The CoC Source - July 31, 2012
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Annual Cancer Case Volume Data Ready for Release to the Public

Your hospital's 2010 Annual Cancer Case Volume (previously referred to as FIPS Level II data) has been posted to CoC Datalinks and is ready for your cancer program’s review and release. This table reflects the site and stage distribution of cases submitted to the National Cancer Data Base (NCDB) from your facility for the diagnosis year 2010.  These cases were submitted in 2012.  

The CoC strongly encourages you to share these data with patients through the CoC Hospital Locator on the CoC website. Instructions below tell you how to release the data through the CoC Datalinks website.

Please discuss the release of your Annual Cancer Case Volume with your cancer committee and designate a cancer committee member with CoC Datalinks access to take the following actions to release your data:

1.    Log onto CoC Datalinks at 
*If you have forgotten your User ID or Password, please use the “Forgot Username or Password” link on the login page.
2.    On the Activity Menu, click: CoC Hospital Locator: Annual Cancer Case Volume
3.    Read and accept the NCDB Disclaimer
4.    Review the data table
5.    Select one of the three release options as follows:

Accurate Release to CoC - If you select this option, you can add a short narrative description of your facility in the text box provided, and describe your patient population.  
For example, if you treat more patients (diagnosed elsewhere but treated at your facility) than the number submitted to the NCDB, you may want to describe that difference in your case counts. The narrative description is optional. Your facility’s data will be immediately displayed on the CoC website.

Accurate Do Not Release to CoC - If you choose this option, please let us know what your concerns are about releasing these data by contacting

Inaccurate Do Not Release to CoC - If you choose this option, please contact to let us know your concerns.

If none of these options is selected, your Annual Cancer Case Volume will remain in DRAFT form, and you will continue to receive e-mail reminders requesting release.  Your facility’s listing on the CoC Hospital Locator will continue to have 2009 data displayed if you released data last year, or there will not be an “Annual Caseload” link for your facility listing.

Please review your Annual Cancer Case Volume and indicate your decision to release by August 31, 2012.

Questions? Contact

Managing Staff Contacts in CoC Datalinks

For CoC-accredited cancer programs accessing CoC Datalinks, a new Manage Staff Contacts link has been added to the Activity Menu as of July 9, 2012. Current CoC Datalinks users can now log into the new system and update staff contact information and/or add new staff to receive access to CoC Datalinks.  This feature eliminates the need for programs to submit a CoC Datalinks User Request Form.  Please review the instructional information below to learn more about managing staff contacts.  

The Manage Staff Contacts page has three parts:

  1. Staff Contact Information – Current Contacts:  This section of the page is an accordion-style menu of all contacts listed for your facility and the CoC Datalinks roles each contact has been assigned. Click on the name of a contact to see the detailed contact information, including Name, e-mail address, and Access Role(s).
  2. Staff Contact Information – Previous Contacts:  This section of the page is an accordion-style menu of all contacts that were previously listed for your facility.  These contacts may have previously had access to CoC Datalinks, but no longer have access at the present time.  The previous contacts will remain in this section for the duration of one year.  This will allow you to edit and assign a role to a previous contact in the event that they were removed by mistake or return to your facility.
  3. Pending Contacts: If you have added a new contact for your facility, they will appear in this section until they have been processed by the CoC Datalinks Administrator.  The Pending Contact additions will disappear and the new contacts will be listed in the Current Contacts section as soon as they are processed.

Managing Your Staff Contacts:

Edit:  You can edit a current contact or previous contact by selecting the person’s name and clicking the “Edit” button. 

  • Contact Info Change:  You can change the address, phone, e-mail, etc. for current or previous contacts.  Click SAVE at the bottom of the edit pop-up screen.  
  • Role Change/Addition: You can assign an additional role (i.e., a Registrar is also a Coordinator) or change a role by checking or unchecking the access role from the list.  Click SAVE at the bottom of the pop-up screen after making any changes to the person’s record.

Removing a User:  You can remove a user through the Edit pop-up screen by either unchecking all access roles, or clicking the “Remove” button at the bottom of the role list.  Click SAVE and the contact will drop down to the Previous Contacts list.

Add: The “Add” button should only be used to add a completely new contact not already listed in the Current or Previous Contacts lists.  Complete the necessary fields of the new contact screen, select a role, and click SAVE.

Managing Staff Contact Tips:

  • The contacts listed for your facility have an existing record in our database so the name field is “read only.”  If the person listed has truly changed their name, please e-mail with the name change.  If it is a completely new contact, please remove this user and add the new contact (instructions above).
  • CoC Datalinks Login information is unique to the user and connected to that user’s e-mail account for access purposes.  Each contact listed MUST have a unique e-mail address listed.  If one e-mail address is listed for multiple users, access to CoC Datalinks may be denied.
  • The question mark at the top of the Manage Staff Contacts screen is a Help section that has instructional information for managing staff contacts and access role definitions.


Patient Brochure Now Available for CoC-accredited Cancer Programs

A new CoC patient brochure, designed to assist CoC-accredited cancer programs in promoting and defining their CoC-accreditation status to visiting patients and their families, is now available for purchase online.  CoC-accredited cancer programs can order a package of 50 brochures, costing $40 per package, through the link below.

Commission on Cancer Surgical Oncology Scholar-in-Residence Program

The American College of Surgeons (ACoS) CoC is offering a two-year fellowship in surgical oncology outcomes and health services research beginning July 1, 2013.  The ACoS CoC has one position available every two years for a surgical resident who has completed two or three years of clinical training in the U.S. or Canada. The fellow will work within the Cancer Programs Department of the ACoS to conduct clinical research and further the research agenda of the CoC’s National Cancer Data Base (NCDB) whose goal is to improve the quality of care for the cancer patient. The application deadline is August 15, 2012.

The primary objective of the Surgical Oncology Scholar-in-Residence Program will include a specific focus on utilizing the power of the NCDB to devise studies that will impact the quality of cancer patient care delivery within the CoC’s 1,500+ accredited cancer programs.  The scholar will have access to the NCDB analytic files which contain a full complement of data items necessary to conduct a broad range of clinical studies. In addition, the scholar will be expected to support the NCDB’s objective of promoting the growth and development of its Participant User Files (PUF) by helping to foster communities of experts and establishing a core user community that will serve as an effective reference point for future uses. It is anticipated that this work will result in several disease-specific presentations at major oncologic and surgical meetings held in the U.S. and/or Canada to include the Society of Surgical Oncology and the American Surgical Association, resulting in the publication of peer-reviewed articles in major oncologic and surgical publications.

A secondary objective of the Surgical Oncology Scholar-in-Residence Program will include working with multidisciplinary panels on the development, validation, and assessment of quality measures in cancer care that can be broadly disseminated among the CoC’s accredited cancer programs to benchmark performance and facilitate quality improvement initiatives at the local provider level. It is expected that this measure development work will build upon the current National Quality Forum-endorsed breast, colon, and rectal quality measures that are currently being assessed within Commission programs.

Details about the program can be found on the CoC website at

Program questions and completed applications with supporting documentation should be directed to Connie Bura, Administrative Director of Cancer Programs at the ACoS, at

CoC ProvenCare Lung Cancer Collaborative Adds Six New Sites

Six CoC-accredited institutions will join a select group of six existing institutions in a national pilot study promoting evidence-based evaluation and treatment standards for patients with non-small cell lung cancer (NSCLC).  The pilot study was launched in July 2010 by the CoC.  The ProvenCare® Lung Cancer Collaborative is based on the success of Geisinger Health System’s ProvenCare model which relies on evidence-based standards of medical treatment. In other care episodes, such as coronary artery bypass graft, Geisinger’s ProvenCare model has significantly increased adherence to guidelines, improved clinical outcomes, and engaged patients as participants in their own medical care.

This groundbreaking study, which has accrued 500 patients, marks the first time that Geisinger’s ProvenCare model has been applied to a population of patients undergoing a lung resection procedure for NSCLC.  The procedure promotes a specific care pathway of 38 standard elements that are followed from patients’ preoperative to postoperative care.  Treatment teams at the following six CoC-accredited institutions have joined the collaborative with patient data collection, beginning August 6:

  • Baystate Medical Center, Springfield, MA
  • Providence Portland Medical Center, Portland, OR
  • Providence Regional Medical Center, Everett, WA
  • Sinai Hospital, Baltimore, MD
  • Stony Brook University Medical Center, Stony Brook, NY
  • UMass Memorial Medical Center, Worcester, MA

Treatment team members at each participating institution commit to providing all 38 of the established care pathway steps to ensure that patients receive the highest standard of care.  Institutions also must provide resources for a collaborative web-based data entry process and data abstraction capabilities. As of April 2012, 90 percent of the 38 elements of care were followed by the initial pilot sites for each patient entered into the study.

Importantly, patients in the study lend their participation to the process by making a commitment to communicate with the members of their surgical team, getting their family or loved ones involved in their treatment plan, and completing important care steps outlined to them by their health care providers.  Patient engagement is an important element of Geisinger’s ProvenCare model as research studies have shown that patients have better results when they participate in their own care.  

The six new participating institutions join the following inaugural participants with the goal of capturing 1,000 patients over the next 12 months.   

  • Geisinger Health System, Danville, PA
  • University of Washington Medical Center,  Seattle
  • Northshore University Health System, Evanston, IL
  • Northwestern University Medical Center, Chicago, IL
  • Kern Medical Center, Bakersfield, CA
  • Duke Raleigh Hospital, Raleigh, NC  

For more information on the project visit the press release on the CoC News page at, or contact Connie Bura at  

CoC to Exhibit at the NCC - CDC

The CoC will host an exhibit at the National Cancer Conference of the Centers for Disease Control and Prevention (NCC – CDC), August 21-23, at the Omni Shoreham Hotel, in Washington, DC. 

If you are attending this meeting, stop by CoC booth #616 and see the new materials the CoC has to offer. To learn more about the CoC, visit


CoC Datalinks Transition

The CoC would like to thank everyone for their patience during the transition of the CoC Datalinks upgrade in early July. As we continuously work with the new database the “kinks” are slowly but surely being worked out, and your feedback on issues has been greatly appreciated.

Please take note that ALL the Eligibility Requirement (ER) screens (and uploaded documents) are required to be completed by ALL programs by September 30, 2012, with 2012 cancer program activity. Completing the ER section allows accreditation staff to validate that important program components are in place and fully functioning. The Eligibility Requirement section will be required to be completed each year from July 1 to September 30, the new Annual Update Period. Surveys will not be scheduled until this ER section has been completed.

Currently there are three other important links available for access on the new Datalinks activity menu: Facility Information, Manage Staff Contacts, and the Historical Survey Application. We ask that you review and complete the Facility Information screens during this time so that the Hospital Locator will reflect current services and resources by October. The Manage Staff Contact screens are important, as they reflect the most current staff contact information for your facility, directly update the CoC database, and assist the surveyors when they need to contact your facility.

To review the old SAR, click on the Historical Survey Application Record link. Another Historical Survey Application Record link will appear. Click on that link to view your previous SAR. Note that unless you are scheduled for a 2012 survey, the SAR will be in a read-only format. To view uploaded documents from the previous SAR, click on Uploaded SAR Documents after clicking on the Historical Survey Application link. The documents are noneditable from this view.

Cancer programs scheduled for a 2012 survey will keep their “editable” access to the SAR until three days postsurvey.

Chapters 1 through 5 of the 2012 Standards Manual will be accessible in the new SAR in October 2012, once the ER screens have been completed.

CAnswer Forum: Look at Us Now!

Do you have unanswered questions? Are you looking for clarification? Do you think you have coded a field correctly but would like it confirmed? If you answered yes to any of these questions, we invite you to join the more than 4,000 members and guests who use the CAnswer Forum to get their answers.

In the fall of 2010, the CoC launched the new CAnswer Forum. We were off to a slow start, which often happens when a new system is introduced, but now we are running at full speed. So far, 3,425 questions have been submitted to the Forum, and there are 10,155 answers, replies, and comments. The average turnaround time for a question to be answered is three to five business days in most forums. Some question may need to be sent to a curator for an answer, which could take longer.

If you are looking for answers to your questions, we invite you to join the crowd and become a member of the CAnswer Forum. Log in and register at

Cancer Program Standards 2012: Best Practices Repository—What’s New in July?

This month we will introduce two of the newest examples and/or resources submitted to the CoC Best Practices Repository. These documents have been reviewed and approved by the Standards Advisory Group for Excellence (SAGE).

The first best practice example is a poster submitted by Carla Amato-Martz, JD, LCSW. This poster, titled “Patient Navigation: An Overview,” was presented by Ms. Amato-Martz at the Association of Oncology Social Workers (AOSW) national conference in May 2012. It gives an overview of patient navigation, including a definition of patient navigation; lists disparities that are impacted by the patient navigation process; and shows how patient navigation affects patient care outcomes.

The second best practice example is a Colorectal Cancer Prevention Event, submitted by Grady Memorial Hospital in Delaware, OH. This document supports Standard 4.1 Prevention Programs and all aspects of the screening standard.

We hope our constituents find these examples helpful as they prepare to comply with the new 2012 Standards. To view these documents and other newly posted documents, follow the link to the Best Practice Repository:

We would like to thank our constituents, member organizations, and staff for contributing tools and examples to the repository. We would like to encourage all accredited programs to share with us any best practice contributions. Please visit the link above to download instruction for submitting your best practice.

Clinical Trial Accrual Rates to Follow

Clarification for clinical trial accrual rates cancer programs are to follow for survey and nonsurvey years 2012–2014:

2011 Category         

2012 Category   




















































This table also applies to resolving deficiencies in Standard 5.2 or Standard 1.9 with resolution due dates through 2014.


2012 Standards Highlights – Chapter 5 Data Quality

The final standards in the 2012 manual address the quality of data that is captured by the cancer registry at each CoC-accredited program. The requirements for six of the seven standards in this chapter are the same as in the previous manual.

Standard 5.1 – Cancer Registrar Credentials
The changes to this standard are significant and may present a challenge for compliance to some CoC-accredited programs. That said, it is important to focus on the professional growth fostered by the standard. 

The new requirements expand on the requirements of  the 2004 standards.  The 2004 standards required that abstracting is supervised by a Certified Tumor Registrar (CTR). This supervision of noncredentialed staff included a component of education with the goal of certifying all registry staff. The current standard takes this to the next level by requiring that abstracting be performed by a CTR. To operate the cancer registry, a cancer registrar must possess considerable knowledge and skills that encompass all aspects of data collection and case abstracting. The CTR credential is the recognized indicator for the cancer registry profession.

CoC-accredited cancer programs have three years (until January 1, 2015) to implement this standard during which time current registry staff who are not certified will obtain the CTR credential.  

The CoC encourages accredited programs to hire staff who already hold a CTR, however, staff who are abstracting and who are hired after January 1, 2012 have a one-time, three-year period in which to obtain the CTR.  During this three year period, the non-credentialed staff is supervised by a CTR. A staff person who does not obtain the CTR credential within the three- year period cannot abstract in any CoC-accredited program.

Registry staff who are working to obtain the CTR credential should review the eligibility requirements that are posted on the National Cancer Registrars Association website.

The program complies with the standard when abstracting is performed by a CTR or when a CTR provides supervision to noncredentialed staff who are in the one-time, three-year grace period.

Standard 5.2 Abstracting Timeliness
Timely abstracting is a necessary component to accurate data collection and the evaluation of patient outcomes. The requirements for this standard remain the same as in previous versions; 90 percent of cases must be abstracted within six months of the date of first contact with the facility. 

Abstracting timeliness is verified by the National Cancer Data Base (NCDB) and by surveyor review of abstracts during the on-site visit. Abstractingshould be maintained at all times, and compliance is based on the compliance for each year in the survey cycle. 

A compliance rating is assigned when at least 90 percent of cases are abstracted within the six-month time frame each year. A Commendation rating is assigned when 95 percent of cases are abstracted within six months annually. This rate has increased from previous standards.

Standard 5.3 and 5.4 Follow-up of patients
Patient follow-up is necessary to obtain information about additional treatment received by the patient with cancer as well as patient outcomes. Accurate and complete information is needed to compare the CoC-accredited program outcomes with regional, state, and national data.

Many resources are available to obtain follow-up information, including information from the patient’s managing physician, inpatient or outpatient care provided by the program, communication with other facilities that provided care to the patient, and Internet resources.

The CoC-accredited program obtains current follow-up information on 90 percent of patients diagnosed during the last five years and 80 percent of patients who are included in the data base since the reference date. No Commendation rating is available for these standards.

Standard 5.5 Data Submission and Standard 5.6 Accuracy of Data
These related standards address the timely and quality submission of data to the National Cancer Data Base (NCDB), which is required of each CoC-accredited program. Data submitted to the NCDB provide performance feedback to cancer programs, enable the comparison of treatment and patient outcomes, and facilitate publications by researchers.

Each year the CoC-accredited program submits data by following the requirements and deadlines that are outlined in the annual call for data. The quality of data is ensured by applying standardized data edits to each case and correcting identified errors.

Cases with errors and rejected records that are not corrected before submission are corrected and resubmitted by the specified resubmission deadline.

NCDB staff evaluate the data submissions and assign a compliance rating when complete data are submitted each year during the accreditation period. NCDB staff also determine if the resubmission criteria have been meet each year and record a compliance rating for this standard. If data are error-free at the initial submission for each year during the accreditation period, then the CoC-accredited program will earn a Commendation rating for standard 5.6.

Standard 5.7 CoC Special Studies
Periodically, the CoC will undertake hypothesis-based special studies that are used to evaluate patient care, set benchmarks, and provide feedback to improve care in cancer programs.

A specific group of programs will be designated to participate in the study, and the cases and additional data to be submitted will be identified by the NCDB. CoC-accredited programs are expected to participate in the identified studies and receive a compliance rating for the standard when this is accomplished.

The CoC standards address the full continuum of high-quality cancer care, support the needs of patients with cancer, and increase the focus on improving the quality of the care provided. 

This article concludes the series highlighting the requirements of the 2012 standards. For additional information on the standards, please visit the CoC Online Education Portal and view the webinar series on the 2012 standards.

New Cancer Liaison Manager Arrives August 6

Please welcome back Nina Miller, OSW-C, who will return as manager of Cancer Liaison Initiatives (previously called the Cancer Liaison Program) on August 6.

Nina is a graduate of the University of Wisconsin (UW) School of Social Work, in Madison. Her clinical practice as an oncology social worker included years of practice in a variety of settings including acute care, outpatient care, long-term care, home health care, and hospice. She was a fellow in the Office of Cancer Communications at the National Cancer Institute (NCI) in 1994 and subsequently managed NCI’s Cancer Information Service in their regional office at the UW Comprehensive Cancer Center. At the American Cancer Society, Nina managed the Patient Navigation program for the Midwest Division and served on several national work groups. She managed the Cancer Liaison Program for two years and looks forward to her return to the CoC.

Cancer Liaison Physicians Breakfast Meeting - October 1, 2012

Mark your calendars for the Cancer Liaison Physician Breakfast Meeting, which will take place on Monday, October 1, 6:30-8:00 am, at the Hyatt Regency McCormick Place in Chicago, IL. This year’s breakfast meeting will focus on Standards 4.4 and 4.5 that require compliance with CoC accountability and quality improvement measures. Topics  will include the following:

  • How the CoC determines accountability vs. QI measures
  • How you can develop a process for addressing these standards
  • New QI and accountability measures currently being developed

In addition, speakers will tell liaisons how to use National Cancer Data Base data to determine whether their programs are in compliance with Standards 4.4 and 4.5, and how to delve into the data to improve compliance rates. The Rapid Quality Reporting System (RQRS) will be demonstrated, and liaisons will learn how RQRS can help maintain compliance with quality standards. The breakfast meeting will be podcast for those who are unable to attend the meeting. The podcast will be available on the CoC website on the day after the meeting.

NCDB Edit Metafile Announcements

Most programs have upgraded or will soon upgrade their registry software to version 12.2, the version that incorporates Collaborative Stage (CS) version 02.04. That change involves some edit modifications due to the new coding instructions for some CS items, and it also involves some updates for other items. This article describes one change that the National Cancer Date Base (NCDB) has received questions about and two edits that affected NCDB submissions earlier this year.

The first change was made to the updated edits after the posting of errata for the AJCC Cancer Staging Manual, 7th Edition ( There were some changes in the list of stageable histologies in the “Ovary and Primary Peritoneal Carcinoma” chapter (37). As a result, the following question was posed to the NCDB, and it is broad enough to apply to other situations: How do you stage a case if you have no staging information at all, such as a case that had previously been considered not stageable? The NCDB advises that when a case record has no information to code clinical or pathologic T, N, or M, those items should be left blank. If Clinical Stage Group cannot be staged for a stageable case, it should be coded 99. If your program is not recording the pathologic staging items, these may be left blank; otherwise, an unknown Pathologic Stage Group is coded 99. If a case is being changed from stageable to not stageable, or from not stageable to stageable, remember to change the TNM Edition and Staged-By items appropriately. See the instructions in FORDS: Revised for 2012 for coding instructions for all of these items (

The April CoC Flash announced problems with two edits in the NCDB Call for Data edit metafile for version 12.1 prior to the most recent update (see The 32 registries that failed the staging edits for lacrimal gland primaries have been contacted individually and will resubmit those cases in August with no repercussions for their CoC Survey Ratings.

The NCDB has posted a corrected 12.1 metafile that removes these problems for further submissions of data to the Rapid Quality Reporting System (RQRS), or to NCDB data by new programs or programs submitting to resolve data deficiencies, during the remainder of 2012. The corrected 12.1 metafile is available for download at This corrected metafile applies ONLY to cases submitted using layout 12.1, or prior to the 2012 upgrades to their hospital registry software. Programs that have already upgraded to layout 12.2 should not use this metafile.

Update to FORDS: Revised for 2012 Posted

A new posting of FORDS: Revised for 2012 corrects some errors in coding instructions that were recently reported and that may affect registry coding.

  • The previous versions of FORDS: Revised for 2012 had an error in the codes for Type of Multiple Tumors that can best be described as a “Microsoft Word typo.” Codes 20 and 30 were inadvertently changed to 13 and 14 when the content of a SEER Multiple Primaries and Histology pdf file was converted to Word to make the modifications needed to put the item into FORDS. Word apparently noted the three preceding values were 10, 11, and 12 and modified the next two values to follow that sequence. Registries are advised to check whether any values 13 or 14 are recorded in their data for this item and to correct those codes to 20 and 30, respectively, if any are found.
  • Unknown primary (C80.9) was added to the list of types of cancers for which the Multiplicity Counter is to be coded 88. If any unknown primary sites in your registry have a value other than 88 entered for Multiplicity Counter, those should be changed to 88.
  • The second Class of Case example was incorrectly displayed as code 00; it should be 13 and has been corrected.

A small number of other changes also were made, but they do not have a direct effect on coding. To identify all changes in the updated volume, search for pages dated “06/12” or search Appendix C for “06/29/2012.” The updated FORDS: Revised for 2012 is available now at

Focus Under Forty at ASCO University

The Commission on Cancer is one of six educational partners for the Focus Under Forty series at ASCO University, an initiative that helps providers address the unique needs of cancer patients between the ages of 15 and 39. The series, which includes 11 FREE e-Learning courses, explores best practices for addressing challenges associated with this patient population. All courses are CME-accredited and include interactive patient case scenarios. 

Recommended Courses Include:


AJCC Cancer Staging Atlas, 2nd Edition Available for Pre-Order

Significantly expanded, expertly and beautifully illustrated, the AJCC Cancer Staging Atlas, 2nd Edition, offers more than 600 illustrations created exclusively for this new edition and is fully updated to reflect the concepts discussed in the 7th editions of both the AJCC Cancer Staging Manual and its companion Handbook. The Atlas illustrates the TNM classifications of all cancer sites and types included in the 7th edition of the Staging Manual and visually conceptualizes the TNM classifications and stage groupings.

Specifically designed for simplicity and precision, the drawings have been verified through multidisciplinary review to ensure accuracy and relevancy for clinical use. Every illustration provides detailed anatomical depictions to clarify critical structures and to allow the reader to instantly visualize the progressive extent of malignant disease. In addition, nodal maps are included for each site, appropriate labeling has been incorporated to identify significant anatomic structures, and each illustration is accompanied by an explanatory legend.

  • The AJCC Staging Atlas comes with a CD containing all images
  • Users can also import figures into presentations for cancer conferences, grand rounds, presentations, and journal articles/book chapters
  • Based on the 7th edition staging system

The AJCC Cancer Staging Atlas, 2nd Edition, is an official publication of the American Joint Committee on Cancer, the recognized international leader in state-of-the-art information on cancer staging. The Atlas has been created as a companion to the updated 7th edition of the AJCC Cancer Staging Manual, which continues to disseminate the importance of anatomical and pathological staging in the management of cancer. This state-of-the-art, invaluable 2nd edition includes a CD containing PowerPoint slides of all illustrations, additional color, and a user-friendly, easy-to-read layout. The AJCC Cancer Staging Atlas, 2nd Edition will serve as an indispensable reference for clinicians, registrars, students, trainees, and patients. Order your copy today at or directly from the publisher at

Collaborative Stage Improvement Suggestion Site

The Collaborative Stage (CS) workgroups announce the availability of a website for the collection of feedback, comments, and suggestions related to the Collaborative Stage Data Collection System.

The comments and suggestions for improvement submitted through this website will be reviewed by the CS workgroups, including the Governance Committee, Mapping Team, Informatics Team, and Educations and Training Team, as appropriate. The information received will be considered by these teams as future versions of CS are designed, developed, and deployed. Also, feedback on these suggestions will be provided to the CS community as appropriate via future NAACCR and CoC communications.

The CS Improvement Suggestion Site can be accessed through the NAACCR website and is open to the public. All submissions will be recorded anonymously. You can access the site via the NAACCR home page or through this link:

This website is not intended as a mechanism for users to submit questions related to the use and coding of CS. All medical, abstracting, coding, and staging questions should continue to be submitted to the CAnswer Forum at

Questions submitted to the CAnswer Forum are reviewed and answered by the CS Technical Advisory Panels in consultation with CS schema mappers.


Lead Your Breast Program to Excellence Conference
Learn from those who developed the standards.

The National Accreditation Program for Breast Centers (NAPBC®), in conjunction with the National Consortium of Breast Centers (NCBC) will host a dynamic two-day conference where nationally recognized leaders will discuss critical success factors for comprehensive breast centers.

When: Friday and Saturday, November 16–17, 2012

Where: Renaissance Chicago O’Hare Suites, Chicago, IL

What: Learn how others “built” their multidisciplinary breast centers from the ground up using nationally recognized programs. This two-day conference will include authorities discussing:

  • National Quality Programs: The What, Why, and How of NAPBC, NQMBC, and BICOE
  • Developing a High-Quality Breast Program
  • Critical Success Factors for Developing Certification/Accreditation-Worthy Breast Programs
  • Benefits and Cost-Effectiveness of Breast Center Programs
  • Defining Benchmarks for Breast Centers of Excellence
  • Breast Diagnostic, Treatment, and Management Quality Metrics
  • Aggressive Screening Programs, Patient Navigation, Genetic Risk Assessment and Counseling, Survivorship, and Advocacy

Who: The ideal audience for this conference includes:

  • Hospital CEOs and COOs
  • Service Line Administrators
  • Breast Program Leaders (BPLs) and Other Physicians Involved with Breast Centers
  • Radiologists and Technologists Involved with Breast Centers
  • Nurse Navigators, Quality Managers
  • Breast Imaging Supervisors
  • Genetic Counselors
  • Social Workers

The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American College of Surgeons designates this live activity for a maximum of 16 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CE hours pending approval from NCRA.

Seating for this conference will be limited and because of the comprehensive nature of the agenda will sell out quickly.

Learn more about the conference and REGISTER TODAY by visiting

NAPBC Call for Data Placed on HOLD

The NAPBC recently initiated an annual Call for Data, which consists of mandatory reporting for six breast-specific performance measures. The Call for Data is scheduled through September 30, 2012. Preliminary reports from several centers indicate that this exercise is difficult, time-consuming, and duplicative for those centers affiliated with Commission on Cancer-accredited facilities that submit data to the National Cancer Data Base.

NAPBC leadership recently met and has agreed to re-review, and possibly redesign, the performance measure reporting process. The overall objective of this initiative and related process for data collection will be discussed at a meeting later this month with the objective of streamlining the process for Commission on Cancer-accredited facilities, which include 93 percent of all NAPBC accredited centers.

The NAPBC leadership is advising that you discontinue completion of the performance measure tables in the Survey Application Record until further notice. Additional information regarding this initiative will be sent to you in the near future.

The NAPBC appreciates the time and effort you have given to this initiative thus far and apologizes for the inconvenience.

NAPBC Exhibit Schedule

The NAPBC is scheduled to exhibit at the following national meetings:

ASCO Breast
September 13–15
San Francisco, CA

American College of Surgeons Clinical Congress
September 30–October 4
Chicago, IL

Lynn Sage Breast Cancer Symposium
October 4–7
Chicago, IL

Stop by the exhibit hall at any one of these meetings and pick up an NAPBC Information Kit or additional information about the program.

ACS Clinical Research Program News

ACS Clinical Researchers Propose Manual of Surgical Standards

The American College of Surgeons Clinical Research Program (ACS CRP) has proposed the development of a manual to detail surgical standards, including surgical checklists. This project is particularly timely as many if not all of the essential elements have been developed in the context of either clinical trials or as part of Commission on Cancer (CoC) accreditation standards. Some CoC standards such as the 12 lymph node count for colon cancer have become national quality metrics. There have been substantial efforts to standardize surgical procedures and establish measurable metrics for cancers covered by the National Cancer Institute’s Cooperative Groups and the ACS Commission on Cancer.  The ACS CRP Cancer Care Standards Development (CCSD) Committee will collate available surgical standards to launch the first edition of a surgical standards manual.  

Ideally, the new manual will resemble previously published surgical standards projects with checklists and summary recommendations, assessing the level of evidence in support of recommended standards, and suggesting areas in need of research. The scope of the manual will be restricted to the intra-operative experience; that is, from skin incision to skin closure. The manual will likely cover surgical procedures for only the most common solid malignancies.

If you or a colleague wants to participate in developing the manual, please contact Kelly Hunt, MD, FACS, Chair of the CCSD Committee, at, or  The first public town hall on the surgical standards project will take place during the ACS 2012 Clinical Congress, on October 3.   


American Cancer Society Cancer Action Network (ACS CAN)

Crucial Legislation Would Improve Patients’ Quality of Life: Ad Campaign Will Emphasize Importance of Improving Patient Access to Growing Field of Palliative Care

WASHINGTON, DC – July 20, 2012 – Two bills introduced yesterday in the U.S. Congress aim to reduce suffering and improve the quality of life of patients undergoing care for serious illnesses such as cancer.

Sen. Ron Wyden (D-Ore.) and Rep. Eliot Engel (D-N.Y.) have introduced the “Palliative Care and Hospice Education and Training Act” (S.3407 and H.R. 6155), which addresses the deficit in palliative care training offered in the nation’s medical schools by creating new incentives for the training and development of interdisciplinary health professionals in palliative care. The bill would create up to 24 Palliative Care Education Centers at medical schools across the country to expand interdisciplinary training, as well as establish fellowships that would provide faculty in medical schools and other health profession schools short-term intensive courses focused on palliative care.

Rep. Emanuel Cleaver (D-Mo.) and Rep. Spencer Bachus (R-Ala.) have introduced the “Patient Centered Quality of Life Act” (H.R. 6157), which puts in place the building blocks of a national effort to improve the fragmented care that people with cancer and other serious diseases often receive by drawing more national attention to palliative care. The bill would require the director of the National Institutes of Health to expand and intensify research on palliative care and expands on the Wyden-Engel legislation by supporting palliative care training for nurses, nurse practitioners, and other allied health professionals.

ACS CAN has launched a major advertising campaign in Capitol Hill publications that aims to educate lawmakers and their staff about the importance of palliative care. The ad, which will run in print and online, features a woman in ballet shoes above the word “cancer,” which has been changed to read “dancer.” The ad emphasizes that palliative care restores patients’ quality of life by treating them as well as their disease.

ACS CAN, the not-for-profit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit

American Cancer Society Book Promotion - CoC Discount

American Cancer Society Book Promotion
With more than 66 books and e-books on treatment, cooking and nutrition, caregiving, coping, side effects, survivorship, and prevention, the American Cancer Society’s online bookstore is “The World’s Largest Library of Books on Cancer.” The Society’s e-books are available for use on the Kindle, Nook, Sony Reader, and iPad, as well as on all smart phones and other reading devices. Review the offerings at or download a flyer from the news page on the CoC website at

CoC Discount: ACS Bookstore
Patients, caregivers, staff, and providers at CoC-accredited cancer programs can enter code HP014F09 at checkout to receive a 40 percent discount on all Society books and e-books. CoC member organizations are also welcome to take advantage of the discount offer.

For institutional/bulk purchases, please direct inquiries on quantity discounts to

American College of Radiology Releases Appropriateness Criteria Updates

The American College of Radiology (ACR) has released the newest version of the ACR Appropriateness Criteria® (ACR AC). This latest release includes 39 updated topics and five new topics from various expert panels. There are now 180 topics with more than 850 variants.

The ACR AC are evidence-based guidelines to assist referring physicians and other health care providers in making the most appropriate imaging or treatment decision for a specified medical condition. They are developed by expert panels in diagnostic imaging, interventional radiology, and radiation oncology. More than 80 physicians from specialties outside of radiology/radiation oncology participate in the development and review of the topics.

Individuals within your organization or facility will benefit from the latest, most evidence-based radiology guidance available. The updated ACR AC can be accessed free of charge for individual users on the ACR website at


NCRA Presents a New Fall Webinar by Carol Hahn Johnson, CTR
Guidelines to Using the 2012 Hematopoietic Coding Manual
Wednesday, October 10, 2012

In this webinar, participants will review the previous hematopoietic and lymphoid neoplasm MP and PH rules and introduce registrars to the new ones. Learn how and when to use the hematopoietic and lymphoid neoplasm multiple primary, primary, site and histology, and grade rules by learning how to use the manual efficiently and be better equipped to facilitate accurate abstracting of hematopoietic and lymphoid neoplasms.

This one-hour webinar is $50 for members/$75 nonmembers and will offer 1 CE. For more information and to register, go to

NCRA Announces a Four-Part Webinar Series on Strategic Abstracting
This new webinar series on strategic abstracting is designed to assist registrars with providing better information for cancer control. The series will view the abstract through a wider lens and introduce the idea that all data in the abstract is connected and interdependent. Participants will come to appreciate how a strategic view of the data improves quality and better supports meaningful analysis.

Wednesday, September 26, 2012
General Coding and Data Relationships will address the complex relationships among editing, coding rules, site-specific coding, and clinical work-ups in the abstracting process.

Wednesday, October 24, 2012
Strategic Abstracting: Genitourinary Sites

Wednesday, November 14, 2012
Strategic Abstracting: Skin and Melanoma

Wednesday, January 9, 2013
Strategic Abstracting: Breast

Each webinar is $50 for members/$75 nonmembers and will offer 1 CE. For more information and to register, go to

Monthly Spotlight: American Hospital Association

The Commission on Cancer regularly collaborates with over 50 member organizations in its mission to provide quality cancer care. This month we introduce the American Hospital Association (AHA).   

The AHA is the national organization that represents and serves all types of U.S. hospitals, health care networks, and their patients and communities. Close to 5,000 hospitals, health care systems, networks, other providers of care, and 42,000 individual members constitute the AHA.  Through our representation and advocacy activities, AHA ensures that members' perspectives and needs are heard and addressed in national health policy development, legislative and regulatory debates, and judicial matters. Our advocacy efforts include the legislative and executive branches and include the legislative and regulatory arenas.  Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. 

Vision: The AHA vision is of a society of healthy communities, where all individuals reach their highest potential for health.

Mission: To advance the health of individuals and communities. The AHA leads, represents, and serves hospitals, health systems and other related organizations that are accountable to the community and committed to health improvement.

For more information on this organization, please visit the AHA website at

Monthly Spotlight: Academy of Nutrition and Dietetics

The Commission on Cancer regularly collaborates with over 50 member organizations in its mission to provide quality cancer care. This month we introduce the Academy of Nutrition and Dietetics (AND or the Academy).     

The Academy is the world's largest organization of food and nutrition professionals. The Academy is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy.  Approximately 72 percent of the Academy's nearly 74,000 members are registered dietitians (RDs) and 2 percent are dietetic technicians, registered (DTRs). Other Academy members include students, educators, researchers and international members. Nearly half of all the Academy's members hold advanced academic degrees.

Academy members represent a wide range of practice areas and interests. Affiliate, dietetics practice, and member interest groups share the common purpose of serving the profession, the public, and members in such areas as continuing professional education, public information on nutrition and health, government advocacy and relations, membership recruitment, Academy leadership, and public relations. These membership groups reflect the many characteristics of the Academy's membership and the public it serves.

The Oncology Nutrition Dietetic Practice Group (ON DPG,, a dietetic practice group of the Academy, promotes quality oncology nutrition practice in cancer treatment, prevention, survivorship and education.  The ON DPG is a technical resource for its nearly 2000 dietetics professional members and students, and for allied organizations such as the American Cancer Society, the Oncology Nursing Society, the National Cancer Institute and the Commission on Cancer.  

Event Information:
Food & Nutrition Conference & Expo—Philadelphia, PA October 6-9, 2012                                               

Recent Publications and/or Products:
Oncology nutrition quality practice initiatives of the Academy and ON DPG include the
Evidence Analysis Library: Oncology Nutrition (
Oncology Evidence-Based Nutrition Practice Guideline (
The Revised Standards of Practice and Standards of Professional Performance for Registered Dietitians in Oncology Nutrition (
Board Certification in Oncology Nutrition
(  through the Commission on Dietetic Registration.  The Board Certification in Oncology Nutrition credential (Certified Specialist in Oncology Nutrition, CSO) provides potential employers, oncology patients and caregivers with a tool to evaluate the expertise of the dietetics professional providing oncology nutrition services. Currently 546 registered dietitians in the US and Canada have successfully become Board Certified in Oncology Nutrition.    

For more information on this organization, please contact:
Kathryn K Hamilton, MA RD CSO CDN, 120 South Riverside Plaza, Suite 2000, Chicago, IL
Email: | Web Address:

Association of Oncology Social Work Releases Updated Standards of Practice

The Association of Oncology Social Work announces the release of its updated Standards of Practice in Oncology Social Work. Oncology social work is the primary professional discipline that provides psychosocial services to patients, families,and significant others facing the impact of cancer.

Psychosocial services provided by oncology social workers include individual, family, and group counseling; education; advocacy; discharge planning; case management; patient navigation; and program development.

Oncology social work services are available to patients and their families throughout the continuum of care.

There are five standards: Qualifications, Service to Patients and Families, Services to Institutions and Agencies, Service to Community, and Services to the Profession.

These Standards underscore the values and skill set of oncology social workers whose work reflects a focus on enhancing patient-centered care.

American College of Oncology Administrators Update

The American College of Oncology Administrators (ACOA) is a specialty group within the Academy of Medical Administrators (AAMA), a multidisciplinary health care network representing multiple specialties, all levels of health care administration and the federal, public, and private sectors.  ACOA’s mission is to promote growth and development opportunities for oncology managers and administrators. Its primary focus is to provide education, resources, and networking opportunities to its members.

Over the past year ACOA has worked to cultivate partnerships with various professional organizations in addition to the Commission on Cancer, in particular the Oncology Nursing Society.  For this year’s ACOA Oncology Update, ACOA partnered with ONS to conduct a preworkshop titled “Choosing Quality Metrics for Your Oncology Program: Metrics Demystified!”  

The American College of Surgeons hosted ACOA’s 2012 Oncology Update conference, June 20-22.  This year’s annual conference, titled “Compassion and Numbers,” was designed to address the challenges facing oncology health care administrators.  Sessions included a panel discussion on the 2012 Commission on Cancer standards, Quality Oncology Practice Initiative (QOPI) certification, a SG2 update, consulting and partnership relationships, health care reform, and drug shortages.

AAMA will present the 2013 conference, April 10-12, in Las Vegas, in conjunction with the annual conferences of its cardiovascular and neuroscience Colleges.

ACOA activities for the upcoming months include the formation of a Quality Work Group to address performance improvement and quality metrics.  More information about the American College of Oncology Administrators is available at                            

Executive Training on Navigation and Survivorship: Finding Your Patient Focus

Precourse Webinar
September 10, 2012

Executive Training
September 27-28, 2012

Embassy Suites ● Washington, DC

The George Washington University Cancer Institute will host a two-day training program that will equip health care professionals with the necessary tools to launch and sustain navigation and survivorship programs, two cornerstones of patient-centered care. Participants will learn strategic planning techniques for developing, implementing, evaluating, and sustaining patient navigation and survivorship programs. The training combines distance-learning and traditional classroom instruction to maximize participants' time. Before the in-person training, participants engage in an online webinar discussion that lays the foundation for the two-day skill development training. At the conclusion of raining, participants should have a cohesive plan for a survivorship and for a patient navigation program that will enhance the patient focus of their organization. The program is ideal for clinicians, administrators, program managers, and staff of institutions that provide care to cancer patients and survivors and those who are considering or in the process of establishing navigation and/or survivorship programs. Register online today to secure a spot! For questions and additional information, please contact Elisabeth Reed,, or 202-994-4088. More information on caSNP programs can be found by visiting