MCR MINI-UPDATE DECEMBER 2014
Fellow Registrars,
This year is quickly drawing to a close. Thanks for all you have done to make it a
successful one for the cancer registry.
Due Dates
We are particularly interested in getting any remaining 2013 cases submitted this month. Large
hospitals (>500 cases/yr.) are to report May 2014 cases by December 15 and smaller facilities (<300
cases /yr.) report the 2nd Quarter of 2014 by January 15.
Educational Opportunities - November
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.
December 4, 2014 – Using the Multiple Primary and Histology Coding Rules
Live Meetings - Visit our Education and Training page to listen to previous Live Meetings. Remember
after December 31, 2014 recordings will no longer be available.
December, 2014 – No Live Meeting This Month
To register for any of our educational opportunities, call 1-866-240-8809 or contact Shari Ackerman at
ackermans@health.missouri.edu.
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:
December 16, 2014 – Overview of Myelofibrosis, Current Treatment Options and Quality of
Life Concerns
December 17, 2014 – Update on Lymphoma from the 2014 American Society of Hematology
(ASH) Annual Meeting
For more information and to register, visit the CancerCare Website or call 1-800-813-HOPE (4673).
MCR News
New Hire
Sue Stulgo will join the MCR staff in December as our software support analyst. She’ll be working to
make sure that our software systems are working smoothly together. She comes to us from the MU IT
department with great experience, so we expect a fairly seamless transition as she learns our
processes. Please join us in welcoming her.
Reminder: Live Meeting Recordings – Final month! Listen now before they are gone!
Please take advantage of any sessions you missed by listening to the recordings posted on our website:
http://mcr.umh.edu/mcr-livemeeting.php. Unfortunately, in 2015 you will no longer have access to
these previous recordings.
NAACCR Submission
MCR completed our annual data submission to NAACCR just before Thanksgiving. Thank you for the
cases you sent us. QA worked hard to get them into our database and Saba helped us to do all the
required pre-submission quality checks. We are hopeful that together we will achieve gold certification
again – stay tuned! Now we gear up for our submission to NPCR in January!
Abstracting Tips
DCIS
When abstracting breast primaries, for ACoS hospitals you may save time by cutting down on the
amount of detail you enter in the Pathology text field. I.e., when both invasive and in situ tumor is
present, there is no need to record each subtype of DCIS or to specify grading for the in situ
histologies. Instead, cite the presence of in situ tumor in terms that support the code for CS SSF 6. For
example, text for code 040 might be stated as, “2 cm DCIS with 1 mm focus of invas.” Reducing the
amount of DCIS info in the text is appropriate for non-ACoS hospitals as well because SSF 6 is not
required by MCR.
Neuroendocrine cancer of the prostate
Very rarely a newly diagnosed prostate cancer is found to have neuroendocrine histology (de novo
NEPC). More commonly now NEPC is occurring as a result of treatment of advanced prostate cancer
with hormone therapy (transformed treatment related or t-NEPC). They typically have very low PSA but
an aggressive course, so they are sometimes diagnosed at metastasis as neuroendocrine primaries of
unknown origin. This is a very informative article:
http://www.pcf.org/site/c.leJRIROrEpH/b.8747629/k.F201/Subtype_of_Highly_Aggressive_Prostate_Ca
ncer_Increasing_Tied_to_Drug_Resistance_to_Hormone_Therapy.htm#.VG0G7CnxO9Y.email
Additionally, SEER Inquiry Question 2013221 gives some guidance on using the MP/H rules:
Question
MP/H Rules/Multiple primaries--Prostate: How many primaries are accessioned for a diagnosis of
metastatic small cell neuroendocrine carcinoma of the prostate following a previous diagnosis of
adenocarcinoma of the prostate?
Answer
Accession two primaries, adenocarcinoma [8140/3] of the prostate [C619], followed by small cell
(neuroendocrine) carcinoma [8041/3] of the prostate [C619] for each of the examples given per Rule
M10.
In each case, the second histology (because it is not adenocarcinoma) is a new prostate primary. Small
cell carcinoma and small cell neuroendocrine carcinoma are not adenocarcinomas. As a result they are
not covered by Rule M3
Standard Setter News
FORDS 2015 has been published. Find it at: https://www.facs.org/qualityprograms/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual. It contains the Grade rules that went
into effect for 2014 (also found in 2014 MCR Abstract Code Manual and discussed in MCR Live Meeting
recording from July 2014), clarification regarding biopsies followed by surgery (further discussed in MCR
Update November 2014), and new sex codes for 2015 that differentiate transsexual, male to female
from female to male. This is a routine annual update of FORDS. They are still taking suggestions
through 12/31/14 for the FORDS Revision Project: https://www.facs.org/qualityprograms/cancer/ncdb/registrymanuals/cocmanuals/fordsrevision
Registry to Research
MCR was well represented with the following presentations and posters at the American Public Health
Association annual meeting in New Orleans in November. You can find the abstracts by searching
Jackson-Thompson at the conference website:
https://apha.confex.com/apha/142am/webprogram/start.html
One central cancer registry’s use of National Death Index (NDI) linkage to become a
survival registry
Using National Death Index linkage to improve data on female breast cancer survival
How central cancer registry informatics and information technology (HIIT) systems
can benefit other APHA sections
Interactive mapping of leukemia in Missouri
Interactive mapping with cancer incidence, demographic, and behavioral risk data
How an informatics solution increased efficiency and reduced costs in a central
cancer registry (CCR)
How one central cancer registry (CCR) navigated EHR reporting from
Clinic/Physician Offices (C/POs)
How Meaningful Use (MU) Stage 3 may impact one central cancer registry’s
progress in MU Stage 2
Global surveillance of cancer survival 1995—2009: analysis of individual data for
25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962038-9/fulltext
Comprehensive Cancer Control Plans by state (incl. MO data)
http://www.cdc.gov/cancer/ncccp/ccc_plans.htm
Cancer Statistics Animator (SEER data)
Choose various variables and set the graph to animate changes across time or age groups
http://seer.cancer.gov/canstat/
Colorectal cancer increase in young adults (SEER data)
http://archsurg.jamanetwork.com/article.aspx?articleid=1920838
No survival benefit of RAI seen in early-stage thyroid cancer (SEER data)
http://www.practiceupdate.com/News/6361/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4
MTE1NjYS1&lid=10332481
Use of and mortality after bilateral mastectomy compared with other surgical treatments (California
central registry data analysis)
http://jama.jamanetwork.com/article.aspx?articleid=1900512
Differing patterns of treatment for differentiated thyroid patients younger v older than 45 (California
central registry data analysis)
http://www.practiceupdate.com/News/6297/32/1/?elsca1=emc_conf_ATA2014Roundup&elsca2=email
&elsca3=practiceupdate_onc&elsca4=2014101_ATA2014Roundup&elsca5=conference&rid=NTU2MjE4
MTE1NjYS1&lid=10332481
Resources
Small breast cancers how and when to treat
http://www.sciencedirect.com/science/article/pii/S0305737214001649
Cervical cancer is preventable (statistics and infographic)
http://www.cdc.gov/vitalsigns/cervical-cancer/
Molecular testing guidelines for lung cancer (EGFR, ALK, etc)
http://jco.ascopubs.org/content/32/32/3673
Prognostic model for survival after debulking surgery for epithelial ovarian cancer
http://www.gynecologiconcology-online.net/article/S0090-8258(14)01222-0/abstract
Partnering with China to understand cancer epidemiology and cancer control differences
http://dceg.cancer.gov/news-events/linkage-newsletter/2014-11/research-publications/chinapartnership
Dogs can detect thyroid cancer from urine samples.
http://www.practiceupdate.com/News/6256/2/1/?elsca1=emc_enews_dailydigest&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE4
MTE1NjYS1&lid=10332481
Thanks for the work you do every day!
Nancy H. Rold, CTR
Operations Manager
Missouri Cancer Registry and Research Center