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What is the class of case for the following scenario? 3/6/2010 Outpatient Surgery Center (owned by the reporting facility): Patient with 2-month history of rectal bleeding is recommended for colonoscopy. Biopsy of the sigmoid colon was consistent with adenocarcinoma. 3/17/2010 Inpatient Admission: Colon resection consistent with residual adenocarcinoma. Patient chooses to be seen at another hospital. Patient was treated with chemotherapy at the other hospital.

13

Which one of the following casefinding sources would be the best resource for identifying cases that were only confirmed clinically?

  • Radiation Oncology log
  • Medical Oncology log
  • Disease index (correct)
  • Pathology report

    • Which one of the following ambiguous terms would not be considered as diagnostic of cancer?

  • Most likely
  • Potentially malignant (correct)
  • Appears
  • Presumed

    • Which of the following cases do NOT meet the CoC case eligibility requirements?

    <p>A case diagnosed elsewhere and seen for a heart attack at your facility (E)</p> Signup and view all the answers

    Casefinding is the systematic method of identifying what?

    <p>All eligible cases that are to be included in the cancer registry database (C)</p> Signup and view all the answers

    What is the resource that defines all diagnoses and types of cases that should be included and excluded from the registry database?

    <p>Reportable list</p> Signup and view all the answers

    Which of the following is a non-analytic case?

    <p>The patient was diagnosed and treated for a malignancy elsewhere, and presents to your facility for treatment for recurrence or progression of disease. (B)</p> Signup and view all the answers

    Which of the following class of case code ranges are NOT required by the CoC to be reported?

    <p>Both D and E (E)</p> Signup and view all the answers

    Which of the following is NOT true about the analytic class of case codes?

    <p>They are cases first suspected or diagnosed with cancer at autopsy (A)</p> Signup and view all the answers

    Which of the following scenarios would NOT be in the class of case 10-14 range?

    <p>Diagnosed at the staff physician's office and they received their first course of treatment in the staff physician's office (D)</p> Signup and view all the answers

    Date of first contact is the date that what happens?

    <p>Date the patient was first physically seen at the facility for cancer diagnosis or treatment</p> Signup and view all the answers

    Which one of the following statements INCORRECTLY describes a case eligibility rule?

    <p>All tumors with a behavior code of /0 or /1 are reportable if diagnosed after 1/1/2004 (C)</p> Signup and view all the answers

    Which of the following is an analytic case?

    <p>The patient is diagnosed at your facility and sent elsewhere for treatment (A)</p> Signup and view all the answers

    Which of the following cases are required by the CoC?

    <p>A patient is diagnosed with invasive carcinoma of the cervix. (C)</p> Signup and view all the answers

    Casefinding sources for central cancer registries include:

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following cases are reportable to the CoC?

    <p>All of the above (E)</p> Signup and view all the answers

    Which one of the following statements is true about casefinding?

    <p>Multiple sources should be used for casefinding.</p> Signup and view all the answers

    What is the class of case for the following scenario? 7/19/2010 Patient has a transurethral ultrasound with biopsy in a non-staff physician's office. Biopsy of the prostate was consistent with adenocarcinoma. 8/7/2010 Radiation therapy center (owned by the reporting facility): Patient began radiation therapy for the prostate cancer. No other treatment is planned.

    <p>22</p> Signup and view all the answers

    Which of the following cases does NOT meet case eligibility criteria for inclusion into the registry?

    <p>Mass in right upper lobe of lung, worrisome for neoplasm (A)</p> Signup and view all the answers

    Which of the following cases do/does NOT meet(s) the CoC case eligibility criteria for inclusion into the registry?

    <p>Both B and D (A)</p> Signup and view all the answers

    Who must approve the registry procedure manual according to the CoC?

    <p>Cancer Committee</p> Signup and view all the answers

    The five (or more) digits which follow the year in the accession number represent:

    <p>The sequential order in which the patient was entered into the database for that year</p> Signup and view all the answers

    Which of the following CoC retention time frames is incorrect?

    <p>Abstracts can be destroyed one year after the patient expires (E)</p> Signup and view all the answers

    The procedure manual does not have to include which of the following areas of cancer program activities?

    <p>Budget for cancer conferences (C)</p> Signup and view all the answers

    A sequence number of 00 means:

    <p>The patient has one and only one malignant primary cancer (B)</p> Signup and view all the answers

    The first four digits of the accession number represent:

    <p>The year the patient was first seen at the facility (D)</p> Signup and view all the answers

    Which of the following is true about the accession register?

    <p>Numerical gaps are allowed. (D)</p> Signup and view all the answers

    Which is not a main component of an abstract?

    <p>Financial information (C)</p> Signup and view all the answers

    The cancer registry reference date is the effective date when cancer registration starts in a specified at-risk population or in a specific facility. The reference date is:

    <p>Most often January 1 (D)</p> Signup and view all the answers

    The data request log does not need to include which of the following?

    <p>Date registry initiated study (D)</p> Signup and view all the answers

    A patient was abstracted into the cancer registry database in 2008. In December 2009, the patient was diagnosed with a second primary. In January 2010, the patient returned for treatment of this primary and an abstract was prepared. The Accession Number should:

    <p>Not be changed or updated</p> Signup and view all the answers

    An abstract is created:

    <p>Both A and B (C)</p> Signup and view all the answers

    If two cancers or two tumors are diagnosed at the same time, assign the lower sequence number to the one with the worst prognosis.

    <p>True (A)</p> Signup and view all the answers

    A patient is diagnosed with a benign tumor of the brain at your facility. This is the only reportable tumor for this patient. The sequence number for this tumor will be:

    <p>60</p> Signup and view all the answers

    The codes for Sequence Number are divided into two groups:

    <p>Malignant/In Situ and Non-Malignant (C)</p> Signup and view all the answers

    What is the hospital cancer registry's reference date?

    <p>Date the registry database started</p> Signup and view all the answers

    The Commission on Cancer encourages programs to change their reference date to improve the facility's follow-up rate.

    <p>False (B)</p> Signup and view all the answers

    The patient index is not required to include which following item?

    <p>Social Security number (E)</p> Signup and view all the answers

    A patient is diagnosed with colon cancer and received all treatment at a different facility in 2008. In 2010, the patient comes to your facility for treatment of new, separate lung cancer. The sequence number for the lung cancer will be:

    <p>02</p> Signup and view all the answers

    What types of cases are not required to be abstracted by the Commission on Cancer?

    <p>Both A and C are correct (C)</p> Signup and view all the answers

    It is discovered that a patient identified through casefinding is already in the cancer registry database. The cancer registrar should:

    <p>All of the above (E)</p> Signup and view all the answers

    The patient identification section does not include which of the following?

    <p>Date of follow-up (D)</p> Signup and view all the answers

    Which one of the following is true about the suspense system?

    <p>It is used to track unabstracted cases. (D)</p> Signup and view all the answers

    What does the cancer registry use to assess the outstanding workload?

    <p>It can be used to assess the outstanding workload</p> Signup and view all the answers

    Outcomes data items do not include which of the following?

    <p>Date of first contact (D)</p> Signup and view all the answers

    What are the major objectives of a cancer registry?

    <p>All of the above (D)</p> Signup and view all the answers

    Where is most of the information for the patient identification section found?

    <p>Face sheet (B)</p> Signup and view all the answers

    Cases should be abstracted from the suspense system starting with which of the following?

    <p>The oldest cases first (D)</p> Signup and view all the answers

    What should the cancer registrar do if a patient has not started a portion of their recommended first course of treatment?

    <p>Indicate using special codes that the treatment was recommended but not yet started. (C)</p> Signup and view all the answers

    In order to determine possible causes of cancer, which abstracting section would be most vital to a study?

    <p>Demographics (D)</p> Signup and view all the answers

    Which organization publishes the primary data collection manual for hospital cancer registries?

    <p>CoC (A)</p> Signup and view all the answers

    To promote complete and accurate data, the cancer registrar:

    <p>Both B and C. (D)</p> Signup and view all the answers

    When should abstracting always be done to ensure timeliness?

    <p>First contact in date order (B)</p> Signup and view all the answers

    What forms the basis for most of the registry's functions?

    <p>Abstract (E)</p> Signup and view all the answers

    Who determines the abstracting timeframe for a cancer registry?

    <p>Policies &amp; Procedures (A)</p> Signup and view all the answers

    First course of treatment data items do not include which of the following?

    <p>Diagnostic confirmation (D)</p> Signup and view all the answers

    Case administration data items do not include which of the following?

    <p>Who assigned the AJCC stage (A)</p> Signup and view all the answers

    What time frame is not appropriate for completing an abstract?

    <p>Seven months (C)</p> Signup and view all the answers

    A suspense list does not have to include which of the following?

    <p>Histology (C)</p> Signup and view all the answers

    The cancer registry uses the ____________ to maintain cases identified on casefinding but not yet abstracted.

    <p>Suspense System</p> Signup and view all the answers

    Cancer identification data items do not include which of the following?

    <p>AJCC stage (D)</p> Signup and view all the answers

    Which of the following is the purpose of Chapter 2 in the Optimal Resources for Cancer Care: 2020 Standards?

    <p>Address the responsibility of the cancer program and the medical staff. (C)</p> Signup and view all the answers

    The computer program that checks for conflicts between data items in the abstract is called:

    <p>Edits (A)</p> Signup and view all the answers

    To ensure consistent and uniform data among all cancer registries, abstractors should:

    <p>Apply the coding manuals provided by each governing agency. (A)</p> Signup and view all the answers

    Optimal Resources for Cancer Care: 2020 Standards contain how many different standards?

    <p>38 (B)</p> Signup and view all the answers

    Which of the following statements is true for Standard 9.2 Commission on Special Studies?

    <p>The CoC will design the study. (C)</p> Signup and view all the answers

    Affiliating with professional organizations does not provide which of the following?

    <p>Volunteers to help you at your facility (C)</p> Signup and view all the answers

    If there are errors in the NCDB data submission, resubmission of the corrected data is:

    <p>Required and must be submitted by the deadline specified. (C)</p> Signup and view all the answers

    The scope of operations of data management procedures does not include which of the following?

    <p>Membership in the professional organization (A)</p> Signup and view all the answers

    Which group is not involved in developing data edits?

    <p>NCRA (E)</p> Signup and view all the answers

    Which of the following is not a standard setter?

    <p>NCRA (E)</p> Signup and view all the answers

    Which standard setter is focused on patient care?

    <p>CoC (A)</p> Signup and view all the answers

    Which of the following is not an example of a central registry?

    <p>A hospital registry (E)</p> Signup and view all the answers

    A data set is:

    <p>The group of data items required by a standard setting organization (A)</p> Signup and view all the answers

    Data for all analytic cases are submitted to the NCDB:

    <p>Annually (B)</p> Signup and view all the answers

    What percentage of follow-up rate is maintained for all analytic patients from the cancer registry reference date?

    <p>80% (C)</p> Signup and view all the answers

    To be compliant with Standard 4.3:

    <p>All of the above (D)</p> Signup and view all the answers

    How many of the CoC Standards are eligible to receive a commendation from a successful site review?

    <p>None (D)</p> Signup and view all the answers

    The _____ enables accredited cancer programs to report data on patients concurrently and receive notifications of treatment expectations.

    <p>Rapid Quality Reporting System (RQRS) (C)</p> Signup and view all the answers

    Standardization of data means that each data item has the:

    <p>All of the above (D)</p> Signup and view all the answers

    Which standard-setting organization bases its data set on the goal of cancer control and surveillance?

    <p>NPCR (B)</p> Signup and view all the answers

    Non-credentialed cancer registry staff may abstract cancer cases under the supervision of a CTR.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is not an early detection program?

    <p>Smoking cessation (B)</p> Signup and view all the answers

    The cancer program must complete the PRQ how many days before the scheduled visit?

    <p>30 days (A)</p> Signup and view all the answers

    Which is not one of the six areas of the cancer program to which a coordinator is assigned?

    <p>Cancer committee (C)</p> Signup and view all the answers

    Which does not have to be included in the documentation of a quality study?

    <p>Members working on the study (B)</p> Signup and view all the answers

    Existing CoC Programs undergoing an accreditation review will receive a three-year accreditation with contingency when the program receives which of the following?

    <p>One to seven deficiencies at the time of survey (D)</p> Signup and view all the answers

    What percentage of eligible cancer pathology reports are structured using the synoptic reporting format?

    <p>90% (A)</p> Signup and view all the answers

    For all eligible cases, what percent follow-up rate is maintained from the cancer registry reference date?

    <p>80% (B)</p> Signup and view all the answers

    A Commission on Cancer accredited cancer program is required to complete the following number of quality studies annually:

    <p>At least one quality study (B)</p> Signup and view all the answers

    Which of the following is not a supportive service?

    <p>Breast care education (B)</p> Signup and view all the answers

    A Palliative Care Professional may serve as a member of the Cancer Committee but it is not a mandatory requirement.

    <p>True (A)</p> Signup and view all the answers

    When must the Pre-Review Questionnaire be provided to the Site Reviewer?

    <p>30 days prior to the scheduled visit (B)</p> Signup and view all the answers

    Each required cancer committee member or the member's designated alternate attends what percentage of the cancer committee meetings held each calendar year?

    <p>75% (C)</p> Signup and view all the answers

    The Cancer Committee does not monitor the following Cancer Conference activity:

    <p>Annual budget (A)</p> Signup and view all the answers

    How often are CoC fully accredited programs surveyed?

    <p>3 years (C)</p> Signup and view all the answers

    What percentage of cancer conference cases must be presented prospectively?

    <p>80% (E)</p> Signup and view all the answers

    A three-year accreditation with contingency may be awarded to a new program when one to two standards are rated non-compliant.

    <p>True (A)</p> Signup and view all the answers

    The survey process allows the CoC on-site reviewer to understand which of the following?

    <p>All of the above (E)</p> Signup and view all the answers

    A review of services each calendar year applies to what number of standards?

    <p>12 (C)</p> Signup and view all the answers

    Which of the following is not in the rating system of the CoC Cancer Program Accreditation Awards?

    <p>Provisional accreditation (D)</p> Signup and view all the answers

    Study Notes

    Case Classifications and Eligibility

    • Class of Case 13: Initial diagnosis at the reporting facility with part of first course treatment at another facility.
    • Analytic Cases: Diagnosed and/or treated at the facility and required for follow-up.
    • Non-analytic Cases: Diagnosed and treated elsewhere with subsequent treatment at the facility for recurrence.
    • Eligibility Requirements: Includes cases diagnosed at your facility but not treated, and excludes cases seen for non-cancer issues (e.g., heart attack).

    Casefinding and Resources

    • Best Source for Clinical Confirmations: Disease index is crucial for identifying clinically confirmed cases.
    • Casefinding: A systematic method to identify all eligible cases for the cancer registry.
    • Sources for Casefinding: Physician offices, pathology labs, and death certificates.

    Diagnostic Terms

    • Ambiguous Diagnostic Terms: "Potentially malignant" does not indicate a cancer diagnosis compared to more definitive terms.

    Accession Numbering

    • Accession Number Structure: The year a patient is first seen is indicated by the first four digits; the next digits represent the sequential order in which the patient was entered.
    • Sequence Numbers: Code '00' indicates one malignant primary cancer; '60' indicates a non-malignant tumor.

    Registries and Abstracts

    • Registry Reference Date: Typically set as January 1, marking when cancer registration begins at a facility.
    • Abstract Requirements: Must be created for all reportable cases and for each independent primary cancer diagnosed in the same patient.
    • Components of an Abstract: Includes the stage of disease, first course of treatment, and patient identification, but not financial information.

    CoC Regulations and Retention

    • CoC Reporting Requirements: Certain cancers, like invasive cervix cancer, must be reported; others, like CIS, can be excluded.
    • Retention of Documents: Cancer Conference documentation and meeting minutes must be retained for five years.
    • Eligibility for Inclusion: Specific cases, like those with ambiguous diagnoses, are not eligible for registry inclusion.

    Workflow and Data Management

    • Patient Identification Section: Should include vital details like date of birth and race but not the date of follow-up.
    • Outcome Data: Includes cancer status, date of last contact, and first recurrence but excludes initial contact information.
    • Suspense System Purpose: Used to assess outstanding workload of the registry and track reportable cases.

    Case Updates and Follow-up

    • Identifying Existing Cases: When a patient already exists in the registry, registrars should update information related to existing records or add new diagnoses if applicable.
    • Registry Maintenance: Continuous updates and accurate data entry are essential for maintaining an effective cancer registry.

    Handling Incomplete Information

    • Incomplete Treatments: If treatment has not commenced, registrars may code this in the registry database to reflect the situation accurately.

    Research and Quality Control

    • Quality Control Programs: Ensuring high-quality data is crucial for registries, emphasizing reliability in cancer data collection and reporting.

    Miscellaneous

    • Ambiguous Terms and Definitions: Clear understanding of terms like "suspense system" and "casefinding" is vital for accuracy in cases and registry operations.
    • Reportable Cases to CoC: Any diagnosed malignancy at the facility requires adherence to reporting standards established by the CoC.### Abstract Guidelines
    • Wait until all necessary information is gathered before marking the abstract as complete, regardless of exceeding a 6-month deadline.
    • Use special codes to indicate when treatment is recommended but not yet started before marking the abstract complete.

    Importance of Demographics

    • Demographics section is essential in studies investigating cancer causes, including environmental exposures.

    Primary Data Collection Manual

    • The Commission on Cancer (CoC) is responsible for publishing the primary data collection manual for hospital cancer registries.

    Data Accuracy

    • Cancer registrars must gather information from various sources, including contacting treating physicians and other healthcare facilities to ensure complete data collection.

    Timeliness of Abstracting

    • Abstracting should be conducted in date order based on the first contact to maintain timeliness.

    Registry Function Basis

    • The abstract forms the basis for most cancer registry functions, guiding data collection and reporting.

    Abstracting Timeframe Regulation

    • The cancer registry's abstracting timeframe is determined by Policies & Procedures, annually reviewed and approved by the Cancer Committee.

    First Course of Treatment Items

    • Diagnostic confirmation is not included in the first course of treatment data items, which encompass therapies like chemotherapy and radiation.

    Case Administration Data Items

    • "Who assigned the AJCC stage" is excluded from case administration data items.

    Appropriate Abstract Completion Timeframe

    • Seven months is too long; any extended timeframe beyond established limits is inappropriate for completing an abstract.

    Suspense List Requirements

    • Histology is not required information on the suspense list, which tracks cases awaiting abstraction.

    Case Maintenance

    • The Suspense System helps cancer registries manage cases identified through casefinding that have not yet been abstracted.

    Cancer Identification Data Items

    • AJCC stage is not classified as a part of cancer identification data items, which assess laterality and histology.

    Purpose of Standards for Cancer Care

    • Chapter 2 in the Optimal Resources for Cancer Care: 2020 Standards focuses on establishing responsibilities for quality care improvement between cancer programs and medical staff.

    Conflict Checking Program

    • "Edits" is the computer tool used to verify data consistency, ensuring accuracy in recorded cancer cases.

    Consistent Data Collection

    • Abstractors must apply coding manuals from governing agencies consistently across reportable cases to ensure uniform data collection.

    Number of Standards

    • The Optimal Resources for Cancer Care: 2020 Standards consist of 38 distinct standards.

    Commission on Special Studies

    • The CoC is responsible for designing studies associated with Standard 9.2 related to special studies.

    Benefits of Professional Affiliations

    • Affiliating with professional organizations provides networking and educational opportunities but does not guarantee volunteers assistance.

    Data Resubmission Policy

    • Error correction in NCDB data submissions is mandatory, with resubmissions due by specified deadlines set by the CoC.

    Data Management Operations Scope

    • Membership in professional organizations is not included within the operations scope of data management procedures.

    Data Edits Development

    • NCRA is not involved in the development of data edits; other organizations like SEER and NAACCR participate.

    Patient Care Focus

    • The Commission on Cancer (CoC) emphasizes patient care in its standards compared to other organizations.

    Central Registries

    • A hospital registry is not classified as a central registry; central registries include NPCR, NCDB, and SEER.

    Definition of Data Set

    • A data set is defined as the collection of required data items specified by standard-setting organizations.

    NCDB Submission Frequency

    • Facilities submit data on analytic cases to the NCDB annually.

    Follow-Up Rate

    • An 80% follow-up rate is maintained for all analytic patients starting from the cancer registry reference date.

    Standard Compliance Requirements

    • Compliance with Standard 4.3 necessitates that abstracting is done by a Certified Tumor Registrar or supervised non-credentialed staff.

    Accreditation Standards

    • Existing CoC programs can receive a three-year accreditation with contingency if they have one to seven deficiencies at the time of survey.

    Synoptic Reporting Format Compliance

    • 90% of eligible cancer pathology reports must use the CAP's required synoptic reporting format.

    Quality Study Requirements

    • CoC accredited cancer programs are required to conduct at least one quality study annually.

    Supportive Services

    • Breast care education is not categorized as a supportive service compared to grief counseling and nutritional counseling.

    Palliative Care Committee Membership

    • Palliative Care Professionals may serve on the Cancer Committee but are not required to do so.

    Pre-Review Questionnaire Timeline

    • The Pre-Review Questionnaire must be submitted to the Site Reviewer 30 days before a scheduled visit.

    Cancer Committee Meeting Attendance

    • Each cancer committee member or designated alternate is expected to attend 75% of meetings each year.

    Cancer Conference Monitoring

    • Annual budget discussions are not monitored by the Cancer Committee in cancer conference activities.

    Accreditation Review Frequency

    • CoC fully accredited programs undergo evaluation every three years.

    Prospectively Presented Cases

    • 80% of cases presented in cancer conferences must be prospective.

    Non-Compliance Contingency

    • A new program may be awarded three-year accreditation with contingency if one or two standards are flagged as non-compliant.

    On-Site Review Insights

    • The onsite review process provides insights into clinical care, data accuracy, and overall care quality improvement.

    Standards Review Frequency

    • A comprehensive review of services must address 12 standards annually.

    Accreditation Rating System

    • Provisional accreditation is not included in the CoC Cancer Program Accreditation Awards rating system.

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