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Connecticut Registry Update

Connecticut Registry Update. This work was supported by Contract HHSN26120000024C between the National Cancer Institute and the Connecticut Department of Public Health. CSv02.04. Effective for all cases diagnosed January 1, 2012 and forward Code changes significantly fewer than v02.03

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Connecticut Registry Update

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  1. Connecticut Registry Update This work was supported by Contract HHSN26120000024C between the National Cancer Institute and the Connecticut Department of Public Health

  2. CSv02.04 • Effective for all cases diagnosed January 1, 2012 and forward • Code changes significantly fewer than v02.03 • 111 new codes within 22 schemas • 25 obsolete codes within 15 schemas • Six “notable” schema-specific changes • Corrections made to derived AJCC and SS values returned by algorithm • 20 NEW CS over-ride fields now available • Over-ride CS 20 is for manually coded SS77 or SS2000 and is applicable only to registries within an NPCR reporting area • This over-ride should not be used in SEER regions

  3. CSv02.04 • Notable Changes: • Lung: subheadings of extra tables reformatted to display more clearly • Melanoma of Skin; Merkle cell of Penis, scrotum, skin, vulva: information collected for SSF3 (clinical status of LN) and AJCC staging tables modified to distinguish cN and pN values; secondary nodal basins defined as regional nodes • Breast: Codes expanded for SSF 19 (assessment of positive axillary LN) to include more combinations • Corpus: histology codes 8950 and 8951 re-assigned from sarcoma to carcinoma • Prostate: upper limits for cores examined and positive extended to 100

  4. CSv02.04 • Notable Changes: • Thyroid: s and m descriptors added to T values for AJCC 7 • Obsolete Codes: • “Obsolete data converted v0204” should not be available for use after conversion: code generates an error for AJCC 6, 7 and SS77 and 2000 mappings. • Old Cases: as in prior conversions, cases do not need recoding unless they are edited, fail edits or are returned for review • Documentation: NAACCR Volume II, v12.2; CS Part 1, section 1 and Part 1, section 2 revised • Edits: NAACCR v12.2 metafile (or SEER*Edits) • Resubmission: 2012 cases coded prior to conversion only

  5. SEER Updates • Potential for collapsing CS schemes • CS Governing Group, AJCC Working Group • Review thus far Includes: • Breast, colon • May incorporate work of the SEER public data release workgroup • Review of: • Breast, colon, rectum, lung, prostate • Many current fields contain too many “unknown” values to be reliable or of use to researchers/clinicians • Example: Breast SSFs 8-14 (individual Her-2 tests) • Range of 0% to 76% known • But…92% of SSF 15 values are known (composite result)

  6. SEER Updates

  7. SEER Updates

  8. SEER Updates • CS is broken!!! • SEER is looking for input from the field • Hospital registrars especially encouraged to participate • First site to be reviewed is breast • Proposed CS simplification rules distributed today • Please provide feedback to me; I will consolidate and send to SEER as an “all Connecticut” response

  9. SEER Updates • Next CS: CSv02.05 • To be released mid-2013 • Applies to cases diagnosed 1/1/2014 forward • Minor changes, primarily clarifications • Little or no review/re-code anticipated • SEER Manual 2013 revision: Appendix B only • Release December/January • Next major manual revision for 2014 • New ICD-O codes • Review by manual working group, user feedback • Release December, 2013

  10. SEER Updates • AJCC 8th Edition (not SEER!) • AJCC Working Groups, CS Governance Group • SMEs working on all site groups at present • Registrars included for input as well as review • All standard setters included in process • May be released in a different format • Tentative release date: Mid 2015 • Apply to cases diagnosed January, 2016 forward

  11. SEER Updates • Benign and malignant brain coding • Beta testing scheduled for early 2013 • Delays from ICD-O workgroup • Review of solid tumor database • Procedures and terms that may cause confusion, issues • Kidney, lung, melanoma rules completed • Breast and other sites pending • MPH Manual revision • Review of histology priorities • New combination codes • MP sites being updated • Manual release in text version only

  12. SEER Updates • Hematopoietic Database • No rule changes! • Alternate terms confirmed and updated • Instructions to be moved • Rules to clarify site based on BM biopsy • New wording for rules related to distant lymph nodes, organs • 2013 distribution for review • 160 diseases to review; each registry will have a max of ten • Abstractor note review group welcomes input from the field • Scheduled implementation 2014

  13. SEER Updates • Upcoming Reliability Studies: • Benign and Malignant Brain • Early planning phases for sentinel lymph node biopsy • Issues with miscoding SN and SN+axillary dissection • CTR data appear consistent with practice: • 55% SN or SN+axillary; 18% axillary dissection • NCI-SEER plans to open the studies to all CTRs

  14. SEER Updates • Reliability Studies • 2011 results completed • Results will be distributed to SEER registries • Comparison with SEER overall • Will include hospital results • Will be used for training, quality improvement • SEER and state-wide

  15. CTR Initiatives and Projects • Monthly follow-up reports • Expected to be available ~ 10th of each month • Includes: DMV license and registration, Vital Records, Misc. updates • Annual Incidence Reports • Overall incidence state-wide and county level • Five top sites state-wide and county level • Bladder • Breast • Colorectal • Lung • Prostate

  16. CTR Annual Incidence Reports 2010

  17. CTR Annual Incidence Reports 2010

  18. CTR Initiatives and Projects • Annual Report • Target Audience: Clinicians, Registrars, Researchers, Public Health Professionals • Format: Narrative, tables, graphs • Focus Areas: Annual incidence, county incidence, site-specific focus area • Target Release Date: Late January, 2013 • Other suggestions, wishes?

  19. CTR Initiatives and Projects • Death Clearance: • Plan to send lists/requests to hospitals in early December • Allow a longer response timeframe • Other suggestions? • Patterns of Care Study: • Participation required by NCI-SEER • Inquiry permissible per CGS §19a-74 • Questionnaire distribution ~ March, 2013 • Limit responses to highlighted questions

  20. CTR Initiatives and Projects • Connecticut Tumor Registry-Hospital Partnership • CTR and hospital representatives • Meet ~ twice annually • Discuss mutual goals, resources, needs • Provide and opportunity for cooperative quality improvement • Improve customer service • Provide more meaningful data, resources, and tools • Improve compliance with state and federal mandates • Decrease data availability timeframes • Other opportunities (?) • Volunteers sought from a variety of hospital sizes and geographic locations

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