the Date! MoSTRA 41st Annual Education Meeting November 9-11, 2016, Lake of the Ozarks Stay tuned for details to be published by MoSTRA. MCR NEWS Bec Francis Retires from Full-time Work We could fill a book listing all of Bec’s accomplishments in the registry field over the past 34 years! Bec is opting for a well-deserved retirement from her position as a full-time Senior Data Coordinator on April 15. Fortunately for us, she is retuning part-time in the same capacity the following week! Bec came to MCR in 2006 with more than 20 years of registry experience at the University of Missouri. She has been a part of so many changes in the registry field, from paper abstracts to electronic reporting; from the Data Acquisition Manual of 1988 through ROADS to FORDS 2016; and from SEER Summary 1977 to Collaborative Stage and back again to SEER Summary 2000. Bec is very generous with the wisdom that she has acquired in her professional life. She helped raise me from baby registrar to full-fledged Excel data geek. She is a go-to person on our 800# Help Line and has presented many trainings for MCR. She is hard to stump with questions, but is also conscientious to double-check references to be sure her answers are most current. She has served MoSTRA in several roles. She served on the national committee that revises the NAACCR Data Dictionary annually and has helped me make sure that our MCR Abstract Code Manual and edit sets are properly updated each year. Bec is a stickler for details and precise communication and has encouraged many Missouri registrars to improve their abstracting by utilizing her helpful QA feedback and tips. She is also an eagle-eye editor of this publication and I thank her for making it clear and easy to read. Bec is a delight to work with because she is also a great friend. She cares as deeply about her colleagues as she does about the profession. She can be counted on to recognize the achievements of others, and to enliven discussions with her quick wit and amazing capacity to insert puns into most any conversation. We wish Bec all the best with new-found free time for her own projects and we are delighted that she has chosen to stay on with our staff each morning. What to do with 2016 Cases When You Still have v15 Software Due to delays beyond cancer registry software vendor control, the North American Association of Central Cancer Registries (NAACCR) and state specific version 16 software upgrades may not be available to software vendors until May or even July of 2016. As a result, MCR recognizes that registrars may need to begin abstracting cases diagnosed in 2016 within their current NAACCR/MO v15-compliant software. 2 MCR MINI-UPDATE APRIL 2016 You may start abstracting 2016 cases before you receive your upgraded software; however please note that each case will need to be touched again and additional fields completed after conversion to v16. Consequently, when first abstracting these cases, registrars would be smart to clearly document the detailed T, N, and M information via text that they can use to accurately assign values to the T, N, and M categories once their software has been upgraded to the NAACCR v16 layout. These items have been reformatted in v16 to include “c” and “p” designations for clinical and pathologic staging. In addition, registrars should be sure to record thorough textual documentation for the new data item, Tumor Size Summary [756], which will need to be abstracted for 2016 cases reported to MCR. After you complete the abstracts in v16, MO v16 edits will need to be run and resolved. You will not be able to send the 2016 cases to MCR until after both your software and our Web Plus application are updated to v16. Typically this happens in August. We will keep you apprised of any delays as that time frame approaches. NCI and CoC-approved facilities should also seek advice from those agencies regarding how to handle additional new fields that they will require in v16. For more info on the conversion to NAACCR v16, see the NAACCR implementation guidelines at http://www.naaccr.org/LinkClick.aspx?fileticket=5OHnOz811Dw%3d&tabid=161&mid=523 (particularly pages 18-21) and the MCR required data elements for 2016 http://mcr.umh.edu/mcr-cancer-reportinghospital.php. Death Clearance Death Clearance activities for reporting year 2014 are underway. Hospital participation in the follow back process is expected to begin in late spring. Stay tuned for further details in the coming months. ABSTRACTING TIPS AJCC Stage for Incidental Prostate Cancer When prostate cancer is an incidental finding at cystoprostatectomy for bladder cancer, no clinical stage can be assigned. Because the AJCC rules for clinical staging cannot be met, all clinical staging fields must be left blank. Source: AJCC Curriculum for Registrars, Explaining Blanks and X by Donna Gress (AJCC technical specialist) https://cancerstaging.org/CSE/Registrar/Pages/Presentations.aspx Microscopic Confirmation Necessary for AJCC Stage Microscopic confirmation is required for TNM staging according to the AJCC Cancer Staging Manual, 7th Edition (see Table 1.3 on page 8). When abstracting cases where the Diagnostic Confirmation code is ≥ 5, leave the T, N, M categories and Stage Group fields blank. Use of SEER Summary Stage code 9 For SEER Summary Stage, assign the stage based on the information available in the medical record including clinical and operative/pathological assessment. There may be occasions when complete information is not available. For example, a patient received work up and diagnosis at your facility but was referred elsewhere for surgery. The abstractor should base the SEER Summary Stage on the current information available in the medical record. Use Code 9 only when there is not information to assign another code. It should be used infrequently. Source: SEER Ask a Registrar (ASW12082) 3 MCR MINI-UPDATE APRIL 2016 STANDARD SETTER NEWS TNM Staging Resources SEER TNM Rules are based on UICC TNM and not AJCC TNM. Registrars reporting to MCR and those reporting to CoC are to use the AJCC Cancer Staging Manual as the TNM authority and not materials or notes supplied by SEER. CTR Exam Prep Options 1) If you or your staff are planning on taking the CTR exam in June/July, you might want to consider taking the NAACCR CTR Prep and Review Series. Beginning April 19, 2016 and continuing for 8 weeks, the virtual class meets online every Tuesday afternoon from 1-3:00 EDT. Each week, a different topic from the CTR Exam is covered. Every session is recorded, so if you miss the live meeting, you can view a recording of the session that same day. There are weekly quizzes and reading assignments, ending with a timed test during the final session. This is one way to study for the exam and interact with other registrars who are also preparing for the exam. The cost of the series is $400; it includes live lectures presented by experienced instructors, study materials, take home quizzes, and a timed practice test. For more information, to see a full syllabus, or to register see the CTR Prep page on the NAACCR website. 2) MoSTRA offers a current study guide to use in preparing for the CTR exam. The Education Committee of the Missouri State Tumor Registrars Association reviews this study guide every year. The guide is free for MoSTRA members and $25 for non-members. http://mostractr.org/Resources/Certification/MoSTRACTRPrepBook/tabid/116/Default.aspx 3) Many registrars have successfully passed the CTR exam by studying completely on their own, utilizing online training materials and studying manuals related to the test sections outlined in the exam handbook. http://www.ctrexam.org/resources/ Annual Report to the Nation on the Status of Cancer, 1975-2012 On March 9, 2016, the Annual Report to the Nation on the Status of Cancer, 1975-2012 was published by NCI/SEER in the journal Cancer in collaboration with the American Cancer Society, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. In addition to reporting rates and trends for the most common cancers, this year's report includes a special section about liver cancer. Learn more about the Report to the Nation and this year's key highlights. The report web page also includes related infographics, factoids, videos, and embedded tweets that can be shared easily. http://seer.cancer.gov/report_to_nation/ The Cancer in North America Volume Four: Cancer Survival In the United States and Canada NAACCR has been producing Cancer in North America (CINA) incidence and mortality publications for over 15 years. This is the first time that NAACCR has published cancer survival data for North America. Along with incidence and mortality data, information on population-based cancer survival is necessary to understand the burden of cancer. The CINA Survival publication includes data from 41 registries on more than 6.7 million cases diagnosed among North Americans between 2005 and 2011. In terms of national coverage, CINA Survival includes data from 8 of 13 Canadian provinces/territories, 28 of 50 states, and sub-state areas in Michigan and Washington. National population coverage by CINA Survival is about 62% for the United States and 63% for Canada. For registries to be included in CINA Survival, they need to meet data quality criteria. The results show stark differences in survival for many cancer sites by race in the U.S., a finding seen also in the latest population-based survival statistics published by the National Cancer Institute (SEER Cancer Statistics Review 1975-2012). Link to report: http://www.naaccr.org/DataandPublications/CINAPubs.aspx 4 MCR MINI-UPDATE APRIL 2016 REGISTRY TO RESEARCH Survival Outcomes in Men Undergoing Radical Prostatectomy after Primary Radiation Treatment for Adenocarcinoma of the Prostate (MU author, SEER data) http://www.clinical-genitourinary-cancer.com/article/S1558-7673(15)00340-7/abstract CDC Policies and Practices for Cancer Prevention: Lung Cancer Screening Programs (US Cancer Statistics – SEER and NPCR data) http://www.cdc.gov/cancer/ncccp/pdf/lungcancerscreeningprograms.pdf Increased risk of colorectal cancer in patients diagnosed with breast cancer in women (Swedish data) http://www.sciencedirect.com/science/article/pii/S1877782116000084 Risk of colorectal cancer after the diagnosis of prostate cancer: A population-based study (Manitoba data) http://onlinelibrary.wiley.com/doi/10.1002/cncr.29919/full Care Discordant With Practice Guidelines Compromises Overall Survival in Nasopharyngeal Carcinoma (NCDB data) http://www.sciencedirect.com/science/article/pii/S0936655516000364 Post-Mastectomy Radiation Therapy for Invasive Lobular Carcinoma (SEER data) http://www.clinical-breast-cancer.com/article/S1526-8209(16)30021-0/abstract Radiotherapy After Breast-Conserving Surgery for DCIS (SEER data) http://www.practiceupdate.com/c/35150/3/0/?elsca1=emc_enews_top10&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4MT E1NjYS1&lid=10332481 RESOURCES I-131-MIBG Therapies http://www.ncbi.nlm.nih.gov/pubmed/22056346 http://www.pedrad.org/portals/5/events/2013/granger.pdf Researchers find way to use skin cells to kill cancer http://www.upi.com/Health_News/2016/02/24/Researchers-find-way-to-use-skin-cells-to-killcancer/2651456341916/ Cigarette Smoking Before and After Breast Cancer Diagnosis: Mortality From Breast Cancer and Smoking-Related Diseases http://jco.ascopubs.org/content/early/2016/01/21/JCO.2015.63.9328 Bladder cancer type bears molecular features of breast cancer http://www.medicalnewstoday.com/articles/308068.php The Genomic Landscape of Male Breast Cancers http://clincancerres.aacrjournals.org/content/early/2016/03/09/1078-0432.CCR-15-2840 5 MCR MINI-UPDATE APRIL 2016 Clinical Effect of Molecular Methods in Sarcoma Diagnosis http://www.practiceupdate.com/c/36450/1/1/?elsca1=emc_enews_expertinsight&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE 4MTE1NjYS1&lid=10332481 Latest Biennial Review of Health Problems That May Be Linked to Agent Orange Exposure During Vietnam War Upgrades Bladder Cancer and Hypothyroidism, Downgrades Spina Bifida http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=21845 Cola Intake Increases Exposure of Erlotinib http://jco.ascopubs.org/content/early/2016/02/05/JCO.2015.65.2560.full CDC Report - Ovarian Cancers: Evolving Paradigms in Research and Care http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2016/OvarianCancers_RiB.pdf Alcohol triggers breast cancer-causing gene http://www.medicalnewstoday.com/articles/307917.php Microneedle patch delivers localized cancer immunotherapy to melanoma https://www.sciencedaily.com/releases/2016/03/160324143232.htm Thanks again for all you do! Nancy H. Rold, CTR Operations Manager Missouri Cancer Registry and Research Center 6