Mcr Mini-Update

MCR MINI-UPDATE

MAY 2018

Fellow Registrars,

The season for professional meetings is upon us.Jennifer and Babette will travel to New Orleans for the NCRA annual meeting in May.Perhaps they will see some of you there?In June, Jeannette, Chester and Yilin will travel to Pittsburgh for the NAACCR annual meeting.I’ll be sure to incorporate some tips and news that they bring back from these meetings into my next two Monthly Updates.Closer to home, I hope that many of you are planning to take advantage of the MoSTRA annual meeting which will be held in Columbia October 31-November 2.There is value in the friendships that develop at these meetings and there is always something new to learn in this profession!

DUE DATES

Large hospitals (>500 cases/yr.) are to report October 2017 cases by May 15 and smaller facilities (<300 cases /yr.) report the 4th Quarter of 2017 by July 15. Please hold all cases diagnosed in 2018 until both your software and Web Plus are available in v18 layout.

EDUCATION

NAACCR Webinars

Live:May 03, 2018, 8-11 a.m., Directly Coded Stage. To attend the live broadcast in Columbia, sign up here:

NAACCR 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:

MCR Webinars

GoToMeeting and Zoom Recordings: Previous MCR webinar presentations are posted to the MCR website as recordings:

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.

NAACCR Grade Data Items and Radiation Data Items Special Webinars

A webinar on the new Grade data items and another on the new Radiation data items will be given on the following dates below. The same material will be presented both days. Recordings of the webinar will be posted to the NAACCR 2018 implementation page. Registration for the repeat performances are limited to the first 1000 registrants. These webinars are not eligible for CE’s.

2018 New Grade Coding Rules

May 1, 2018 from 1-2:30 CDT (Registration full)
May 2, 2018 from 1-2:30 CDT

2018 New Radiation Coding Rules

May 16, 2018 from 1-2:30 CDT (Registration full)
May 18, 2018 from 1-2:30 CDT

Save the date for AJCC 8th Edition Cancer Staging Webinar for Registrars

The American Joint Committee on Cancer (AJCC) will be conducting a number of webinars on the AJCC Cancer Staging Manual, Eighth Edition in 2018. The webinars are scheduled as follows: May 15, 2018-Minor Rule Changes; July 25, 2018 - Head and Neck Staging; and Sept. 6, 2018 - Breast Staging. All webinars will be held from 1:00 to 2:00 pm CDT. Category A CE of 1 hour available for each webinar. Attendance documentation is the responsibility of the attendee. AJCC will ONLY provide confirmation to NCRA for CE audits. Make sure to mark your calendars. Recordings will be posted to the AJCC website after the live webinars. Visit the AJCC website for updatesadditional information:

MCR NEWS

2018 reporting to MCR – review and updates

Please do not send 2018 diagnosis cases to MCR at this time. As you will see in the national news section below, it is likely to be at least June before hospital and state registries have software updated to NAACCR v18 layout for completion and submission of 2018 cases. While we can hope for the best, it is advisable to prepare for the worst if software is delayed further. Please don’t place the blame on your software vendors, as they are only responsible for the final step in this complex process.

Here are some updates to ideas I shared last November for being pro-active as 2018 abstracting gets underway:

You may choose to start 2018 cases now in existing v16 software. But you will have to hold and touch the same cases again after upgrading to v18 in order to code the new fieldsand finish the abstract. So it might be advisable to record excellent text initially that will allow you to code new stage and treatment fields with minimal return to the medical record. That text should note details for stage and grade (clinical, pathologic and post-treatment), site-specific labs and prognostic factors, radiation treatment. New fields that may be required by your standard setters include Site Specific Data Items (SSDIs), new TNM choices, grade and radiation treatment fields.
See the NAACCR 2018 Implementation Guidelines for an overview and more information:
See the new field descriptions and preliminary lists of required fields for NPCR and CoC in NAACCR Volume II, Chapters X and VIII, respectively: Note that the NPCR list will change again soon and will serve as the basis for MCR’s usual spreadsheet of requirements. MCR will not require abstracting of TNM codes from non-CoC accredited facilities.
Because you will only be able to do partial abstracts, it is possible that you could outpace your casefinding and experience lulls in abstracting work flow. Anticipate what you can do during lulls to get ahead on other tasks like training, QC, follow-up or outcome studies that may need to be put on the back-burner later when you touch the accumulated cases a second time to complete them.
Anticipate that productivity will be slowed as new codes and fields are learned and as new manuals (SSDI/Grade, Solid Tumor Rules, SEER Summary 2018 and AJCC TNM 8th edition) are consulted.
Make your managers aware of the issues cited above:

-why any 2018 cases you start now will be incomplete until you have v18 software in place

-why you can’t report 2018 cases to the state until after software is upgraded at both the facility and state levels

-why you could lose efficiency touching each case twice and learning new codes

-that you do have important registry work to do even if there are abstracting lulls

Ovarian Study

The majority of requested study forms are in, thank you! We recently contacted a handful of hospitals to request specific supplemental details not available from other treating hospitals. Where cases have had to be excluded from the overall study, we may need to request a few additional cases from your reserve list in coming weeks. We sincerely appreciate your willingness to help with this study.

Jiang Du Graduating

Jiang Du, our graduate research assistant in statistics, will be graduating with a PhD from MU this month. We will miss his smile and dedication. You may remember a poster of his that I highlighted at the last MoSTRA meeting – it displayed maps of colorectal cancer incidence trends by county, age and sex and across a 14-year time period. Because Jiang gained practical experience applying statistical modelling to our de-identified data sets, he was a strong candidate for jobs across many industries and was hired by the real estate marketplace, Zillow. Best wishes for future success, Jiang!

ABSTRACTING TIP

Lip Vermillion in 2018

You will notice in the AJCC Cancer Staging Manual 8th Edition that staging for squamous cell carcinoma of the vermillion border and commissure of the lip (C00.0-C00.2 and C00.6) was moved out of Chapter 7, “Lip and Oral Cavity”. Instead, these 2018 cases will be staged according to the rules in Chapter 15: “Cutaneous SCCA of the Head and Neck”.

In the upcoming SEER Summary Staging 2018 Manual, per Appendix II, SCCA of the lip vermillion will also be staged with the SS2018 Skin chapter. Please remember that reportability and staging are separate issues. For 2018, SCCA of the vermillion border or commissure cases will still be reportable.

STANDARD SETTER AND NATIONAL NEWS

CDC/NPCR

NPCR/MCR Required Data Items 2018

NPCR has one final round of changes to be published that I will need to incorporate into an MCR required data item list. I will let you know when it is posted to our MCR website. Thanks for your patience!

Registry Plus Software

Web Plus v18 is now projected to be released in May. CRS Plus (the application for the MCR main database) is due to be updated for 2018 in June. Hopefully, these upgrades will allow us to accept your cases in a timely manner. The availability of Abstract Plus for 2018 case abstracting is also projected for June.Please do not submit cases diagnosed in 2018 until MCR announces that we are ready to accept them.

United States Cancer Statistics: Data Visualizations

Updates have been made to this tool, a user-friendly product that allows cancer surveillance data to be directly and more easily accessible by the public and cancer control planners. It now includes seven tabs:

Overview
Demographics
Trends
State/County Statistics
Survival
Prevalence
Related Data

New features include:

County statistics
Survival estimates
Prevalence estimates
Display is optimized for mobile devices
Ability to share specific selections on social media

Data displays on national and state incidence, death, and trends are available as maps and bar charts with interpretive text when users scroll over each graphic. Users can customize displays of overall and cancer-specific statistics, download data tables, and share each page via social media. .

NCI/SEER

SEER Releases New Cancer Statistics Review (CSR) and Latest SEER Data

The SEER Cancer Statistics Review (CSR), 1975-2015, published by NCI’s Surveillance Research Program, was released on April 16, 2018. The updated Cancer Statistics Review presents the most recent cancer incidence, mortality, survival, and prevalence statistics.

New materials posted include:

Cancer Statistics Review 1975-2015
Cancer Stat Fact Sheets
SEER*Explorer
Fast*Stats
The Cancer Query Systems
Cancer Statistics Animator
SEER Incidence Data, 1973-2015
Specialized Databases

Screen to Save: NCI Colorectal Cancer Outreach and Screening Initiative

Screen to Save aims to increase colorectal cancer screening rates among men and women age 50 and older from racially and ethnically diverse communities and in rural areas, including American Indians and Alaskan Natives, Asians, Blacks/African Americans, Hispanics/Latinos, and Native Hawaiians and other Pacific Islanders.

Through Screen to Save, community health educators funded by the NCI’s National Outreach Network (NON) and Partnerships to Advance Cancer Health Equity (PACHE), will provide culturally-tailored, evidence-based colorectal cancer information, education, and screening resources within racially and ethnically diverse and rural communities nationwide.

NAACCR

2018 Timeline

The latest 2018 Implementations and Timeline, Version 1.7, is posted to the NAACCR Implementation Information page:

Edits

The NAACCR Edits workgroup hopes to release its first edit metafile for 2018 to states and vendors soon. MCR will be poised to customize it for Missouri and get it to your software vendors quickly after that.

CoC

STORE Manual 2018 (replaces FORDS)

The latest timeline projects publication of this manual in May.

AJCC

AJCC Eighth Edition 3rd printing in stock /

The AJCC Eighth Edition manual third printing is in stock at Springer. The AJCC cannot guarantee that customers will receive the corrected third print from any other retailer right now, including Amazon. To place an order:

Note: MCR will only require this staging from CoC-accredited facilities. You may not need a manual. Those with previous printings of the 8th edition can alternatively download errata from the AJCC website.

See also this AJCC letter to the Cancer Registrar Community:

NCRA

A Role Delineation Study of the Cancer Registry Professional

The purpose of this study was to identify current practices of cancer registry professionals to update test specifications, if necessary, in the certification examination.

Advisors needed for registry student virtual practicums

Some CTR exam candidates have difficulty finding facilities to complete the required 160-hour clinical practicum. To help these candidates, a group of NCRA members developed a network of Independent Clinical Advisors (ICAs) to create ways for students to complete 40 hours of the required tasks virtually.Visit the ICA web pageto learn more about the program and how you can support students to achieve their goal of becoming a CTR!

REGISTRY TO RESEARCH AND SURVEILLANCE (publications using cancer registry data!)

Nine‐year prostate cancer survival differences between aggressive versus conservative therapy in men with advanced and metastatic prostate cancer (CDC data)

Head and neck squamous cell cancers in the United States are rare and the risk now is higher among white individuals compared with black individuals (SEER data)

Minimally Invasive Radical Hysterectomy Is Linked to Shorter Survival than Laparotomy in Women with Early-Stage Cervical Cancer (NCDB data)

Molecular Characterization and Mortality from Breast Cancer in Men (SEER data linkage)

Study Reveals Links between Efficacy of Adjuvant Therapy for Endometrial Cancer and Disease Stage/Grade (NCDB data)

Treatment approaches and outcomes in plasmacytomas: Analysis using a national dataset (NCDB data)

Mutual Risks of Cutaneous Melanoma and Specific Lymphoid Neoplasms: Second Cancer Occurrence and Survival (SEER data)

Association of Marital Status with T Stage at Presentation and Management of Early-Stage Melanoma (SEER data)

Disparities in Colon Cancer Survival by Insurance Type: A Population-Based Analysis (SEER data)

Association of Adjuvant Chemotherapy with Overall Survival in Patients with Rectal Cancer and Pathologic Complete Response Following Neoadjuvant Chemotherapy and Resection (NCDB data)

RESOURCES AND NEWS OF INTEREST

GW Cancer Center’s Newest Social Media Toolkit

May is Melanoma/Skin Cancer Awareness Month, an annual opportunity to raise awareness about melanoma and skin cancer, fundraise for research into their cause, prevention, diagnosis, treatment, survivorship, and cure as well as to support those affected by melanoma and skin cancer. Melanoma/Skin Cancer Awareness Month Social Media Toolkit

From research to agency reporting: producing an atlas of behavioral cancer risk factors in Ontario

Mesothelioma: A Rare Cancer That Targets Senior Citizens

Young Adult Cancer: Influence of the Obesity Pandemic

There is meaning in the work we do together!

Nancy H. Rold, CTR

Operations Manager

Missouri Cancer Registry and Research Center