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January 2015 Update

Due Dates for MCSP Submission of Data~

Please note the submission of data reminders for 2015 listed below!

All reportable conditions diagnosed in 2014 are due to the MCSP by July 1, 2015.

Any missed reports for reportable conditions for diagnosis years prior to 2014 must be submitted

to the MCSP by March 31, 2015.

Don’t forget! Facilities submitting cases electronically are required to submit in the most recent version

of the data exchange format and code structure as specified by NAACCR. For diagnosis year 2014, the

NAACCR format version is 14.0.

The MCSP strongly encourages monthly submission of data. For example, cases abstracted in January

should be submitted to the MCSP in February.

For information on Labeling of Electronic Submission Files and/or Submission of Data, please refer to the

MCSP Cancer Program Manual at http://michigan.gov/mdch/0,1607,7-132-2945_5221-16586--,00.html.

Facilities non-compliant with the Michigan cancer reporting requirements will be addressed and

corrective action taken if necessary.

NOTE: If your registry is in the SEER area (Wayne, Oakland or Macomb County) and you have

questions regarding submission of data, please contact your SEER-State Coordinator, Jeanne Whitlock at

313.578.4219 or whitlock@med.wayne.edu.

Transition to Directly Coded TNM Stage~

The transition from Collaborative Staging to AJCC TNM staging standard begins with 2016 incidence

data. This includes continued collection of information regarding related biomarkers and prognostic

factors. As a reminder, the initial change in 2016 for CDC and NCI registries is focused on the transition

to directly assigned TNM stage; however, it will NOT eliminate all CS variables. In particular, most site-

specific factors will continue to be required as they are either considered a critical component to

assignment of stage, or essential to understanding the cancer (predictive or prognostic factors).

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Directly Coded TNM Stage & SEER Summary Stage~

Directly coded TNM Stage and SEER Summary Stage is required by the Michigan Cancer Surveillance

Program beginning with cases diagnosed January 1, 2015 and forward, for Hospitals with a Registry

and Hospitals without a Registry. Please note that this is a change in reporting requirements for a

hospital categorized by the MCSP as a Hospital without a Registry. The MCSP Cancer Program Manual

and the MCSP Reporting Requirements by Item and Facility Type document will be revised to reflect the

changes in reporting requirements and the revised documents will be posted on the MCSP website at

http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html on Friday, February 13th

.

Directly coded TNM and SEER Summary Stage means that information recorded for TNM Stage and

SEER Summary Stage will not be recorded from the derived Collaborative Stage, but rather will be based

upon information available in the patient’s medical record. For example, Summary Staging uses all

information available in the medical record; in other words, it is a combination of the most precise clinical

and pathological documentation of the extent of disease.

To obtain the current edition of the AJCC Cancer Staging Manual or the AJCC Cancer Staging

Handbook, go to https://cancerstaging.org/references-tools/deskreferences/Pages/default.aspx. For a copy

of the SEER Summary Staging Manual 2000, go to http://seer.cancer.gov/tools/ssm/.

Facility Oncology Registry Data Standards (FORDS): Revised for 2015~

The Facility Oncology Registry Data Standards (FORDS) manual has been revised for 2015. Please note

that this version of FORDS replaces ALL previous versions. As changes in coding rules and coding

categories were incorporated in the revision of FORDS for 2015, registrars should read the Preface and

review Appendix C for an overview of the 2015 changes.

Some of the changes in changes in coding rules and coding categories in FORDS revised for 2015 are

listed below. For a complete list, please refer to FORDS revised for 2015 at

https://www.facs.org/quality-programs/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual

Required Staging: BOTH Clinical and pathologic AJCC T, N, M and Stage Group, as well as,

Collaborative Staging is required for Class of Case codes 10-22.

Rules for Coding Grade/Differentiation: New rules for coding Grade/Differentiation were

implemented by all U.S. cancer registry standard setters beginning with cases diagnosed in 2014,

with the new rules now available in FORDS revised for 2015.

New Sex Codes: New codes 5 (Transsexual, natal male) and 6 (Transsexual, natal female) were

introduced for use in 2015, and may be used for historic cases if desired. Code 4 (formerly

“Transsexual”) is now “Transsexual, NOS.”

New Code for RX Data-Other Flag: Code 15 was added to be used when treatment coded as

Other Therapy was planned, but had not been administered at the last time of follow-up. Code 15

may be assigned for cases diagnosed prior to 2015, if applicable.

Discontinued Items:

o Grade Path System and Grade Path Value are required for cases 2010 through 2013, but

are discontinued under the Grade/Differentiation coding rules.

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o The ICD Revision Secondary Diagnosis is no longer required for any diagnosis year as the

separate fields for ICD-9-CM and ICD-10-CM eliminated the need for this data item.

NOTE: All items in FORDS are required for CoC-accredited cancer programs. The MCSP Cancer

Program Manual and the MCSP Reporting Requirements by Item and Type document will be updated to

reflect the changes in coding rules and coding categories and revised copies will be posted on the MCSP

webpage at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html on Friday, February 13.

AJCC Curriculum for Registrars~

The American Joint Commission on Cancer (AJCC) will be releasing curriculum for registrars in 2015,

with Module 1 of the AJCC Curriculum for Registrars now posted. The curriculum is designed to provide

education in a step-wise learning environment complete with additional resources to reinforce the

information and webinars with interactive quizzes to prompt discussion and also serve as a self-

assessment of the information learned. The modules are free to anyone and can be accessed at

https://cancerstaging.org/CSE/Registrar/Pages/AJCC-Curriculum.aspx.

An outline of module 1 is listed below.

Module 1 Introduction

Overview of staging

High level explanation of why and how

For staff that does not assign stage (many central registry staff, statisticians, researchers)

o Basic principle of stage

o Understand terminology use

o Only lesson they will need

For staff assigning stage

o Foundation of why AJCC staging is different from CS and summary stage

o How it is used

NOTE: The MCSP strongly encourages registrars to review the AJCC Curriculum for Registrar Modules

to ensure accurate coding of the new reporting requirements for directly coded AJCC TNM Stage.

ICD-O-3 Changes Effective January 2015~

A list of the ICD-O-3 changes effective January 2015, is included in the MCSP Cancer Program Manual.

Use the new terms, synonyms, and related terms for existing ICD-O-3 codes. Please note that revision of

the 2016 Multiple Primary and Histology Coding Manual will be available in 2016. To ensure accurate

coding of histology codes, please refer to the MCSP Cancer Program Manual and the MP/H manual. The

MP/H Manual is available at http://seer.cancer.gov/tools/mphrules/. For non-solid tumors (Hematopoietic

and Lymphoid Neoplasms), refer to the 2015 Hematopoietic and Lymphoid Neoplasm Database and

Coding Manual at http://seer.cancer.gov/tools/heme/.

Hematopoietic & Lymphoid Neoplasm & Coding Manual – Updated January 14, 2015~

The Hematopoietic and Lymphoid Neoplasm and Coding Manual was updated on January 14, 2015. This

manual and the corresponding database is to be used for coding cases diagnosed January 1, 2010 and

forward. Please note that the changes do NOT require registrars to recode old cases.

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A revision history for the Hematopoietic Project has been posted. The list provides a brief summary of

the major changes in the revised Hematopoietic and Lymphoid Neoplasm Coding Manual and Database

that was released in 2015. To access the 2015 Hematopoietic and Lymphoid Neoplasm Database and

Coding Manual, along with the revision history, go to http://seer.cancer.gov/tools/heme/

The list below contains the categories of the major changes in the revised Hematopoietic and Lymphoid

Neoplasm Database and Coding Manual released in January 2015.

Diagnostic Confirmation

M Instructions and Rules

PH Instructions and Rules

o Primary Site Coding Instructions

o Histology Coding Instructions

Appendix F: Non-Reportable terms

Glossary

NOTE: It is important that registrars review the revision history to ensure accurate and complete coding

of Hematopoietic and Lymphoid Neoplasms.

Hematopoietic Conversions for 2015~

FYI - A conversion program has been written to convert some of the Hematopoietic data as part of the

Hematopoietic and Lymphoid project update for 2015. Two documents have been posted on the SEER

website that outlines the specifics and rationale for these conversions. Links for both documents are

available on the Hematopoietic Project webpage at http://seer.cancer.gov/tools/heme/.

SEER*RX – Interactive Antineoplastic Drugs Database – New Releases in 2014~

New releases for software and the web version and data were posted in 2014. Software was released in

October 2014 and Web Version and Data in September 2014. SEER now has the ability to update the

web-based SEER*RX tool in real-time and have added a similar feature to the software. How the

software works – each time the user’s computer has an internet connection, it will automatically check to

see if there is a new SEER*RX data, and if there is new data, it will download it. For those who use the

software, you will now have access to published data without having to download a new version of

SEER*RX.

As SEER*RX was developed as a one-step lookup for coding oncology drug and regimen treatment

categories in cancer registries, it is important that registrars use the SEER*RX database for assistance in

proper coding of oncology drug and treatment regimens.

For more information and/or to access the SEER*RX – Interactive Antineoplastic Drugs Database, go to

http://seer.cancer.gov/tools/seerrx/

Version 15: NAACCR Standards Volume II, Data Standards& Data Dictionary~

The NAACCR Standards Volume II, Data Standards and Data Dictionary, Version 15, effective with

cases diagnosed on or after January 1, 2015 is available on the NAACCR website at

http://www.naaccr.org/StandardsandRegistryOperations/VolumeII.aspx#.

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Effective with Version 15, there are 7 new survival-related data items, additional codes for four data

items, and conversions for country code values and for glucagonomas. Version 15 includes multiple

conversions of site, histology, and a few Collaborative Stage data items (necessitating re-derivation) for

some hematopoietic malignancies, whose histology code conversions will be retroactive to 2010

diagnoses. There are also 16 terms that are new to ICD-O-3, ten of which are reportable.

The Implementation Guidelines and Recommendations for Version 15 are available on the NAACCR

website at http://www.naaccr.org/StandardsandRegistryOperations/ImplementationGuidelines.aspx. It

includes changes to the country codes and hematopoietic conversion sections (including Appendix B).

Please note that the revisions are marked by using Track Changes; however, since Appendix B was

completely replaced there are not Track Changes.

As a reminder, the Recommended Abbreviations for Abstractors is included in Volume II of the

NAACCR Data Standards and Data Dictionary in Appendix G. The use of abbreviations is often used by

cancer abstractors to shorten the written narrative entered into required text fields to facilitate the

electronic storage and transmission of required information. Since abbreviations can generate confusion,

because abbreviations may vary among different institutions and even between different specialties within

the same institution, it is critical that ONLY the recommended abbreviations for abstractors as provided in

Appendix G are used by registrars to record written text documentation.

Patient’s Usual Occupation & Industry Prior to Retirement~

We are still receiving reports that contain non-descriptive terms when recording ‘Patient’s Usual

Occupation Prior to Retirement’ and ‘Patient’s Usual Industry Prior to Retirement.’ The rational for the

collection of information for these data items is NOT to determine whether the patient is receiving social

security benefits, but rather the fact that accurate recording of occupation and industry of workers can

reveal the national cancer burden by industry and occupation. Such information can also be used to help

discover jobs that may have a high risk for cancer or other diseases and for which prevention efforts can

be concentrated (or targeted). Please review the coding instructions listed below regarding non-

descriptive terms, self-employed and disability.

Descriptive terms such as “longest,” “current,” “previously,” “prior history unknown, now

working at,” “last 5 years,” “retired,” “not applicable (N/A),” “disabled,” etc. should NOT be

recorded in these data fields.

“Self-employed” by itself is incomplete. The kind of work must be determined. The entry for

business/industry should include both the proper business/industry and the entry “self-employed.”

Do NOT use “retired.” If the patient has retired from his or her usual occupation, the “usual occupation and

business/industry” of the patient must be specified. If not specified, record as “Unknown.”

If the patient is on disability do NOT record “not employed” unless there is documentation that the patient

was never employed.” If the patient’s employment history prior to disability is not known, record as

“unknown.”

For more information on coding instructions, refer to the A Cancer Registrar’s Guide to Collecting

Industry and Occupation, which is provided by CDC and can be downloaded at

http://www.cdc.gov/niosh/docs/2011-173/pdfs/2011-173.pdf.

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MCSP Staff ~

If you have any questions regarding cancer reporting, or would like more information about workshops,

please feel free to give one of us a call.

Jetty Alverson 517.335.8855 alversong@michigan.gov

Brenda Bowen 517.335.9058 bowenb@michigan.gov

Stacey Coltrain 517.373-0758 coltrains@michigan.gov

Glenn Copeland 517.335.8677 copelandg@michigan.gov

Claudia Hardin 517.335.9967 hardinc@michigan.gov

Doug Koster 517.335.8348 kosterd@michigan.gov

Terry McTaggart 517.335.9624 mctaggartT1@michigan.gov

Elaine Snyder 517.335.8949 snydere@michigan.gov

Georgia Spivak 517.335.8702 spivakg@michigan.gov

Mary Stephens 517.335.9403 stephensm2@michigan.gov

Wendy Stinnett 517.335.8747 stinnettw@michigan.gov

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April 2015 Update

Collaborative Stage Transition ~

The process and ongoing efforts to coordinate and effectively transition from the Collaborative

Staging (CS) System to AJCC TNM staging standard, beginning with 2016 incidence data is

currently underway. The transition away from CS to directly assigned TNM stage is a major

change. To effectively deal with the staging transition, the focus in 2015 is training on

assignment of T, N, M and the AJCC TNM stage group. To assist with the training efforts, the

AJCC Curriculum for Registrars was launched in January of 2015. The curriculum is designed

to provide education in a step-wise learning environment complete with additional resources to

reinforce the information and webinars with interactive quizzes to prompt discussion and serve

as a self-assessment for the information learned. If you participate in the webinars, 2 CE hours

are available for each module (webinar). The MCSP encourages ALL registrars to take the

AJCC curriculum modules to meet the new reporting requirements for directly assigned AJCC

Stage. To access the AJCC Curriculum for Registrars, go to

https://cancerstaging.org/CSE/Registrar/Pages/default.aspx.

To view the Collaborative Stage Transition letter, go to

https://cancerstaging.org/cstage/about/news/Pages/Collaborative-Stage-Transition-Newsletter---

March-13-2015.aspx

To obtain the current edition of the AJCC Cancer Staging Manual or the AJCC Cancer Staging

Handbook, go to https://cancerstaging.org/references-tools/deskreferences/Pages/default.aspx.

Directly Coded SEER Summary Stage ~

SEER Summary Stage is a required data item for ALL facility types (Hospital with a Registry,

Hospital without a Registry and Independent Laboratories). Summary stage should be directly

coded using all information available through completion of surgery (ies) in the first course of

treatment or within four months from the date of initial diagnosis. Directly coded refers to the

assignment of stage that is derived from information based on pathologic, operative, and clinical

assessments, with the pathologic examination taking precedence. It is important to read the

pathology and operative reports for evidence of spread, microscopic extension and metastasis, as

well as diagnostic imaging reports for mention of distant disease. Thus, summary stage should

NOT be coded based from the derived CS stage.

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For coding instructions and site-specific schemas for assignment of Summary Stage, refer to the

SEER Summary Staging Manual – 2000. To obtain a copy of the SEER Summary Staging

Manual 2000, go to http://seer.cancer.gov/tools/ssm/. Additional coding guidelines for the

assignment of Summary Stage are also included in the MCSP Cancer Reporting Manual. For a

copy of the MCSP Cancer Program Manual, go to http://michigan.gov/mdch/0,4612,7-132-

2945_5221-16586--,00.html.

MCSP Cancer Program Manual and Resource References ~

The following documents have been revised by the Michigan Cancer Surveillance Cancer

Program:

MCSP Cancer Program Manual (rev. 3/20/2015).

MCSP Cancer Report Form (3/20/2015)

MCSP Reporting Requirements by Item & Facility Type for Cases Diagnosed in 2015 or

Earlier (rev. 3/20/2015)

MCSP Site-Specific Factor (SSF) Fields for Collaborative Staging (CS) Version 02.05

(rev. 3/20/2015)

The MCSP Cancer Program Manual and resource reference documents can be obtained from the

MCSP webpage at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html.

Cancer Reporting Meaningful Use (MU) Update ~

The Michigan Cancer Surveillance Program is accepting electronic cancer case reports to assist

eligible providers with the Stage 2 meaningful use menu objective: Capability to identify and

report cancer cases to a public health central cancer registry. To date, we are providing technical

assistance to 411 providers and their electronic health record (EHRs) vendors. To meet the

measure, providers must register and begin sending test cancer reports. Currently, we are

accepting test reports from EHR vendors. Testing with the EHR vendor enables providers to

meet the cancer reporting measure. Those vendors include NextGen, Altos Solutions and

Modernizing Medicine. If you are using one of these products and are participating in the EHR

Incentive Program, you may be eligible to receive meaningful use credit.

For more information, please contact Laura Rappleye, laura.rappleye@altarum.org or visit

https://www.michiganhealthit.org/public-health/cancer-registry/.

For more information on the Michigan cancer reporting requirements, please contact Jetty

Alverson at 517.335.8855 or alversong@michigan.gov.

Facility Oncology Registry Data Standards (FORDS): Revised for 2015~

Reminder! The Facility Oncology Registry Data Standards (FORDS) manual has been revised

for 2015. Please note that this version of FORDS replaces ALL previous versions. As changes

in coding rules and coding categories were incorporated in the revision of FORDS for 2015,

registrars should read the Preface and review Appendix C for an overview of the 2015 changes.

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NOTE: All items in FORDS are required for CoC-accredited cancer programs. The MCSP

Cancer Program Manual and the MCSP Reporting Requirements by Item and Type document

has been updated to reflect the changes in coding rules and coding categories and is available on

the MCSP webpage at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html.

Cancer Case Coding Questions/Answers ~

Question #1

Question: Ambiguous terminology: How is “likely” to be interpreted when determining

reportability?

Answer: Follow the ambiguous terminology list strictly as written. “Likely” is NOT on the list

so the so the case is not reportable based upon ambiguous terminology only of “likely.”

Comment: If the physician treats the patient as having cancer based upon the ambiguous

diagnosis of “likely”, the case would be considered reportable. Document the clinical diagnosis

by the physician in the appropriate text field(s).

Reference sources:

Facility Oncology Registry Data Standards (FORDS) at https://www.facs.org/quality-

programs/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual.

Additional coding instructions on reportability are included in the MCSP Cancer Program

Manual at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html.

Question #2

Question: When are carcinoids of the appendix reportable?

Answer: If the diagnosis date is 2014 or earlier, appendix carcinoids are reportable when stated

to be malignant in the pathology report, when there are discontinuous malignant metastases or

metastases to regional lymph nodes. Effective 2015, code 8240/1 for Carcinoid tumor, NOS, of

appendix (C18.1) becomes obsolete. Carcinoid tumors of the appendix (C18.1) must be coded to

8240/3, effective with cases diagnosed 2015 and forward.

Reference sources:

Facility Oncology Registry Data Standards (FORDS): Revised for 2015 at:

https://www.facs.org/quality-

programs/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual.

o See Preface 2015, page xi.

Multiple Primary and Histology Coding Rules Manual at

http://seer.cancer.gov/tools/mphrules/

Question #3

Question: Can laterality be assigned for sites other than those listed in the paired sites table?

Answer: NO. FORDS/CoC permits coding of laterality for non-paired organs (solid tumors);

however, the MCSP does not. For submission of data to the MCSP, facilities must follow the

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MCSP cancer reporting requirements for submission of data. Laterality for sites (solid tumors)

defined as ‘not a paired organ’ must be coded as ‘0 – not a paired site.’

Reference source: MCSP Cancer Program Manual at http://michigan.gov/mdch/0,4612,7-132-

2945_5221-16586--,00.html.

Question #4

Question: Should hematopoietic diseases not considered to be reportable before 2010 be

included in the sequencing of reportable hematopoietic diseases?

Answer: NO. If the original hematopoietic disease was not reportable at the time of diagnosis,

do NOT include it in the sequencing of a new incidence of a reportable hematopoietic disease.

Reference sources:

Hematopoietic and Lymphoid Neoplasm Database/Manual at

http://seer.cancer.gov/tools/heme/

Facility Oncology Registry Data Standards (FORDS) at https://www.facs.org/quality-

programs/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual

Question #5

Question: How many primaries should be reported if a patient has 2 synchronous tumors in the

descending (or ascending, transverse, etc.) colon? The first is a grade 3 adenocarcinoma with

signet ring differentiation and focal mucinous features (8255/3). The second tumor is a grade 2-

3 adenocarcinoma in a tubulovillous adenoma (8263/3).

Answer: Apply MP/H rule M7 to this case and report as one primary tumor.

Reference source: Multiple Primary and Histology Coding Rules Manual at

http://seer.cancer.gov/tools/mphrules/

Retirement ~

This past March, Terry McTaggart retired from the State of Michigan, with his last 6 years of

service at the State with the Michigan Cancer Surveillance Program. As part of Terry’s role as

department analyst at the MCSP, he was responsible for the customization and facility support

for the Michigan Abstract Plus software. The MCSP staff wishes Terry much happiness and

relaxation in his retirement; however, we will miss his expert computers skills that he used

within the department and as a contact for Abstract Plus. Yes, we are currently working on the

customization of Abstract Plus version 15.0, which will allow for the abstracting of cases

diagnosed 2015 or earlier. We are currently waiting the final customization of the Abstract Plus

software from CDC and are expecting to provide version 15.0 to facilities by the end of the

month.

If you need assistance with the Abstract Plus software and/or password reset for the secure FTP

site for transmission of data, please contact Jetty Alverson at 517.335.8855 or

alversong@michigan.gov

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MCSP Submission of Data Due Dates ~

Don’t forget the data submission deadline dates for 2015!

DUE DATES:

All reportable conditions diagnosed in 2014 are due to the MCSP by July 1, 2015.

Any missed reports for reportable conditions for diagnosis years prior to 2014 must be

submitted to the MCSP by March 31, 2015.

January through March 2015 cases must be submitted by September 1st. The MCSP

strongly encourages monthly submission of data. For example, cases abstracted in

January should be submitted to the MCSP in February.

REMINDERS:

Data submission format: Facilities submitting cases electronically are required to submit

in the most recent version of the data exchange format and code structure as specified by

NAACCR.

Labeling of Electronic Submission Files and/or submission of data: For more

information on the MCSP requirements for labeling of electronic submission files and/or

submission of data, please refer to the MCSP Cancer Program Manual at

http://michigan.gov/mdch/0,1607,7-132-2945_5221-16586--,00.html.

Facilities non-compliant with the Michigan cancer reporting requirements will be addressed

and corrective action taken if necessary.

NOTE: If your registry is in the SEER area (Wayne, Oakland or Macomb County) and you have

questions regarding submission of data, please contact your SEER-State Coordinator, Jeanne

Whitlock at 313.578.4219 or whitlock@med.wayne.edu.

2015 MCSP Educational Workshops ~

The Michigan Cancer Surveillance Program will be offering a series of educational workshops

during 2015. The workshops will be held at the Capitol View Building in Lansing and

registration is free of charge. If you are a new registrar, attendance at the workshops is strongly

recommended. Registration is also open to those who have taken previous workshops and

seasoned registrars interested in taking a refresher course. All workshops will be held from

8:45am to 4:00pm and CE hours will only be offered for workshops 2-4.

If you are interested in registering for any of the workshops, please complete a copy of the

attached registration form (see page 7). As space is limited early registration is recommended.

The 2015 MCSP Educational Workshops series is as follows:

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Workshop #1

Topic: Basic Cancer Reporting

Date: Friday, May 1

Workshop #2

Topic: Hematopoietic and Lymphoid Neoplasms: Database and Coding Rules

Date: Friday, May 29

Workshop #3

Topic: Directly Code SEER Summary Stage & AJCC Stage

Date: Friday, June 5

Workshop #4

Topic: Multiple Primary and Histology Coding Rules/Manual

Date: Friday, June 26

For more information, please feel free to contact Jetty Alverson at 517.335.8855 or

alversong@michigan.gov.

Save the Date ~

The MCSP will be offering an Educational Conference on Friday, July 31. Registration is free

and CE hours will be offered for this workshop. This workshop is applicable to seasoned and

non-seasoned registrars. Some of the topics that will be included are: Updates (MCSP cancer

reporting requirements), Edit Issues, Coding and Cancer Case Scenarios. Agenda and

registration information will be provided in May.

MCSP Staff ~

If you have any questions regarding cancer reporting, or would like more information about

workshops, please feel free to give one of us a call.

Jetty Alverson 517.335.8855 alversong@michigan.gov

Brenda Bowen 517.335.9058 bowenb@michigan.gov

Stacey Coltrain 517.373-0758 coltrains@michigan.gov

Glenn Copeland 517.335.8677 copelandg@michigan.gov

Claudia Hardin 517.335.9967 hardinc@michigan.gov

Doug Koster 517.335.8348 kosterd@michigan.gov

Elaine Snyder 517.335.8949 snydere@michigan.gov

Georgia Spivak 517.335.8702 spivakg@michigan.gov

Mary Stephens 517.335.9403 stephensm2@michigan.gov

Wendy Stinnett 517.335.8747 stinnettw@michigan.gov

REGISTRATION

Complete this registration form and fax attention to Jetty Alverson at (517) 335-9513 or email a copy of the completed form to alversong@michigan.gov.

Please note!

A separate form is required for EACH attendee!

Registration is complimentary, but space is limited so register early!

Confirmation of registration acceptance to attend workshop(s) will be provided by EMAIL only!

Name

Title/Credentials

Organization/Facility

Phone Number Alternate Phone Number

__________________________________________________________________________________ Emergency Contact Name and Phone Number

E-mail Address

NOTE: Place a check mark next to each session you would like to register to attend.

_____ Session #1: Basic Cancer Reporting

_____ Session #2: Hematopoietic and Lymphoid Neoplasms: Database and Coding Manual

_____ Session #3: Directly Coded SEER Summary and AJCC TNM Stage

_____ Session #4: Multiple Primary and Histology Coding Rules

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July 2015 Update

Don’t Forget the Data Submission Deadlines for 2015! ~

• ACoS approved facilities: All reportable conditions diagnosed in 2014 were due to the MCSP by July 1, 2015.

• Abstract Plus users (Non-ACoS facilities): Due to the delay in availability of a version of Abstract Plus for 2014 diagnosis year, the deadline for submission of 2014 cases has been extended to August 31. Facilities are still required to meet the submission deadline date for 2014 cases, which may require the use of MCSP cancer report form. The current version of the MCSP Cancer Report Form can be downloaded from http://www.michigan.gov/mdch/0,1607,7-132-2945_5221-16586--,00.html

• Any missed reports for reportable conditions for diagnosis years prior to 2014 were due on March 31, 2015.

• January through March 2015 cases must be submitted by September 1st. The MCSP strongly encourages monthly submission of data. For example, cases abstracted in January should be submitted to the MCSP in February.

• Please note that facilities non-compliant with the Michigan cancer reporting requirements will be addressed and corrective action taken if necessary.

Data submission format: Facilities submitting cases electronically are required to submit in the most recent version of the data exchange format and code structure as specified by NAACCR. The MCSP will continue to accept submission of data in NAACCR format version 14.0 through August 31. Starting September 1, 2015, data submission to the MCSP must be in NAACCR format version 15.0. For more information on the MCSP requirements for labeling of electronic submission files and/or submission of data, please refer to the MCSP Cancer Program Manual at http://michigan.gov/mdch/0,1607,7-132-2945_5221-16586--,00.html. Note: If your registry is in the SEER area (Wayne, Oakland or Macomb County) and you have questions regarding submission of data, please contact your SEER-State Coordinator, Jeanne Whitlock at 313.578.4219 or whitlock@med.wayne.edu.

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NAACCR – Registries Certified in 2015 for 2012 Incidence Data ~ The NAACCR board of directors has certified that the Michigan Cancer Surveillance Program has attained the NAACCR Gold Standard for Quality, Completeness, and Timelnes for its 2012 incidence data. A big THANK YOU goes out to everyone for submitting timely data, which makes it possible for the MCSP to achieve the highest recognition. The Michigan central cancer registry could not have accomplished this without you! Your efforts on submitting complete, accurate and quality data on a timely basis are sincerely appreciated by the MCSP staff! NAACCR Publication Cancer in North America: 2008-2012 Now Available ~ NAACCR has posted the 25th edition of Cancer in North America (CINA): 2008-2012 to its website. Visit www.naaccr.org and select "Data and Publications" to download. The publication series presents cancer incidence data as collected by the regional, state, provincial, and territorial NAACCR-member registries across North America. Collaborative Stage Transition ~ To effectively deal with the staging transition from Collaborative Stage to directly coded AJCC TNM Stage, the focus in 2015 is training on assignment of T, N, M and the AJCC TNM stage group. To assist with the training efforts, the AJCC Curriculum for Registrars was launched in January of 2015. The curriculum is designed to provide education in a step-wise learning environment complete with additional resources to reinforce the information and webinars with interactive quizzes to prompt discussion and serve as a self-assessment for the information learned. If you do participate in the live webinars, 2 CE hours are available for each eligible module. To access the AJCC Curriculum for Registrars, go to http://cancerstaging.org/CSE/Registrar/Pages/AJCC-Curriculum.aspx If you missed any of the previous modules it is not too late to participate in the training as the modules presented can be accessed after the live webinar. Materials for Module IV will be made available July 15. Note: The MCSP strongly encourages registrars to review the AJCC Curriculum for Registrar Modules to ensure accurate coding of the new reporting requirements for directly coded AJCC TNM Stage.

Directly Coded SEER Summary Stage ~ SEER Summary Stage is a required data item for ALL facility types (Hospital with a Registry, Hospital without a Registry and Independent Laboratories). Summary stage should be directly coded using all information available through completion of surgery(ies) in the first course of treatment or within four months from the date of initial diagnosis. Directly coded refers to the assignment of stage that is derived from information based on pathologic, operative, and clinical assessments, with the pathologic examination taking precedence. It is important to read the pathology and operative reports for evidence of spread, microscopic extension and metastasis, as well as diagnostic imaging reports for mention of distant disease. Thus, summary stage should NOT be coded based from the derived CS stage. Guidelines for directly coding Summary Stage will be presented during the upcoming 2015 MCSP Cancer Registry Workshop in Lansing on Friday, July 31.

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For coding instructions and site-specific schemas for assignment of Summary Stage, refer to the SEER Summary Staging Manual – 2000. To obtain a copy of the SEER Summary Staging Manual 2000, go to http://seer.cancer.gov/tools/ssm/. Additional coding guidelines for the assignment of Summary Stage are also included in the MCSP Cancer Reporting Manual. For a copy of the MCSP Cancer Program Manual, go to http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html.

SEER* Educate ~ Don’t forget about SEER*Educate, which is an online training curriculum provided by SEER that includes material for recent graduates preparing for a registry job, registrars studying for the CTR exam and CTRs earning CE hours in Practical Application and Registry Operations. The site can be accessed via https://educate.fhcrc.org. As of May 2015, the following training series are available:

• Practical Application Tests menu o Case Coding – CSv0204 (295 cases) o Case Coding – CSv0205 (160 cases) o Heme 2015 Cases (35 cases) o MP/H Rules 2007 (50 Cases) o TNM 7th Edition (140 Cases)

• General Knowledge Tests menu o Anatomy and Physiology (1,600 questions) o Computers (200 questions) o Medical Terminology (1,100 questions)

• CTR Prep Tests menu o CoC Cancer Program Standards (100 questions) o Statistics (200 questions) o Coding Guidelines (Heme Database and Manual) (40 questions) o Cancer Registry Management (600 questions)

Cancer Reporting Meaningful Use (MU) Update ~ The Michigan Cancer Surveillance Program is accepting electronic cancer case reports to assist eligible providers with the Stage 2 meaningful use menu objective: Capability to identify and report cancer cases to a public health central cancer registry. To meet the measure, providers must register and begin sending test cancer reports. Currently, we are accepting test reports from EHR vendors. Testing with the EHR vendor enables providers to meet the cancer reporting measure. Those vendors include NextGen, Altos Solutions and Modernizing Medicine. If you are using one of these products and are participating in the EHR Incentive Program, you may be eligible to receive meaningful use credit. For more information, please contact Laura Rappleye, laura.rappleye@altarum.org or visit https://www.michiganhealthit.org/public-health/cancer-registry/. For more information on the Michigan cancer reporting requirements, please contact Jetty Alverson at 517.335.8855 or alversong@michigan.gov.

Date Information Missing in Text Fields ~ The MCSP is still receiving cases without proper and complete supporting text documentation that validates the codes selected. The date along with the type of procedure(s) and results must

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be recorded. Supporting text documentation assists the central cancer registry with information to properly consolidate reports submitted, especially when multiple reports from different facilities are submitted for the same case. The rationale behind supporting text documentation is that anyone should be able to view/print the free text and re-abstract the case solely from the supporting text fields. The MCSP thanks you in advance for taking time to read the instructions on supporting text documentation provided below. When documenting supporting text, be as specific as possible. For example, in the Surgery Text Field record the date and the complete name of the surgical procedure. If multiple surgical procedures are performed, record the date and name of each surgical procedure. Also, make sure that procedure dates for x-rays, blood tests, path reports, etc. are included in your text fields so procedures and be identified in the correct chronological order. Remember! Text documentation is not just recommended, but is a required component of the abstract, which justifies the codes selected AND allows for documentation of information that is not coded. Since the purpose of text is to provide the opportunity for checking coded values, the text fields MUST contain a description of the disease process entered by the abstractor from review of the medical record and NOT from the generated electronically coded values. Text fields CANNOT contain control characters (Note: Copying and pasting of text documentation from the electronic medical record and/or hospital record system might contain control characters. Issues with control characters are not identified during submission of data and instead during the central cancer registry case consolidation process. If there is no information for a particular text field, do NOT leave the data item blank. Record “N/A,” “None” or “Unknown” in the appropriate text field. This documentation confirms that information was searched for but no information exists. Only NAACCR approved abbreviations should be utilized. Recommended abbreviations for Abstractors are included in Appendix G of the NAACCR Volume II Data Standards and Data Dictionary http://www.naaccr.org/Applications/ContentReader/Default.aspx?c=17 For more information on Text Documentation, refer to: NAACCR Standards for Cancer Registries, Data Standards and Data Dictionary (Volume II) at http://www.naaccr.org/StandardsandRegistryOperations/VolumeII.aspx. 2015 MCSP Cancer Registry Workshop ~ The MCSP will be conducting a Cancer Registry Workshop in Lansing on Friday, July 31, from 9:00am to 4:00pm. The workshop will be held on the first floor of the Capitol View Building located at 201 Townsend St., Lansing, MI 48913.

Topics to be presented at the workshop include the 2014 Tumor Grade Rules with case exercises, Cancer Genomics presentation, Guidelines for Directly Coded Summary Stage, MCSP Reporting Requirements Overview/Update, Validating Data with Text, and Case Coding Exercises/Answers.

This workshop is geared towards all facility types and applies to both seasoned and non-seasoned registrars including CTRs and non-CTRs. CE hours will be offered; however, approval is currently pending from NCRA.

Registration is free, but space is limited. To register, please complete the attached registration form (also available on the MCSP webpage) and submit according to the instructions on the form.

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Confirmation of registration to attend the workshop will be provided by email ONLY. As space is limited, registration will be accepted on a first-come first-serve basis or until conference room capacity has been reached.

Fall 2015 MICRA Conference ~ The annual Michigan Cancer Regitrars Association conference is scheduled for October 22-23 at the Crowne Plaza in Lansing. For more information, visit the MICRA web site http://www.miregistrars.org/ or contact Lisa Ross, MICRA Corresponding Secretary at lisaross@med.umich.edu.

Improving Quality in Data Collection and Reporting ~ Papillary carcinoma of the thyroid

Papillary carcinoma of the thyroid is often miscoded as 8050. Papillary carcinoma of the thyroid should be coded 8260. Reference source: See Multiple Primary & Histology Coding Rules Manual ‘Other Sites’ Rules H14 and H15.

Patient Address at DX and Patient Address – Current: Locating and entering zip codes and county codes

Correct zip and county codes are important for hospitals and local health departments to assess the health of patients and residents and to be able to compare findings against other localities. Zip codes are also used at the State level to investigate cancer cluster concerns. Patient Address – Current provides a current address used for follow-up purposes. It may or may not be different than the patient’s address at the initial time of diagnosis. If the current address is the same as the address at diagnosis, duplicate the address information in the current address field. Do not leave this data item blank. The following tools can be used to determine proper zip codes and county FIPS codes: To determine correct zip code by street address or city, use this search tool provided by the United States Postal Service https://tools.usps.com/go/ZipLookupAction!input.action To determine correct county name by city name or zip code, use this search tool provided by the US Census Bureau http://quickfacts.census.gov/cgi-bin/qfd/lookup Three-digit county FIPS codes for Michigan counties can be found on page 189 of the MCSP Cancer Program Manual. The manual can be downloaded from the MCSP web page http://www.michigan.gov/mdch/0,1607,7-132-2945_5221-16586--,00.html Three-digit county FIPS codes for all counties in the United States listed in alpha order by state: http://www.naaccr.org/Applications/ContentReader/Default.aspx?c=11

Assigning correct sequence numbers to CIN III tumors

All facilities are required to report cervical intraepithelial neoplasia grade III tumors to the central registry. Michigan is one of the few registries that collect these precancerous cervical tumors for research purposes, so it is important that they are properly sequenced in relation to other patient cancers. Abstracts submitted to the central registry for cervical intraepithelial neoplasia grade III (CIN III), “HGSIL,” “HSIL,” or “severe dysplasia” tumors of the cervix (C53.0, C53.1, C53.8,

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C53.9) with an assigned morphology of 8077/2 should be assigned a tumor sequence number within the range of 00-59 (invasive or in situ). Do not assigned sequence numbers in the 60-87 range (non-malignant) or sequence number 98 to these tumors. For more information on reportable conditions for CIN III, including AIN III, HSIL/HGSIL, VAIN III and VIN III, please refer to the MCSP Cancer Reporting Manual located at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html.

Correct values for RX Summary – Radiation to CNS (NAACCR item #1370)

Note: For lung and leukemia cases only. Code for radiation given to the brain or central nervous system for lung and leukemia cases only. Includes treatment given at all facilities as part of the first course. Codes for lung and leukemia cases only: 0 No radiation to the brain and/or central nervous system 1 Radiation 7 Patient or patient’s guardian refused 8 Radiation recommended, unknown if administered 9 Unknown Codes for all other cases (primaries other than lung or leukemia): 9 Not Applicable Note: SEER does not collect this data item beginning with 1998 cases. They retain the codes for older cases in this field, and they have also recoded radiation coded here as radiation in RX Summ--Radiation [1360]. CoC does not collect this data item beginning with 1996 cases.

Accurate coding of measurements in CS Site Specific Factor Fields Make sure to consult notes and coding examples for CS Site Specific Factor fields so you fully understand how to accurately enter lab measurements as rules are unique to each SSF. Errors such as the following have been found in submitted abstracts: Prostate Schema SSF1 – PSA Level: PSA level in chart shown to be 7.580. Value was coded as 758 instead of the correct value of 076. Colon Schema SSF1 – CEA Level: CEA level in chart stated as 3.9. Value was coded ad 390 instead of 039.

Staff Changes at MCSP ~ We are pleased to announce that David Westover has joined the Michigan Cancer Surveillance Program staff as Departmental Analyst for the Registry Operations Unit. Dave is a former instructor of chemistry at Grand Valley State University and has multiple masters degrees in chemistry, environmental science, and college education. Brenda Bowen is no longer employed at the MCSP. If you have any questions or concerns regarding abstract uploads, please contact Wendy Stinnett at 517.335.8747 or stinnettw@michigan.gov or Jetty Alverson at 517.335.8855 or alversong@michigan.gov.

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MCSP Staff ~ Please feel free to contact one of us if you have any questions regarding cancer reporting or if you would like more information about upcoming training/workshop opportunities. Jetty Alverson 517.335.8855 alversong@michigan.gov Stacey Coltrain 517.373-0758 coltrains@michigan.gov Glenn Copeland 517.335.8677 copelandg@michigan.gov Claudia Hardin 517.335.9967 hardinc@michigan.gov Doug Koster 517.335.8348 kosterd@michigan.gov Elaine Snyder 517.335.8949 snydere@michigan.gov Georgia Spivak 517.335.8702 spivakg@michigan.gov Mary Stephens 517.335.9403 stephensm2@michigan.gov Wendy Stinnett 517.335.8747 stinnettw@michigan.gov David Westover 517.335-9624 westoverd1@michigan.gov

MCSP Cancer Program Manual and Resource References ~ The MCSP Cancer Program Manual and resource reference documents can be obtained from the MCSP webpage at http://michigan.gov/mdch/0,4612,7-132-2945_5221-16586--,00.html. Funding for the MCSP Workshops was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the State of Michigan Department of Health and Human Services and the U.S. Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government..

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Registration Form

2015 MCSP Cancer Registry Workshop

Friday, July 31 Complete this registration form and fax attention to Jetty Alverson at (517) 335-9513 or email a copy of the registration form to alversong@michigan.gov.

Please note!

• A separate form is required for EACH attendee!

• Registration is complimentary, but space is limited. Register early!

• Confirmation of registration acceptance to attend the workshop will be provided by EMAIL only!

Name

__________________________________________________________________________________ Title/Credentials

Organization/Facility

Phone Number Alternate Phone Number

____________________________________________________________________ Emergency Contact Name and Phone Number

E-mail Address

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October 2015 Update

MCSP Edit Set~

A new edit set for electronic submission of data to the MCSP is now available. The edit set is

available on the MDCH File Transfer (FTP) site at https://sso.mdch.state.mi.us/. The edit set file

is labeled as ‘NAACCR_v15.rmf.’

Installation of the new MCSP edit set is required for proprietary cancer registry software users

AND Abstract Plus version 15.0. Electronic data submissions that do not meet the MCSP

requirements for reporting, which include the MCSP edit set will be rejected.

If you have any questions regarding the implementation of the new MCSP edit set, please contact

Jetty Alverson at Alversong@michigan.gov or (517) 335-8855. If you do not have an FTP

account, need password reset and/or assistance with installation of the edit set, please contact

David Westover at WestoverD1@michigan.gov or (517) 335-9624.

Data Submission Format~

Data submission format: Facilities submitting cases electronically are required to submit in the

most recent version of the data exchange format and code structure as specified by NAACCR.

Currently, the MCSP is ONLY accepting data submissions in NAACCR format version 15.0 and

include the most current MCSP edit set. Electronic submission of files must follow the MCSP

reporting requirements for labeling of file name.

For more information on the MCSP requirements for labeling of electronic submission files

and/or submission of data, please refer to the MCSP Cancer Program Manual at

http://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_5221-16586--,00.html.

Note: If your registry is in the SEER area (Wayne, Oakland or Macomb County) and you have

questions regarding submission of data, please contact your SEER-State Coordinator, Jeanne

Whitlock at 313.578.4219 or whitlock@med.wayne.edu.

MCSP Reporting Requirements~

Submission of data to the MCSP must follow the MCSP reporting requirements as defined in the

MCSP Cancer Program Manual. It is important to note that the MCSP reporting requirements do

differ from those of the Commission on Cancer (for approved cancer programs by the American

College of Surgeons). Please review the information provided below, as well as, the MCSP

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Cancer Program Manual to ensure that the facility meets the MCSP requirements for submission

of data to the central cancer registry.

Facility Reporting Responsibilities

Know the MCSP reporting requirements as provided in the MCSP Cancer Program

Manual. Please note that changes to reporting requirements do occur on a yearly basis

and/or as applicable.

Select an abstract reporting option; whether on paper or electronic and establish a

schedule for regular reporting.

Notify the MCSP of any changes in the method of reporting and/or facility contact

information.

If the facility uses proprietary cancer abstracting software, it is the responsibility of the

facility to ensure that the software is compliant with the MCSP reporting requirements,

including most recent edit set.

Perform ALL casefinding activities (as applicable based upon facility type) to ensure

completeness of reporting.

Note: For more information on reporting responsibilities, refer to the MCSP Cancer Program

Manual.

Social Security Number

The social security number (SSN) is a required data item regardless of facility type. If the

SSN is not documented or unavailable in the patient’s medical record(s), out-patient records, or

other facility specific records, follow-back with the physician(s) on record is required.

If the SSN is unknown after ALL applicable facility follow-back is conducted, record the SSN as

unknown (999999999). If the SSN is coded as unknown (9’s), supporting text documentation of

facility follow-back is required in the applicable text field.

Race

Race is a required data item regardless of facility type. If the patient’s race is not available/not

documented, facility follow-back with the physician(s) on record. If facility follow-back is

required and the patient’s race cannot be obtained, record the race as unknown (99) in race fields

1-5, AND record supporting documentation on follow-back in the applicable text field.

Coding Instructions:

Record the patient’s race according to the documentation in the patient’s medical

record(s) and/or facility records.

All tumors for the same patient must have the same race code.

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If multi-racial, enter each race according to the documentation in the patient’s records,

for a total of five races.

In general, race should be reported as American Indian, white, black, etc.

White includes Mexican, Puerto Rican, Cuban, and all other Caucasians.

If Asian, enter the national origin as Chinese, Vietnamese, Japanese, Hmong, etc.

Note: For electronic submission, please refer to the MCSP Cancer Program Manual for

additional information on coding race fields 1-5.

Laterality

Laterality refers to a specific side of the body or lobe of an organ. In the case of paired or

bilateral organs, it is important to indicate whether the primary site of the tumor is right, left, or

bilateral involvement. Laterality refers to the primary site ONLY; do NOT code the laterality of

metastatic site(s). If the primary site is reported as “unknown primary site,” code the laterality to

“0 - not a paired site.”

If the primary site being reported is NOT defined as a paired site, laterality must be coded

as “0 – not a paired site” regardless of facility type.

Codes are as follows:

0 Not a paired site

1 Right: origin of primary

2 Left: origin of primary

3 Only one side involved, right or left origin unspecified

4 Bilateral involvement at time of diagnosis, lateral origin unknown for a single primary; or

both ovaries involved simultaneously, single histology; bilateral retinoblastomas;

bilateral Wilms tumors

5 Paired site: midline tumor *

9 Paired site, but no information concerning laterality

* "Midline" in this context refers to the point where the "right" and "left" sides of paired

organs come into direct contact and a tumor forms at that point. Most paired sites cannot

develop midline tumors. For example, skin of the trunk can have a midline tumor, but the

breasts cannot.

Laterality for sites defined as a paired organ MUST be recorded as 1, 2, 3, 4, 5, or 9.

For a complete list of allowable laterality codes by primary site code and description, download

“MCSP Laterality Codes by Primary Site” on the MCSP website

(http://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_5221-16586--,00.html). Additional

information on coding instructions is provided in the MCSP Cancer Program Manual.

Treatment Fields

In order to properly code patient treatment, it is necessary to think about treatment data as sets of

fields in which all of the data values must coincide regarding how (or whether) a modality was

administered. All the fields required to code radiation treatment are listed in the tables below.

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The value in each of these fields records a certain aspect of the modality and it is important that

one value doesn’t contradict another in the set. Non-agreement of codes can lead to edit errors.

For example, if the patient does not receive radiation, then only the following values are allowed

in the radiation treatment fields:

Tx Data Field Value Explanation of Value

RxDateRad (Blank)

RxDateRadFlag 11 RX Modality not given; autopsy only

RxSumRad 0 None

RadRegModal 00 No radiation treatment

ReasonNoRad 1* Radiation therapy not administered; not planned 1st course

*Other values are allowed to explain why radiation was not administered

If it is unknown whether or not radiation treatment was administered, then only the following

values are allowed in the radiation treatment fields:

Tx Data Field Value Explanation of Value

RxDateRad (Blank)

RxDateRadFlag 10 Unknown if RX modality performed/administered

RxSumRad 9 Unknown

RadRegModal 99 Unknown; unknown if RT given

ReasonNoRad 9 Unknown if RT recommended or performed; DC-only/autopsy

Below are other major treatment data sets. There must be agreement between all values recorded

within each set.

Surgery Chemotherapy Hormone Therapy BRM Therapy

RxDateSurg RxDateChemo RxDateHorm RxDateBRM

RxDateSurgFlag RxDateChemoFlag RxDateHormFlag RxDateBRMFlag

RxDateMostDefSurg RxSumChemo RxSumHorm RxSumBRM

RxDateDefSurgFlag

RxSumSurgSite

ReasonNoSurg

Patient Address at DX Fields and Current Address Fields

There are two sets of data fields to capture patient address information – a set for the patient’s

residence at time of diagnosis and another set for the patient’s current usual residence. Complete

data for both address sets is required for all submitted abstracts. The data recorded in these sets

may be different or identical depending on patient circumstances.

NAACCR description of Address at DX information: The number and street address or the rural

mailing address of the patient’s residence at the time the reportable tumor was diagnosed. If

the patient has multiple tumors, address at diagnosis may be different for each tumor. Additional

address information such as facility, nursing home, or name of apartment complex should be

entered in Addr At DX—Supplemental. Do not update this item if patient moves after diagnosis.

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NAACCR description of Current Address information: The number and street address or the

rural mailing address of the patient’s current usual residence. This can be used to generate a

follow-up inquiry, and must correspond to other fields in the current address. If the patient has

multiple tumors, the current address should be the same. Additional address information such as

facility, nursing home, or name of apartment complex should be entered in item Addr Current--

Supplemental.

The table below lists required data fields for each set.

Address at DX Current Address

Number and Street Number and Street

Supplemental Number and Street Supplemental Number and Street

City City

State State

Zip Code Zip Code

County Code County Code

Country Code Country Code

If data values for Address at DX and Current Address are the same, some registry software

provides a shortcut to duplicate the field data. For example, Abstract Plus allows the user to copy

all Address at DX field data into the corresponding Current Address fields by placing the cursor

in the “Addr Current-No Street” field and then pressing the F5 key.

Recording Breast Case ER/PR/HER2 Receptor Assay Results

The following CS Site-Specific Factor fields capture receptor assay data:

Site-Specific Factor 1 Estrogen Receptor (ER) Assay

Site-Specific Factor 2 Progesterone Receptor (PR) Assay

Site-Specific Factor 8 HER2: Immunohistochemistry (IHC) Lab Value

Site-Specific Factor 9 HER2: Immunohistochemistry (IHC) Test Interpretation

Site-Specific Factor 10 HER2: Fluorescence In Situ Hybridization (FISH) Lab Value

Site-Specific Factor 11 HER2: Fluorescence In Situ Hybridization (FISH) Test

Interpretation

Site-Specific Factor 12 HER2: Chromogenic In Situ Hybridization (CISH) Lab Value

Site-Specific Factor 13 HER2: Chromogenic In Situ Hybridization (CISH) Test

Interpretation

Site-Specific Factor 14 HER2: Result of Other or Unknown Test

Site-Specific Factor 15 HER2: Summary Result of Test

Site-Specific Factor 16 Combinations of ER, PR, and HER2 Results

See notes and instructions for each SSF field at https://cancerstaging.org/cstage/schema/Pages/

version0205.aspx

To stay clear of potential edit errors, avoid discrepancies when recording values in all SSF fields

that are associated with receptor assay data.

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Example: Assay test results are as follows:

ER – Positive

PR – Positive

HER2 (IHC) – (2+) Equivocal

FISH – (Ratio 1.2) Negative

The field values should be recorded as follows:

Site-Specific Factor Value Interpretation

SSF 1 010 Positive/elevated

SSF 2 010 Positive/elevated

SSF 8 002 Score 2+

SSF 9 030 Borderline; equivocal; indeterminate; undetermined

SSF 10 120 Ratio of 1.2

SSF 11 020 Negative/normal

SSF 12 998 Test not done

SSF 13 998 Test not done

SSF 14 998 Test not done

SSF 15 020 Negative/normal; within normal limits; not amplified

SSF 16 110 ER Negative, PR Negative, HER2 Negative*

* In this example, value for FISH is recorded in the combined results because the HER2 assay

results were equivocal.

Supporting Text Documentation

Remember that your text field documentation must include enough information so that an

abstract can be completed based upon a text review only. Text is required to support coded

values such as:

Race

Age

History of cancer

Sequence number (when the patient has multiple reportable conditions)

Method of diagnosis

Pathology/cytology report (final diagnosis including addendum and applicable

comments)

Primary Site

Histology

Tumor Grade

Stage (extent of disease)

Surgical procedure/work-up

Treatment work-up

First course of treatment including date, type of type (i.e. chemo agents), and start date. If

the decision is made not to treat the tumor, then the reason for non-treatment must be

noted, e.g., Not recommended due to other health issues. Keep in mind that Active

Surveillance can be considered as first course of treatment.

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The MCSP will begin conducting quality assurance audits on text documentation. Facilities non-

compliant with the Michigan cancer reporting requirements, which include completeness,

accuracy and timeliness of data submission, will be addressed and corrective action taken if

necessary.

ICD-O-3 Implementation and Reportability~

CDC is following the NAACCR Guidelines for ICD-O-3 Update Implementation (published

Dec. 2013). At this time, it has not been determined whether the new reportable histology codes

originally intended for implementation with 2015 diagnoses will become effective for 2016

diagnoses. More information will be provided in the NAACCR 2016 Implementation Guide, as

well as in the revised MCSP Cancer Program Manual for 2016.

Reportable Conditions for CIN III, HGSIL/HGSIL~

To ensure that ONLY eligible CIN cases are submitted to the MCSP, please review the

guidelines for reportability as provided in the MCSP Cancer Program Manual. See ‘Reportable

Conditions for AIN III, CIN III, HSIL/HGSIL, VAIN II, VIN III.’ If the case is identified as a

reportable condition, please record the final diagnosis as provided in the pathology report in the

pathology text field. Any pertinent information such as date of diagnosis, type of procedure and

other applicable information must be recorded in the appropriate text field.

For these cases, histology is based on a histologically confirmed diagnosis that includes at least

one of the following terms: “cervical intraepithelial neoplasia grade III (CIN III),” “HGSIL,”

“HSIL,” or “severe dysplasia.” Histology for any of these cervical neoplasia conditions is coded

as 8077 with or without the term “carcinoma in situ.”

Example: Final diagnosis on the pathology report is “high grade squamous

intraepithelial neoplasia (HGSIL).”

Code histology as 8077.

Do NOT code the histology in this instance as 8070.

For pre-invasive cervical lesions, cases identified by only a PAP smear ARE NOT eligible for

inclusion. The diagnosis must be confirmed by some other method, which could include a

clinical diagnosis (physician’s statement) or positive biopsy pathology.

Examples of Reportable versus Non-Reportable diagnoses based upon histological confirmation

are provided below. Additional information on coding of data items for reportable CIN III cases

is included in the MCSP Cancer Program Manual.

Examples Reportable

“CIN 2 and 3” is reportable

“CIN 2 & 3” is reportable

“CIN 2 + 3” is reportable

“Moderate and severe dysplasia” is reportable

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Not Reportable

“CIN 2-3” is NOT reportable

“CIN 2/3” is NOT reportable

“Moderate to severe dysplasia” is NOT reportable

Web Plus~

What is Web Plus? It is a Web-based application that collects cancer data securely over the

public Internet. It is ideal for use by central cancer registries for all electronic reporting needs.

Web Plus supports three main functions: online abstracting, file upload and download, and

follow-back efforts. Web Plus online abstracting capacity is ideal for reporting from physician

offices and other low-volume reporting sources, while the file upload feature can be used for

electronic submission of data from all other reporting sources to the central cancer registry.

The follow-back features in Web Plus enables the central cancer registry to upload partially filled

abstracts generated from death certificate and pathology lab files, and to notify the appropriate

facility via e-mail to log in and update the abstracts.

All records are saved in a database at the hosting central cancer registry, and cases entered by

one facility or offices are not visible to other facilities. Data are validated by the CDC EDITS

engine running on a Web server. Users, display types, and edit configurations are managed at the

hosting central registry. Web Plus is hosted on a secure Web server that has a digital certificate

installed; the communication between the client and the server is encrypted with Secure Sockets

Layer (SSL) technology.

The MCSP is currently in the process of implementing Web Plus for electronic submission of

data. Once the Web-based application server is up and running, information on the revision for

electronic submission of data will be provided. Please watch for upcoming correspondence and

webinar schedule to assist facilities with the revisions for electronic submission of data.

MCSP Staff ~

Please feel free to contact one of us if you have any questions regarding cancer reporting or if

you would like more information about upcoming training/workshop opportunities.

Jetty Alverson 517.335.8855 alversong@michigan.gov

Stacey Coltrain 517.373-0758 coltrains@michigan.gov

Glenn Copeland 517.335.8677 copelandg@michigan.gov

Claudia Hardin 517.335.9967 hardinc@michigan.gov

Doug Koster 517.335.8348 kosterd@michigan.gov

Elaine Snyder 517.335.8949 snydere@michigan.gov

Georgia Spivak 517.335.8702 spivakg@michigan.gov

Mary Stephens 517.335.9403 stephensm2@michigan.gov

Wendy Stinnett 517.335.8747 stinnettw@michigan.gov

David Westover 517.335-9624 westoverd1@michigan.gov

9

MCSP Cancer Program Manual and Resource References ~

The MCSP Cancer Program Manual and resource reference documents can be obtained from the

MCSP webpage at http://www.michigan.gov/mdhhs/0,5885,7-339-71551_2945_5221-16586--

,00.html.

Funding for the MCSP is made possible (in part) by the Centers for Disease Control and

Prevention. The views expressed in written conference materials or publications and by speakers

and moderators do not necessarily reflect the official policies of the State of Michigan

Department of Health and Human Services and the U.S. Department of Health and Human

Services, nor does the mention of trade names, commercial practices, or organizations imply

endorsement by the U.S. Government.