High-Level Strategic Group (HLSG) and Mid-Level Tactical Group (MLTG)
NCRA's HLSG Liaison: Paulette Zinkann, CTR
NCRA's MLTG Liaison: Jennie Jones, CTR, MSHI-HA, CHDA
The purpose of the HLSG and MLTG is to ensure high-level coordination among all cancer surveillance organizations regarding the development and implementation of major changes in standards and procedures.
The groups are collaborating with standard setters to closely monitor and review any proposed changes/new data item requests for NAACCR version 22. The deadline to submit requests for new data items or changes to existing data items was October 1, 2020. Every effort is being made to fine tune the timeline to ensure that updates and changes are implemented in a timely fashion via a systematic process. Be sure to review the resources and available education and training for Version 21 by following the link here.
Thanks to everyone for your efforts in working together as a unified cancer registrar community.
National Accreditation Program for Breast Cancers (NAPBC)
NCRA's NAPBC Liaison: Cynthia Boudreaux, LPN, CTR
The NAPBC announced to programs in mid-December 2020 that they will not be held to 50% delivery requirement for 2020 or 2021 on S2.20-Breast Cancer Survivorship Care plan. However, they are expected to do what they can concerning the standard. The site visit will still include a review of all aspects of S2.20, such as development of a SCP. A non-compliant rating will not be given if SCP's are delivered to less than 50% of eligible patients seen during those years. Centers should endeavor to provide cancer patients access to resources and information either online or virtually even if they are unable to provide a SCP.
North American Association of Central Cancer Registries (NAACCR)
NCRA's NAACCR Liaison: Heather Stabinsky, MS. Ed, CTR
The NAACCR Uniform Data Standards (UDS) Workgroup is currently discussing the issues surrounding "blank" values in the context of the new NAACCR XML Data Exchange Standard. A new ad hoc task force will continue reviewing the complexities surrounding how "blank" should be defined. The work group completed its review of the Race code "03" and has approved the removal of the term "Eskimo" and the addition of the term "Alaskan Native". This will be implemented for diagnosis year 2022.
The work group is also reviewing change requests to revise surgical codes for Colorectal (included Anus, Rectosigmoid, Colon and Rectum) and Breast, and the request to add the new data item "Total Mesorectal Excision (TME)". These requests for changes and additions are sponsored by CoC. The currently expectation is these changes will be implemented for diagnosis year 2022.
The NAACCR UDS Workgroup includes representation from several US states, Canada, Cancer Registry Standard Setters, and software vendors and is responsible for reviewing and approving codes and coding instructions for new data items.
College of American Pathologists (CAP)
NCRA's CAP Liaison: Deborah Dickerson, CTR
The Ask the Pathologist (ATP) forum of CAP is designed to allow constituents to post, view and answer questions applicable to pathology such as: terminology, biology, histologic clarification, extent of disease, molecular markers, and prognostic laboratory tests associated with cancer. Questions posted on the Ask the Pathologist (ATP) sub-forum are addressed by members of CAP's Cancer Committee.
The ATP sub-forum is not for registry coding, staging, or multiple primary rules. When posting in Ask the Pathologist forum, think about the type of questions that you would ask the pathologist at your facility. Questions related to solid tumor rules and coding instructions would not be appropriate. These are CAP Cancer Committee pathologists answering the questions. They are not familiar with registry-related coding guidelines.
Examples of questions NOT to ask in the ATP forum:
- Solid tumor rules
- Reportability for state or CoC
- Coding rules
- Primary site/histology codes
Examples of questions one might ask in the ATP forum:
- Explaining the terminology in histologies (not codes)
- Involvement/invasion needed for the T category in the CAP Protocol
- Unclear information from a pathology report
- Explaining terminology used in a pathology report
Currently one-half to two-thirds of the questions posted in the ATP forum are not appropriate for pathologists to answer. The registry community greatly appreciates the time extended from the CAP Cancer Committee Pathologists by answering the questions in the ATP forum. We must improve our understanding on the appropriate use of this forum to continue this important affiliation.
Commission on Cancer; CSSP
CoC Operative Standards 5.3-5.8: Updates on Educational Resources
NCRA's CSSP Liaison: Nadine Walker, MS, CTR
The Commission on Cancer (CoC) accreditation standards, Optimal Resources for Cancer Care (2020 Standards), now include six new operative standards for breast, colon, rectal, lung cancer and melanoma surgeries. Incorporation of these operative standards is a step toward improving oncologic outcomes by reducing the variation in the way cancer operations are performed across the United States.
As programs prepare for and work toward achieving compliance, the Cancer Surgery Standards Program (CSSP) is developing resources that can be utilized to help surgeons, pathologists, and registrars understand their role in meeting these standards. We recommend that all registrars at CoC-accredited cancer programs review and share the following resources with their staff:
CoC Operative Standards Introduction Video - This
brief, 6-minute video introduces the operative standards and the rationale for their incorporation into the CoC accreditation standards.
- Additional short videos on each operative standard will be released in the coming months. These short videos can be shown at multidisciplinary tumor boards.
Educational Webinars on CoC Operative Standards - In the following webinars, multidisciplinary panels discuss the goal of and evidence behind Standards 5.7 and 5.8, best practices for achieving compliance, and the role of these evidence-based standards in improving outcomes for patients with cancer. Recordings, slides, and 1-page summaries of each webinar can be found on the CSSP Resources page.
- CoC Standard 5.7 (Total Mesorectal Excision)
- CoC Standard 5.8 (Pulmonary Resection)
- Additional webinars on Standards 5.3-5.6 will be scheduled in the coming months.
SurgOnc Today® Podcast - In this
SurgOnc Today® podcast, sponsored by the Society of Surgical Oncology, James Howe, MD, FACS interviews Kelly Hunt, MD, FACS and Matthew H.G. Katz, MD, FACS about the Commission on Cancer accreditation standards 5.3 through 5.8, what these standards are, where they came from, and why they are so important to all surgeons and their patients.
- Podcasts on Standards 5.7 and 5.8 coming soon!
"2020 CoC Operative Standards: Where are we now?" Bulletin Article - Read more about resources and education for the CoC operative standards in this feature article published in the January 2021 issue of the Bulletin of the American College of Surgeons.
CoC Operative Standards Visual Abstracts - These one-page visual abstracts available on the
CSSP Resources page summarize the technical components of the operation, pathology documentation requirements and implementation timelines for CoC Standards 5.7 and 5.8.
- Visual abstracts on Standards 5.3-5.6 coming soon!
- A comprehensive list of FAQs for the operative standards will be released in the coming months.
