Download Mini-Update - June 2016 - Missouri Cancer Registry

MCR MINI-UPDATE
JUNE 2016
Fellow Registrars,
As you can imagine, we are quite busy at MCR putting the final touches on plans for the
NAACCR 2016 meeting in St. Louis June 14-16. You will see below, we’ve also been busy
collecting important information to share with you.
DUE DATES
Large hospitals (>500 cases/yr.) are to report Nov. 2015 cases by June 15 and smaller facilities (<300
cases /yr.) report the 4th Quarter of 2015 by July 15.
EDUCATION
NAACCR Webinars
Live: June 2, 2016, 8-11 a.m., Collecting Cancer Data: Prostate (look for the recording to be up soon)
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.
http://mcr.umh.edu/mcr-education.php
GoToMeeting
Live - Upcoming:
July 13, 2016, 10-11 a.m., TNM General Rules AJCC Staging Manual, 7th Edition with Jennifer
Sedovic. A sign-up link will be provided next month.
August 10, 2016, 10-11 a.m., Coding Pitfalls with Kirsten McDowell
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
Reach us at 1-800-392-2829 during regular office hours, or leave a message; a member of our QA team
will return your call within one business day.
MCR NEWS
MCR Website Redesign Underway
Besides a clean new look, the links across the top of the page to NAACCR and other important resources
have been moved to the 'Links' page that can be accessed from the left navigation pane. We are
working to add better mobile device adaptability as well.
2016 Required Data Elements - Revised
MCR tables of required data elements for 2016 reporting were revised in May to agree with NPCR
revisions. Please replace copies of the previous version that you have saved. Prostate SSFs 8 & 10 will be
retained and SSF 25 will not be required for Peritoneum or Peritoneum - Female cases. The Required
Data Elements document for 2016 is in a user friendly Excel workbook that includes an additional tab
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showing the required fields for years 2004 - 2015. It is located on our website:
http://mcr.umh.edu/mcr-cancer-reporting-hospital.php
2016 MCR Abstract Code Manual
The MCR Abstract Code Manual for 2016 is available on our website http://mcr.umh.edu/mcr-cancerreporting-hospital.php It is a good idea to review it annually. We have again highlighted changes in blue
font for easy identification. The changes include:
 Clarifications are added to be in agreement with updates to the 2016 FORDS Manual and NPCR
Requirements
 Six additional conditions are defined as reportable beginning in 2016
 Sex, code 3 - wording is changed to reflect modern terminology
 Staging – Edits made to Text-Staging section and to Chapter 8 Staging Schemes to reflect
transition from Collaborative Stage to AJCC Staging and to include newly required fields.
 References to required Site Specific Factors are updated in Special Grade System table and rules
 Clarifications are added to instructions for coding Surgical and Diagnostic Staging Procedure vs.
Surgical Procedure of the Primary Site in a particular circumstance to agree with revised
instructions in 2016 FORDS.
 New instruction inserted clarifying that chemotherapy administered as a low dose
radiosensitizer or radioprotectant is not to be coded as treatment.
 TNM stage coding is required for all cases in 2016. NPCR does not exempt any class of case.
Registrars are encouraged to code TNM items based on best available information.
TNM Questions
In an effort to reduce duplication of TNM-related questions on the CAnswer Forum, the national
standard setters are implementing a new procedure for asking AJCC staging questions. The bottom line
is that only Central Registries may submit questions for that section of the CAnswer Forum. Here are the
steps we recommend you take when you have a TNM question:
1. Look in the AJCC Cancer Staging Manual and on the CAnswer Forum for a previously posted answer.
2. If no answer is found, call the MCR help line, 1-800-392-2829, or submit detailed written question to
MCR via: [email protected]
3. MCR will further search references and respond with an answer if found.
4. If an answer is not found, the MCR Education & Training Coordinator (ETC) will forward your question
to CDC NPCR staff; their staff or Donna Gress (AJCC CTR) post this new question and an answer on the
CAnswer Forum.
5. CDC NPCR staff will notify the MCR ETC that an answer has been posted.
6. MCR will notify the original submitter that an answer has been posted and include the post here as an
abstracting tip, if of general interest.
NAACCR v16 Edits
The national release of NAACCR v16 edits is now delayed until June. We will work hard to get your
software vendor a MO- specific edit metafile as soon as possible after the national file is finalized.
Death Clearance Follow Back
Death Clearance follow back for the reporting year 2014 is fast approaching. This year’s process will be
essentially the same as last year. If a refresher is needed, please refer to the previously recorded Death
Clearance 2015 Go To Meeting under the MCR Education/Training page and/or review the Death
Clearance Instructions and Web Plus Screenshots found under the Hospital tab of the MCR website. This
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also would be a good time to submit an updated Web Plus User Contact Form if there has been a change
at your facility. Find this form under the Web Plus Tab of the MCR website. It is important to have
current Web Plus User contact information to ensure that you will receive your Death Clearance follow
back requests and announcements regarding the official start of the Death Clearance process.
ABSTRACTING TIPS
Prostate Grade
When abstracting prostate cases, assign the grade codes according to the FORDS Gleason conversion
values that were in effect for the year of diagnosis. Refer to the following tables:
Diagnosis year before 2014
Diagnosis year 2014 and after
Grade
Code
Gleason Score (summary of
primary and secondary
patterns)
Grade
Code
Gleason Score (summary of
primary and secondary
patterns)
1
2, 3, 4
1
1, 2, 3, 4, 5, 6
2
5, 6
2
7 (also applies with dx before
2003)
3
7, 8, 9, 10
3
8, 9, 10
Kidney Histology
Kidney: Per SEER: Only code Sarcomatoid (Spindle Cell) as Sarcomatoid (8318) if the final path states
Sarcomatoid (Spindle Cell) Carcinoma. Do not use the ambiguous terms mentioned in MPH rules
(features of, subtype, predominantly, etc.) to code Sarcomatoid. Ignore Sarcomatoid when used with
those terms. This will be addressed in the next version of the MPH Rules.
Sentinel Lymph Node Coding
When sentinel lymph node biopsy is performed, the entry for Regional Lymph Nodes Examined should
be ≥ 01. Sentinel lymph nodes that are identified are removed and submitted for pathologic
examination. Regional Lymph Nodes Positive should not be coded 98 when SLN biopsy is performed.
STANDARD SETTER NEWS
FORDS
Skin Surgery Code Clarification
Because the wording of the skin surgery note after codes 45-47 in Appendix B has been re-written
significantly between 2013 and 2016 FORDS, the registrar should review it carefully. Code 45
instructions indicate that resection margins must be microscopically negative by greater than 1 cm. The
note of explanation now reads: If the excision or re-excision has microscopically confirmed negative
margins less than 1 cm OR the margins are more than 1 cm but are not microscopically confirmed; use
the appropriate code, 20-36.
Ambiguous Terminology Lists: References of Last Resort
From CoC: The purpose of this communication is to clarify the use of Ambiguous Terminology as listed in
FORDS: Revised for 2016 for case reportability and staging in Commission on Cancer (CoC)-accredited
programs. When abstracting, registrars are to use the “Ambiguous Terms at Diagnosis” list with respect
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to case reportability, and the “Ambiguous Terms Describing Tumor Spread” list with respect to tumor
spread for staging purposes. However, these lists need to be used correctly.
The first and foremost resource for the registrar for questionable cases is the physician who diagnosed
and/or staged the tumor. The ideal way to approach abstracting situations when the medical record is
not clear is to follow up with the physician. If the physician is not available, the medical record, and any
other pertinent reports (e.g., pathology, etc.) should be read closely for the required information. The
purpose of the Ambiguous Terminology lists is so that in the case where wording in the patient record
is ambiguous with respect to reportability or tumor spread and no further information is available from
any resource, registrars will make consistent decisions. When there is a clear statement of malignancy
or tumor spread (i.e., the registrar can determine malignancy or tumor spread from the resources
available), they should not refer to the Ambiguous Terminology lists. Registrars should only rely on these
lists when the situation is not clear and the case cannot be discussed with the appropriate
physician/pathologist. The CoC recognizes that not every registrar has access to the physician who
diagnosed and/or staged the tumor, as a result, the Ambiguous Terminology lists continue to be used in
CoC-accredited programs and maintained by CoC as "references of last resort".
MCR Note: Please document clearly in your text fields the source upon which you base your
reportability and staging decisions. Also please note that while AJCC (whose constituents are primarily
physicians) does not define any ambiguous terms to be used in assigning TNM, FORDS 2016 p. 21 does
provide a guidance table for registrar use in situations as described above.
Save Time When Starting 2016 Cases in v15
If you need to begin abstracting 2016 cases while still in v15 software, keep the following tip in mind.
Only complete the CS fields that will be required for 2016 (see MCR website and other standard setters
for 2016 requirements). Ignore 2015 edits on CS fields. After upgrade to v16, run v16 edits and make
any corrections. If you instead fill out all CS fields, they will have to be switched back to blank, creating
extra work.
MCR note: MCR will not be able to accept 2016 diagnosed cases until at least August. If you cannot
make a submission because all of your abstracting is 2016 cases, please send a transmittal form to state
that cases are being held. That way I won’t bug you about missed submissions!
NCRA
Informational Abstracts
These free site-specific sheets outline the types of information to include in abstracts for 9 common
sites. An individual outline of the information that should be included in text fields is provided for each
site. You can also earn CE’s by subscribing to a quiz to test your knowledge.
http://www.cancerregistryeducation.org/rr
SEER
SEER Releases New Data
On April 15, 2016, 2013 SEER data was released. This dataset includes SEER incidence and population
data associated by age, sex, race, year of diagnosis, and geographic area.
In 2013, there were 410,153 malignant cases reported, with a total of 8,234,845 malignant cases
recorded from 1973–2013. For more information, visit http://seer.cancer.gov/data/. SEER also released
the SEER Cancer Statistics Review (CSR), 1975-2013, which presents the most recent cancer incidence,
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mortality, survival, and prevalence statistics. The report is now available at
http://seer.cancer.gov/csr/1975_2013/.
SEER*Explorer
SEER*Explorer is a new interactive website to provide easy access to a wide range of SEER cancer
statistics. It provides detailed statistics for a cancer site by gender, race, calendar year, age, and for a
selected number of cancer sites, by stage and histology. With SEER*Explorer, you can:
 Create custom graphs and tables
 Download data and images
 Download SEER*Stat sessions
 Share links to results
CDC
View New Video Abstract About Cancer Incidence and Mortality
Hannah Weir, MD, CDC epidemiologist in the Division of Cancer Prevention and Control, talks about her
work to predict cancer incidence and mortality through 2020. Her predictions are based on population
projections from the US Census Bureau and on national cancer surveillance data from the National
Program of Cancer Registries and the National Vital Statistics System. Projections were calculated by
using age–period–cohort regression models. Although cancer rates are decreasing or stabilizing, cancer
incidence and mortality will continue to rise The public health community needs to do more to address
these increases by reducing the number of people who get cancer through prevention and by reducing
the number of people who die of cancer through early detection and treatment. Results of this work
were previously published in both Preventing Chronic Disease and Cancer. To access the video, click on
this link:
http://www.cdc.gov/pcd/issues/2016/16_0024.htm?utm_source=ALL+MEMBERS&utm_campaign=4745
c5335c-April_2016_Impact_Brief&utm_medium=email&utm_term=0_2d1d01a756-4745c5335c37124881
REGISTRY TO RESEARCH
Geographic variation of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and
hepatocellular carcinoma in the United States (SEER data)
http://www.ncbi.nlm.nih.gov/pubmed/25837669
Contributions of Subtypes of Non-Hodgkin Lymphoma to Mortality Trends (SEER data)
http://www.ncbi.nlm.nih.gov/pubmed/26472423
US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma (SEER
data)
http://www.ncbi.nlm.nih.gov/pubmed/26084209
Incidence and incidence trends of the most frequent cancers in adolescent and young adult Americans,
including "nonmalignant/noninvasive" tumors (SEER data)
http://www.ncbi.nlm.nih.gov/pubmed/26848808
Survivors of childhood cancer in the United States: prevalence and burden of morbidity. (SEER data)
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http://www.ncbi.nlm.nih.gov/pubmed/25834148
US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. (SEER data)
http://www.ncbi.nlm.nih.gov/pubmed/25925419
Melanoma Risk Increased in Some Lymphoma Survivors (SEER data)
http://www.cancertodaymag.org/Spring2016/Pages/Melanoma-Risk-Increased-in-Some-LymphomaSurvivors.aspx
RESOURCES
SEER Glossary for Registrars will be updated quarterly
http://seer.cancer.gov/seertools/glossary/
SEER Did You Know? Video series – 8 new videos
http://surveillance.cancer.gov/newsletters/spring2016.pdf
A Story of Discovery: NCI’s SEER Program Harnesses Cancer Data for Discovery
http://www.cancer.gov/research/progress/discovery/cancer-data
Future Directions for NCI’s Surveillance Research Program
http://www.cancer.gov/news-events/cancer-currents-blog/2015/seer-future
NCI-DOE Collaboration Paving Way for Large-Scale Computational Cancer Science
http://www.cancer.gov/news-events/cancer-currents-blog/2016/nci-doe-computing
Proposed Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma
A Paradigm Shift to Reduce Overtreatment of Indolent Tumors
http://oncology.jamanetwork.com/article.aspx?articleid=2513250
Happy abstracting!
Nancy H. Rold, CTR
Operations Manager
Missouri Cancer Registry and Research Center
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