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Questions and Answers
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.
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.
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Which one of the following casefinding sources would be the best resource for identifying cases that were only confirmed clinically?
Which one of the following casefinding sources would be the best resource for identifying cases that were only confirmed clinically?
Which one of the following ambiguous terms would not be considered as diagnostic of cancer?
Which one of the following ambiguous terms would not be considered as diagnostic of cancer?
Which of the following cases do NOT meet the CoC case eligibility requirements?
Which of the following cases do NOT meet the CoC case eligibility requirements?
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Casefinding is the systematic method of identifying what?
Casefinding is the systematic method of identifying what?
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What is the resource that defines all diagnoses and types of cases that should be included and excluded from the registry database?
What is the resource that defines all diagnoses and types of cases that should be included and excluded from the registry database?
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Which of the following is a non-analytic case?
Which of the following is a non-analytic case?
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Which of the following class of case code ranges are NOT required by the CoC to be reported?
Which of the following class of case code ranges are NOT required by the CoC to be reported?
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Which of the following is NOT true about the analytic class of case codes?
Which of the following is NOT true about the analytic class of case codes?
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Which of the following scenarios would NOT be in the class of case 10-14 range?
Which of the following scenarios would NOT be in the class of case 10-14 range?
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Date of first contact is the date that what happens?
Date of first contact is the date that what happens?
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Which one of the following statements INCORRECTLY describes a case eligibility rule?
Which one of the following statements INCORRECTLY describes a case eligibility rule?
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Which of the following is an analytic case?
Which of the following is an analytic case?
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Which of the following cases are required by the CoC?
Which of the following cases are required by the CoC?
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Casefinding sources for central cancer registries include:
Casefinding sources for central cancer registries include:
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Which of the following cases are reportable to the CoC?
Which of the following cases are reportable to the CoC?
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Which one of the following statements is true about casefinding?
Which one of the following statements is true about casefinding?
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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.
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.
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Which of the following cases does NOT meet case eligibility criteria for inclusion into the registry?
Which of the following cases does NOT meet case eligibility criteria for inclusion into the registry?
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Which of the following cases do/does NOT meet(s) the CoC case eligibility criteria for inclusion into the registry?
Which of the following cases do/does NOT meet(s) the CoC case eligibility criteria for inclusion into the registry?
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Who must approve the registry procedure manual according to the CoC?
Who must approve the registry procedure manual according to the CoC?
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The five (or more) digits which follow the year in the accession number represent:
The five (or more) digits which follow the year in the accession number represent:
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Which of the following CoC retention time frames is incorrect?
Which of the following CoC retention time frames is incorrect?
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The procedure manual does not have to include which of the following areas of cancer program activities?
The procedure manual does not have to include which of the following areas of cancer program activities?
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A sequence number of 00 means:
A sequence number of 00 means:
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The first four digits of the accession number represent:
The first four digits of the accession number represent:
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Which of the following is true about the accession register?
Which of the following is true about the accession register?
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Which is not a main component of an abstract?
Which is not a main component of an abstract?
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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:
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:
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The data request log does not need to include which of the following?
The data request log does not need to include which of the following?
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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:
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:
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An abstract is created:
An abstract is created:
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If two cancers or two tumors are diagnosed at the same time, assign the lower sequence number to the one with the worst prognosis.
If two cancers or two tumors are diagnosed at the same time, assign the lower sequence number to the one with the worst prognosis.
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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:
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:
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The codes for Sequence Number are divided into two groups:
The codes for Sequence Number are divided into two groups:
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What is the hospital cancer registry's reference date?
What is the hospital cancer registry's reference date?
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The Commission on Cancer encourages programs to change their reference date to improve the facility's follow-up rate.
The Commission on Cancer encourages programs to change their reference date to improve the facility's follow-up rate.
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The patient index is not required to include which following item?
The patient index is not required to include which following item?
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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:
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:
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What types of cases are not required to be abstracted by the Commission on Cancer?
What types of cases are not required to be abstracted by the Commission on Cancer?
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It is discovered that a patient identified through casefinding is already in the cancer registry database. The cancer registrar should:
It is discovered that a patient identified through casefinding is already in the cancer registry database. The cancer registrar should:
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The patient identification section does not include which of the following?
The patient identification section does not include which of the following?
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Which one of the following is true about the suspense system?
Which one of the following is true about the suspense system?
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What does the cancer registry use to assess the outstanding workload?
What does the cancer registry use to assess the outstanding workload?
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Outcomes data items do not include which of the following?
Outcomes data items do not include which of the following?
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What are the major objectives of a cancer registry?
What are the major objectives of a cancer registry?
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Where is most of the information for the patient identification section found?
Where is most of the information for the patient identification section found?
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Cases should be abstracted from the suspense system starting with which of the following?
Cases should be abstracted from the suspense system starting with which of the following?
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What should the cancer registrar do if a patient has not started a portion of their recommended first course of treatment?
What should the cancer registrar do if a patient has not started a portion of their recommended first course of treatment?
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In order to determine possible causes of cancer, which abstracting section would be most vital to a study?
In order to determine possible causes of cancer, which abstracting section would be most vital to a study?
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Which organization publishes the primary data collection manual for hospital cancer registries?
Which organization publishes the primary data collection manual for hospital cancer registries?
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To promote complete and accurate data, the cancer registrar:
To promote complete and accurate data, the cancer registrar:
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When should abstracting always be done to ensure timeliness?
When should abstracting always be done to ensure timeliness?
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What forms the basis for most of the registry's functions?
What forms the basis for most of the registry's functions?
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Who determines the abstracting timeframe for a cancer registry?
Who determines the abstracting timeframe for a cancer registry?
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First course of treatment data items do not include which of the following?
First course of treatment data items do not include which of the following?
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Case administration data items do not include which of the following?
Case administration data items do not include which of the following?
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What time frame is not appropriate for completing an abstract?
What time frame is not appropriate for completing an abstract?
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A suspense list does not have to include which of the following?
A suspense list does not have to include which of the following?
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The cancer registry uses the ____________ to maintain cases identified on casefinding but not yet abstracted.
The cancer registry uses the ____________ to maintain cases identified on casefinding but not yet abstracted.
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Cancer identification data items do not include which of the following?
Cancer identification data items do not include which of the following?
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Which of the following is the purpose of Chapter 2 in the Optimal Resources for Cancer Care: 2020 Standards?
Which of the following is the purpose of Chapter 2 in the Optimal Resources for Cancer Care: 2020 Standards?
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The computer program that checks for conflicts between data items in the abstract is called:
The computer program that checks for conflicts between data items in the abstract is called:
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To ensure consistent and uniform data among all cancer registries, abstractors should:
To ensure consistent and uniform data among all cancer registries, abstractors should:
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Optimal Resources for Cancer Care: 2020 Standards contain how many different standards?
Optimal Resources for Cancer Care: 2020 Standards contain how many different standards?
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Which of the following statements is true for Standard 9.2 Commission on Special Studies?
Which of the following statements is true for Standard 9.2 Commission on Special Studies?
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Affiliating with professional organizations does not provide which of the following?
Affiliating with professional organizations does not provide which of the following?
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If there are errors in the NCDB data submission, resubmission of the corrected data is:
If there are errors in the NCDB data submission, resubmission of the corrected data is:
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The scope of operations of data management procedures does not include which of the following?
The scope of operations of data management procedures does not include which of the following?
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Which group is not involved in developing data edits?
Which group is not involved in developing data edits?
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Which of the following is not a standard setter?
Which of the following is not a standard setter?
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Which standard setter is focused on patient care?
Which standard setter is focused on patient care?
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Which of the following is not an example of a central registry?
Which of the following is not an example of a central registry?
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A data set is:
A data set is:
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Data for all analytic cases are submitted to the NCDB:
Data for all analytic cases are submitted to the NCDB:
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What percentage of follow-up rate is maintained for all analytic patients from the cancer registry reference date?
What percentage of follow-up rate is maintained for all analytic patients from the cancer registry reference date?
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To be compliant with Standard 4.3:
To be compliant with Standard 4.3:
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How many of the CoC Standards are eligible to receive a commendation from a successful site review?
How many of the CoC Standards are eligible to receive a commendation from a successful site review?
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The _____ enables accredited cancer programs to report data on patients concurrently and receive notifications of treatment expectations.
The _____ enables accredited cancer programs to report data on patients concurrently and receive notifications of treatment expectations.
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Standardization of data means that each data item has the:
Standardization of data means that each data item has the:
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Which standard-setting organization bases its data set on the goal of cancer control and surveillance?
Which standard-setting organization bases its data set on the goal of cancer control and surveillance?
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Non-credentialed cancer registry staff may abstract cancer cases under the supervision of a CTR.
Non-credentialed cancer registry staff may abstract cancer cases under the supervision of a CTR.
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Which of the following is not an early detection program?
Which of the following is not an early detection program?
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The cancer program must complete the PRQ how many days before the scheduled visit?
The cancer program must complete the PRQ how many days before the scheduled visit?
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Which is not one of the six areas of the cancer program to which a coordinator is assigned?
Which is not one of the six areas of the cancer program to which a coordinator is assigned?
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Which does not have to be included in the documentation of a quality study?
Which does not have to be included in the documentation of a quality study?
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Existing CoC Programs undergoing an accreditation review will receive a three-year accreditation with contingency when the program receives which of the following?
Existing CoC Programs undergoing an accreditation review will receive a three-year accreditation with contingency when the program receives which of the following?
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What percentage of eligible cancer pathology reports are structured using the synoptic reporting format?
What percentage of eligible cancer pathology reports are structured using the synoptic reporting format?
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For all eligible cases, what percent follow-up rate is maintained from the cancer registry reference date?
For all eligible cases, what percent follow-up rate is maintained from the cancer registry reference date?
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A Commission on Cancer accredited cancer program is required to complete the following number of quality studies annually:
A Commission on Cancer accredited cancer program is required to complete the following number of quality studies annually:
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Which of the following is not a supportive service?
Which of the following is not a supportive service?
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A Palliative Care Professional may serve as a member of the Cancer Committee but it is not a mandatory requirement.
A Palliative Care Professional may serve as a member of the Cancer Committee but it is not a mandatory requirement.
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When must the Pre-Review Questionnaire be provided to the Site Reviewer?
When must the Pre-Review Questionnaire be provided to the Site Reviewer?
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Each required cancer committee member or the member's designated alternate attends what percentage of the cancer committee meetings held each calendar year?
Each required cancer committee member or the member's designated alternate attends what percentage of the cancer committee meetings held each calendar year?
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The Cancer Committee does not monitor the following Cancer Conference activity:
The Cancer Committee does not monitor the following Cancer Conference activity:
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How often are CoC fully accredited programs surveyed?
How often are CoC fully accredited programs surveyed?
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What percentage of cancer conference cases must be presented prospectively?
What percentage of cancer conference cases must be presented prospectively?
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A three-year accreditation with contingency may be awarded to a new program when one to two standards are rated non-compliant.
A three-year accreditation with contingency may be awarded to a new program when one to two standards are rated non-compliant.
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The survey process allows the CoC on-site reviewer to understand which of the following?
The survey process allows the CoC on-site reviewer to understand which of the following?
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A review of services each calendar year applies to what number of standards?
A review of services each calendar year applies to what number of standards?
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Which of the following is not in the rating system of the CoC Cancer Program Accreditation Awards?
Which of the following is not in the rating system of the CoC Cancer Program Accreditation Awards?
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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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