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Announcing Release of the New Commission on Cancer Standards for Accreditation

The Commission on Cancer (CoC) announces the formal release of the Cancer Program Standards 2012: Ensuring Patient-Centered Care.  You should have received a special issue of the CoC Flash officially announcing the release.  This publication is the culmination of more than two years of work by a group of dedicated individuals that include staff of the Accreditation Program at the CoC, including Connie Bura, Asa Carter and her team, Andrew Stewart, and David P. Winchester, MD, FACS.  In addition, while it is impossible to list all those who worked on this project, key volunteers in the development of the standards include the project co-chairs, Frederick Greene, MD, FACS, and Diana Dickson-Witmer, MD, FACS, the respective workgroups chairs, vice-chairs and members, and Daniel McKellar, MD, FACS, and Robert Flanigan, MD, FACS, chair and vice-chair of the Accreditation Committee.

Ultimately, we express our gratitude to the accredited cancer programs for  the feedback they provided throughout the development process.  Thanks to all for your commitment to this project.  These standards, scheduled for implementation in 2012, ensure that key elements of quality cancer care are provided to every cancer patient treated in a CoC-accredited facility throughout diagnosis and treatment, including psychosocial support, care for cancer-related pain, palliative care, and hospice care.  These standards challenge cancer programs to enhance the care they provide by addressing patient-centered needs and measuring the quality of the care they deliver against national standards.  Both areas are critical components of quality cancer care.

Information about the standards, including soon-to-be-released resources to support them, can be found on the CoC website at, where you can also download a PDF copy or order additional hard copies of the standards.

National Cancer Data Base (NCDB)
A Precautionary Tale of an Edit: Date of First Course of Treatment and Treatment Status

The National Cancer Data Base (NCDB) works closely with other cancer registry standard setters. An example of that cooperation involves an edit that affects cases diagnosed in 2010 or later. In 2009, the National Program of Cancer Registries (NPCR) performed an audit that checked the accuracy of coding for the Facility Oncology Registry Data Standards (FORDS) data item, Date of the First Course of Treatment (NAACCR Item #1270). The auditors discovered substantial failure to follow coding instructions accurately.

That item requires a date to be entered unless the case was diagnosed at autopsy. The first three instructions for Date of the First Course of Treatment in FORDS: Revised for 2011 read as follows:

  • Record the earliest of the following dates: Date of First Surgical Procedure (NAACCR Item #1200), Date Radiation Started (NAACCR Item #1210), Date Systemic Therapy Started (NAACCR Item #3230), or Date Other Treatment Started (NAACCR Item #1250).
  • If active surveillance or watchful waiting is selected as the first course of treatment (RX Summ-Treatment Status [NAACCR Item #1285] = 2), record the date this decision is made.
  • In cases of nontreatment (RX Summ—Treatment Status [NAACCR Item #1285] = 0) in which a physician decides not to treat a patient or a patient’s family or guardian declines all treatment, the date of first course of treatment is the date this decision is made.

Except for autopsy-only cases, there must be a date entered for Date of the First Course of Treatment or else the Date 1st Crs RX Flag must indicate that the date is unknown (10 or 12).

NPCR requested NCDB to sponsor an edit that controls the use of the Date 1st Crs RX Flag based on Class of Case because the items involved are FORDS items. The resulting edit, “RX Summ--Treatm Stat, Date of 1st Crs RX--COC(COC),” checks that:

For cases for which RX Summ--Treatment Status = 0 (no treatment given), THEN

  1. If Class of Case = 38 (autopsy only), Date of 1st Crs RX Flag must = 11 (autopsy only case)
  2. If Class of Case NOT = 38 (autopsy only), Date of 1st Crs RX Flag must = blank (a date has been coded), 10 (unknown whether any treatment was given), or 12 (a date is applicable, but unknown).
Because the item RX Summ--Treatment Status was defined for use beginning in 2010, the new edit applies to cases diagnosed starting in 2010. NCDB will collect cases diagnosed in 2010 for the first time in January of 2012. However, because a state central registry reported to NCDB that it was seeing a substantial number of current cases failing the edit, we are bringing it to your attention now so you can review your existing cases for accuracy and make any coding procedure changes that might be necessary for the future.  

To correct cases that fail the edit, review the date of first course treatment and treatment status as well as the first course treatment date flag and class of case.

For questions, contact

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August 31, 2011
In This Issue
CoC News
“Use of Radioactive Iodine for Thyroid Cancer” Journal of the American Medical Association, Vol. 306, No. 7, Aug. 17, 2011
Rapid Quality Reporting System: Enrollment Starts September 19
Applications Being Accepted - American College of Surgeons Commission on Cancer Surgical Oncology Scholar-in-Residence Program
You Can Still Register for Survey Savvy!
ProvenCare® Lung Cancer Collaborative Update
CoC Datalinks Access: Security and Maintenance
Accreditation Program
Annual Update Period Extended
Highlighting the 2012 Standards—Eligibility Requirements
NewsCLiPs: News for Cancer Liaison Physicians
Cancer Liaison Physician Outstanding Performance Awards
Cancer Liaison Physician Breakfast Meeting at Clinical Congress to Be Videotaped
Revised State Chair Toolkit Now Available
CLP Webinar Series
New State Chairs
National Cancer Data Base (NCDB)
A Precautionary Tale of an Edit: Date of First Course of Treatment and Treatment Status
NCDB September Submissions
Educational Activities
New Webinars Now Available On-Demand
New On-Demand Webinars to Support the New CoC Standards Coming Soon
News from the American Joint Committee On Cancer (AJCC)
AJCC Update: Letter from the Chair of the AJCC
AJCC Website Survey
A Fond Farewell to Dr. Irvin Fleming
CS FAQ Document with Known Issue for v02.03
Collaborative Stage Reliability Study - Mark your Calendars!
News from the National Accreditation Program for Breast Centers (NAPBC)
Pursuing Excellence through Accreditation Workshop – November 18, 2011
NAPBC Components and Standards Webinar Offered On-Demand
NAPBC Exhibit Schedule – Fall 2011
News from CoC Partners
SGO Releases Report on Women’s Cancer Research Priorities for Next Decade
Pfizer Launches Cancer: It’s Personal
Monthly Spotlight on Member Organizations
Monthly Spotlight: American College of Obstetricians and Gynecologists
American Urological Association
The American Academy of Pediatrics
The American Pediatric Surgery Association
Upcoming Programs
Survey Savvy, Sept 15-16, 2011
Hollywood, CA
Space Still Available 

New On-Demand Webinars
Move to the Fast Track: Getting your Cancer Program Ready for the Rapid Quality Reporting System (RQRS)

The College of American Pathologists (CAP) Cancer Protocols: Where We’ve Been and Where We’re Going

New Free Webinar
Preparing for Your CoC Survey

Contact CoC Staff

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