Cancer Registry B
Standard 1.7
Monitoring Cancer Conference Activity The cancer conference coordinator monitors the cancer conference program annually and reports conference activity to the cancer committee each year.
Standard 1.8
Monitoring Community Outreach The community outreach coordinator monitors the community outreach program annually, prepares the community outreach activity summary, and shares the report with the cancer committee each year.
What national association for registries certifies central cancer registries
NAACCR
Has business agreements with hospital registries
NCDB
Patient's name and accession # are sent to ______ during national case transmittal
NCDB
Submit data to once a year.
NCDB
Where do CoC accredited facilities submit their data?
NCDB
After a series of tests was performed on a sample of tissue removed while the patient was under anesthesia, the patient was diagnosed as having cancer. Would you say this patient received treatment?
NO. A biopsy is a diagnostic technique - an aid in identifying the disease, not in treating it. Removal of a portion of a tumor for diagnosis is called and incisional biopsy.
NETS
NPCR Education and Training Series
NCDB
National Cancer Database
SEER registries cannot submit to NCDB they submit to
National Cancer Institue (NCI)
NCi
National Cancer Institure's
NCPCP
National Cancer Prevention and Control Program
NCRA
National Cancer Registrars Association
NCCDPHP
National Center for Chronic Disease Provention and Health Promotion
NCCCP
National Comprehensive Cancer Control Program
NIEHS
National Institute of Environmental and Health Sciences
NPCR
National Program for Cancer Registries
NPCR
National Program of Cancer Registries
NACRS
National ambulatory care reporting system
NRTRS
Navy regional tumor registry supervisor
NTRC
Navy tumor registry consultant
A term meaning "new growth"
Neoplasm
Benign neoplasm
Noncancerous tumor Harmful tumor - is an option as sometimes benign tumors can be harmful.
Fat necrosis is common in:
Obese women
Meaningful Use
Objectives for the use of the EHR: improve safety/quality/reduce health disparities engage patints improve care coordinator improve population and public health ensure privacy and security protections for personal health information
Passive casefinding
Occurs when other depts notify the registrar of potentially reportable cases. a concern with passive is that non-registry staff are not as familiar with reporting criteria and terminology so potential cases may be missed & incomplete casefinding may occur. non-registry staff reporting: not as familiar with tech, incomplete casefinding
The National Cancer Registries Amendment Act was passed in
October 1992
Inflammatory Carcinoma
Orange peel (peau d'orange) appearance of skin thickening of the breast
The term designating a malignant neoplasm of the bone.
Osteosarcoma
Mass seen close to marker on CC view is in what area?
Outer Quadrant (OQ)
All commendations at survey=
Outstanding Achievment Award
Precocious puberty causes (before 8 y/o)
Ovarian cyst, hypothyroidism, or adrenal gland tumor
THE TOTAL NUMBER OF CASES OF CANCER IN A POPULATION AT A GIVEN POINT IN TIME
PREVALENCE
THE P VALUE
PROBABILITY THAT A DIFFERENCE AS LARGE AS THEAT OBSERVED WOULD OCCUR BY CHANCE ALONE
A STUDY THAT BEGINS COLLECTING CASES AT A GIVEN STARTING POINT AND STOPS COLLECTING CASES AT A SPECIFIC POINT IN THE FUTURE
PROSPECTIVE
Standard 2.4 Palliative Care Services.
Palliative care services are available to patients either on-site or by referral.
Which tumor would most likely be found in the postmenopausal patient?
Papillary carcinoma (Usually complex mass, shadowing not usually seen, reactive fibrosis is not common)
Standard 5.2 Rapid Quality Reporting System (RQRS).
Participation From initial enrollment and throughout the three-year accreditation period, the program participates in RQRS, submits all eligible cases for all valid performance measures, and adheres to RQRS terms and conditions.
Casefinding sources
Path, Rad oncology, surgery schedules and reports, out patient dept. disease diagnosis index rad report
Standard 3.1
Patient Navigation The cancer committee assesses the community to identify barriers to care, provides navigation services either on-site or by referral or in partnership with local or national organizations, and assesses and reports on the process annually. The assessment is documented.
PCP
Pediatric Cancer Program
PCPC
Pediatric Cancer Program Component
The facility provides care to only children. No minimum caseload
Pediatric cancer program
What tumor is considered the malignant counterpart of the benign fibroadenoma?
Phyllodes
Standard 1.1
Physician Credentials Physicians are currently board certified or in the process of certification.
E5: Cancer Registry
Policy and Procedure The cancer registry policy and procedure manual is used and specifies that current CoC data definitions and coding instructions are used to describe all reportable cases. The cancer registry policy and procedure manual is used and specifies that current CoC data definitions and coding instructions are used to describe all reportable cases.
Tamoxifen
Popular treatment of Breast CA, also linked to Endometrial CA
what are the 2 main types of central cancer registries
Population based & multi hospital or Nonpopulation based
Which best describes cancer registries in other countries
Population based surveillance registries
Colloid carcinoma
Postmenopausal, slow-growing breast CA composed of a gelatinous substance
During Biopsy its important to document
Pre-scan localizing the mass, Pre-fire, Post-fire
Standard 4.1
Prevention Program Each year, 1 prevention program is offered to address the needs of the community and reduce the incidence of a specified cancer type.
When metastasis occurs, we know that the cancer has spread from the ___ ___ and a secondary site is involved by cancer.
Primary Site
______ defines the permissible means of access, use and disclosure of patient information
Privacy
Gynecomastia
Proliferation of subcutaneous fat and fibroglandular tissue in the male breast aka Breast enlargement in MEN
Right now
Prospective
PHAC
Public health agency of canada
Standard 4.8
Quality Improvements Each year, 2 improvements in patient care are implemented.
E7: Radiation Oncology Services
Radiation treatment service locations are currently accredited by a recognized authority or, if not accredited, follow standard quality assurance practices. Services are available either on-site, at locations that are facility owned, or by referral.
Cancer mortality rate
Rate at which persons in the general population die of cancer during a specified time period. Provides a measure of the risk of death attributable to a disease in a population.
Registrars working for the army,navy,or air forces using ACTUR have what kind of access to cancer patients within the DOD
Read-only
What level of protection is needed for confidential health information within organization
Reasonable protection
Linking all patients from a certain small area with same type of cancer
Record linkage
Characteristics of a simple cyst
Round or oval, anechoic, and thin edge shadows
*collects data on routine basis from designated population cancer registries. *the geographic areas represent 26% of US population & based on demographic & epidemiologic factors *TRENDS in cancer incidence, mortality, & patient survival in US derived from this database
SEER
Which agency collects population data for calculating cancer rates?
SEER
Word Root: Cyst
Sac, bladder, or cysts
List steps to prepare a central registry file
See attached
What are 6 measures evaluated by the clinical checks?
See attached
When data is combined, which 2 agencies are able to provide data covering 100% of U.S. Population
Seer and NPCR
ACOS/COC
Sets the standards for accreditation of clinical cancer programs and requires a cancer registry as part of an accredited cancer program.
Echo-palpation
Simultaneous palpation with scanning
Word Root: Myx
Slime, glue-like
Word Root: Lei
Smooth
Best method to visualize pseudo capsule of a benign lesion
Sound beam perpendicular to lesion
Which technique would eliminate useful artifacts like post enhancement and shadowing?
Spatial compound imaging
Improves visualization of superficial lesion
Stand off pad Transducer pressure multiple focal zones NOT lower frequency
SNODU stands for
Standard Nomenclature of Disease Operations
State Legislation
State legislation requires a mechanism whereby malignant and some benign neoplasms are reported to the State Central Registry. State laws do NOT require that hospitals develop and maintain a cancer registry.
Standard 4.7
Studies of Quality Each year, 2 studies of cancer patient care quality and outcomes are conducted.
Most common location for a malignant breast tumor in a male is?
Subareolar area
Childhood cancer Treatment options include:
Surgery, radiation therapy, chemotherapy, and other types of treatments. -Childhood cancers generally respond well the chemo b/c they tend to be cancers that grow fast. - Radiation can often cause more serious side effects in children.
MALIGNANCIES OF THE OROPHARYNX ARE MOST OFTEN FOUND IN
THE MIDDLE PART OF PHARYNX BEHIND MOUTH 1/3 TONGUE SOFT PALATE SIDE/BACKWALLS THROAT TONSILS
American College of Surgeons Commission on Cancer (ACoS, CoC)
The ACoS initially surveyed and approved cancer clinics. These clinics maintained cancer registries. As hospitals developed their own cancer registries, they were a required part of the CoC approved cancer programs. We will discuss this in greater detail in a later topic.
QUALITY IMPROVEMENT MEASURES
The CoC requires the cancer committee to review the quality of patient care using CoC quality reporting
ACCOUNTABILITY MEASURE
The CoC requires the cancer committee to review the quality of patient care using CoC quality reporting tools appropriate to the patients who are treated by the program each year
EUROCARE
The European cancer registry based study on survival and care of cancer patients, a cancer epidemiology research project on survival of chancre patients in europe
ACOS was the forerunner of
The Joint Commission
CPAC
The agency that brought a renewed focus on cancer surveillance directed at national cancer-control strategy development
IARC
The agency that coordinates cancer research across countries and organizations; has been instrumental in describing the global burden of cancer in publications and databases
Standard 3.3 Survivorship Care Plan.
The cancer committee develops and implements a process to disseminate a comprehensive care summary and follow-up plan to patients with cancer who are completing cancer treatment. The process is monitored, evaluated, and presented at least annually to the cancer committee and documented in minutes.
Standard 3.2 Psychosocial Distress Screening.
The cancer committee develops and implements a process to integrate and monitor on-site psychosocial distress screening and referral for the provision of psychosocial care.
Standard 1.7 Monitoring Conference Activity.
The cancer conference coordinator monitors and evaluates the cancer conference activities and reports findings to the cancer committee at least annually.
STANDARD 1.8 MONITORING COMMUNITY OUTREACH
The community outreach coordinator monitors the effectiveness of community outreach activities on an annual basis. The activities and findings are documented in a community outreach activity summary that is presented to the cancer committee annually
Standard 1.8 Monitoring Community Outreach.
The community outreach coordinator monitors the effectiveness of community outreach activities on an annual basis. The activities and findings are documented in a community outreach activity summary that is presented to the cancer committee annually.
National cancer incidence reporting system
The first incidence reporting system in Canada; was an event-based data collection system covering the period of 1969-1991, with a standard eat of requirements for the p/t agencies that supplied data
1969
The first year of cancer incidence data collection in canada
Walter reed army medical center
The location of the DoD central cancer registry
STANDARD 1.2 CANCER COMMITTEE MEMBERSHIP
The membership of the cancer committee is multidisciplinary, representing physicians from the diagnostic and treatment specialties and non physicians from administrative and supportive services. Coordinators who are responsible for specific areas of program activity are designated from the membership
Standard 1.2 Cancer Committee Membership.
The membership of the cancer committee is multidisciplinary, representing physicians from the diagnostic and treatment specialties and non-physicians from administrative and supportive services. Coordinators who are responsible for specific areas of program activity are designated from the membership.
Pediatric Cancer Program Component
The pediatric component within a larger facility accessions a minimum of 50 newly diagnosed pediatric cancer cases each year. The program may be associated with a medical school and participate in training pediatric residents
E1: Facility Accreditation
The program is accredited by a recognized federal, state, or local authority appropriate to the facility type.
Standard 5.7 Commission on Cancer Special Studies.
The program participates in special studies as selected by the Commission on Cancer.
the world health organization classification of hematopoietic & lymphoid neoplasm is based on the underlying concepts of which previous classification system
The revised European American Lymphoma (REAL) Classification
Healthcare Portability and Accountability Act (HIPAA)
This act mandates that covered entities keep the individual's information private. In addition it mandates that, under certain circumstances, release of the information must be authorized. Cancer surveillance data is an exception to this rule if it is required by state law.
National Cancer Registrars Association
This is the nonprofit professional association for cancer registrars.
American Health Information Management Association
This is the nonprofit professional association for health information management professionals.
Surveillance, Epidemiology, and End Results (SEER) Program
This program was established after, and as a result of, the National Cancer Act 1971 which is an ongoing effort of the National Cancer Institute (agency of the US Department of Health and Human Services). SEER operates population-based cancer registries in several geographic areas of the country that cover about 30% of the US population. SEER is an authoritative source of information on cancer incidence and survival in the United States.
Word Root: Fibr
Thread-like, fibers
0 commendations or 1 or more resolved deficiences at survey=
Three year reaccreditation
0 deficiencies and 1 or more commendations at survey=
Three year reaccreditation with commendation
Health registries are developed
To address a specified need and may included cases based upon: geographic area diagnostic setting frequency incidence prevalence or other criteria
TRAM
Transverse Rectus Abdomins Myocutaneous
Immunotherapy
Treatment by stimulating the body's own defense mechanism against disease or supplying antibodies and/or other missing molecules in a deficient immune system
Chemotherapy
Treatment using chemicals in cancer therapy
A deficiency is defined as any standard with a rating of 5. Select one: True False
True
Cancer ID contains data on primary site, histology and behavior
True
Documentation of all submissions to both the central registry and the NCDB should be maintained on file in the cancer registry
True
T or F The TNM staging system describes the anatomic extent of cancer at the time of the initial diagnosis and before the application of definitive treatment
True
True or False: An alphanumeric system of categories means a mixture of letters of the alphabet and numeric digits.
True
True or False: The morphology section of ICD-O is based on the histologic terms in the International Classification of Tumors series.
True
True or False: The principal change in the morphology section of ICD-O-2 is the Non-Hodgkin's Lymphoma section.
True
True or False: ICD-O-2 does not use all the malignant rubrics of ICD-10.
True -- It only uses the rubrics from C00-C80 as the other categories are for histologic entities - lymphomas, leukemia etc. that are coded in the morphology section of ICD-O-2.
Some statistics indicate an abstractor can produce 1 case per hour, with 15 minutes additional per case for case finding, follow up and administrative tasks. T or F
True.
Breast Carcinomas include:
Tubular, Mucinous, Medullary carcinomas
Treatments for childhood cancers are chosen based on
Type and stage of the cancer
USCS
US cancer statistics
Malignant tumor of the kidney in children:
Wilm's tumor
introduced the ICD-10 in 1993 will be implemented in 2014 always implemented on 10/1 of the year in the health information systems
World Health Organization (WHO)
descriptive epidemiology
a comparative analysis of incidence rates (by age group, gender and race/ethnicity)
cancer surveillance
a complex system that captures longitudinal data from multiple and varying data sources using a variety of methods
class of case
a data item and concept used by hospital-based registries to denote whether the case was diagnosed and/or treated at the reference hospital, or has received treatment previously elsewhere
limited data set
a data set that does NOT include any of the following: name, street address, phone/fax numbers, email addresses, SSN, certificate or license numbers, VINs, URLs or IP addresses, full face photos, medical record numbers, health beneficiary numbers, other account numbers, devise identifiers or serial numbers, and biometric identifiers
Abstract
a data summary
reportable list
a list that should include all diagnoses that are to be reported and that specify which diagnoses are not reportable
university of washington physicians network
a nonprofit primary care delivery system in Seattle with nine clinics linked by a computerized networked clinical info system; initiated a diabetes management program in collaboration with the institute for healthcare improvement
World Trade Center Health Registry
a partnership with the NYC Health Department, this registry was established in 2002 to monitor over a 20-year period the physical and mental health of people most directly exposed to the events of 9/11
Death clearance is a function of
a population-based registry
Hospital Comparison Benchmark Reports
a report by NCDB that provides authorized uses at ACoS/CoC accredited cancer programs data to pull their own reports on: - data reported to the NCDB from their own registry - aggregated data - a comparative report that contains data reported from the users
A metafile contains everything necessary to edit the data, except the data. Select one: a. True b. False
a. True
Viruses, worms, and spyware are examples of computer malware. Select one: a. True b. False
a. True
Write in the names of the three germ layers corresponding to their relative position to one another in the embryo. a. Inner layer b. Middle layer c. Outer layer
a. endoderm b. mesoderm c. ectoderm
The three edit components are: Select one: a. metafile, edit set, and individual edits b. metafile, genedits, genedits plus c. metafile, genedits, and individual edits
a. metafile, edit set, and individual edits
Remission
abatement of the symptoms of a disease
circuit riders
abstractors who are employed by the central registry to visit reporting facilities and perform casefinding and abstracting of data in the field
ACAD
academic comprehensive cancer program
5 characteristics of data quality
accuracy-visual review, edit checks case completeness-casefinding audit data completeness-edit checks, COC survey timeliness-CoC survey consistency-CoC studies
The case ascertainment method where registry personnel screen source documents to identify reportable cases is referred to as
active casefinding
AAIR
age-adjusted incidence rates
A biopsy that removes the entire tumor is coded as
an excisional biopsy
TJC
an independant, non-profit, organization to accredit healthcare organizations.
WONDER
an online data query and report system that has been supported by CDC for many years
National Institute of Arthritis and Musculoskeletal and Skin Dieseases
an organization that supports a number of patient research registries: Alopecia Areata, Ankylosing Spondylitis, Juvenile Rheumatoid Arthritis, Lupus, Muscular Dystrophy, Neonatal Lupus, Rheumatoid Arthritis, and Scleroderma
Characteristics of a malignant mass
angular margins post shadowing taller than wide
Best sonographic evaluation of breast augmentation includes scanning:
anterior to implant edges of implant internal compartment of implant
Alpha-fetoprotein (AFP)
antigen for: hepatoma, germ cell carcinoma of the testes, small cell carcinoma of the lung
Reverberation
artifact seen as multiple parallel lines in the anterior part of the cyst
NCDB is located
at the ACoS and requires data from all the accredited cancer programs.
Quality control begins
at the time of abstracting
Major changes to registry data changes by standard setters are instituted every __ year(s). Select one: a. 2 b. 3 c. single
b. 3
The two organizations responsible for teh development of the Edits software are: Select one: a. UDSC and AACCR b. CDC and NPCR c. NCRA and CoC d. NCRA and UDSC
b. CDC and NPCR
A hospital with an ACoS-approved cancer program is not required to maintain a cancer registry. Select one: a. True b. False
b. False
Hospitals are responsible to identify the list of ICD-9-CM codes that are mandatory to include on the disease index file to meet state reporting requirements. Select one: a. True b. False
b. False
Inpatient and outpatient admission and discharge reports are not useful, since they do not contain any information of clinical or pathological diagnosis of cancer. Select one: a. True b. False
b. False
Monitoring the volume of casefinding sources by facility by year is sufficient for ensuring complete reporting of casefinding source records. Select one: a. True b. False
b. False
Only population-based registries are required to perform casefinding. Select one: a. True b. False
b. False
The CoC provides marketing information to local media for each CoC-accredited program. Select one: a. True b. False
b. False
The disease index is the primary casefinding source used by central registries to identify incident cases. Select one: a. True b. False
b. False
The first coding rules and guidelines were established in 1971. Select one: a. True b. False
b. False
The minimum requirements for ACoS cancer program accreditation were first published in 1933. Select one: a. True b. False
b. False
The survey process is the same for every facility. Select one: a. True b. False
b. False
Logical comparison between data entered in one field and data entered in another field is a(n): Select one: a. Allowable range check b. Inter-field check c. Inter-record check d. Inter-database check
b. Inter-field check
A __________ provides a redundant backup power supply to protect computers in the even of a power surge or temporary power outage. Select one: a. DMZ b. UPS c. RAID d. VPN
b. UPS
Massachusetts Cancer Registry
began in 1926; designed to establish cancer clinics throughout the state under the direction of Dr. Herbert Lombard; they published one of the first studies linking oral cancer and the use of tobacco
Agricultural Health Study
began in 1994; gathers information about the health of pesticide applicators and their families in Iowa and North Carolina
Jewett staging
bladder cancer
Where is the hypothalamus is located:
brain
Cathepsin-D
breast
Alpha-lactalbumin
breast cancer
CA-15-3
breast carcinoma
The mucous membrane lining the inner checks is called the
buccal mucosa
Montgomery's glands
bumps along the margin of the areola (lubricating glands)
Which data format(s) are recommended by NAACCR to laboratories for reporting pathology report text information electronically to central registries? Select one: a. HL7 b. Pipe-delimited c. Both a and b d. Neither a nor b
c. Both a and b
Source documents used for case ascertainment include: Select one: a. Operative reports b. Progress notes c. Disease indices d. Physician logs
c. Disease indices
What are two advantages of increasing interoperability of registry data? Mark two choices. Select one or more: a. It reduces the need for federal funding of central registries. b. It protects registry data from unauthorized use. c. It enhances the central registry 's ability to automatically incorporate data from other sources. d. It ensures researchers learn complex registry data coding standards. e. It makes it easier for researchers and others to utilize registry data.
c. It enhances the central registry 's ability to automatically incorporate data from other sources. e. It makes it easier for researchers and others to utilize registry data.
Which of the following statements is true in regards to the Cancer Program Standards Rating System? Select one: a. The surveyor is the solely responsible for assigning a compliance rating for each standard. b. A deficiency is defined as any standard with a rating of 8. c. The Commendation rating (1+) is valid for 7 standards. d. A Commendation rating can be earned at any time during the 3-year survey cycle.
c. The Commendation rating (1+) is valid for 7 standards.
Which one of the following is the most important to consider when trying to resolve an edit using the Edit Report? Select one: a. The Edit Number b. The Edit Name c. The Error Message
c. The Error Message
Which of the following is NOT true of probabilistic record linkage systems? Select one: a. They take into consideration the weighted match probabilities of the different data variables b. They make it feasible and efficient to link large public health datasets in a statistically justifiable manner c. They rely on exact variable matches d. They allow valid matches even when small typographical errors exist in the name or social security number in one or more records of a patient
c. They rely on exact variable matches
caBIG
cancer biomedical informatics grid
What is a descriptive analysis to evaluate cancer occurrences in a certain location or during a certain time period called?
cancer cluster
CI5
cancer in five continents
CINA
cancer in north america
CRSC
cancer registration steering committee
CSR
cancer statistics review
CSS
cancer surveillance system
Scirrhous type
cancers that produce a significant reactive fibrosis around tumor
Four sections of a budget
capital purchases salaries and benefits supplies fixed costs, ie. rent
A LEEP procedure may be performed for which of the following?
carcinoma in situ of the cervix
H-Ras
carcinomas/sarcomas
the process used to identify all eligible cases to be included in the registry is
case ascertainment (case finding)
Process of comparing the number of tumors matched as a precentage of all tumors identified, after case consolidation.
case completness audit
cancer registration begins with
casefinding
Paget's disease
causes redness, skin flaking and a crusty nipple
CDC
centers for disease control and prevention
CBTRUS
central brain tumor registry of the US
CCR
central cancer registry
CNS
central nervous system
IRB
central registries are generally run under review of these from the hosting organization
Collects info from several facilities that submit data to a central office
central registry
Tumor
classically means a swelling or mass; in current usage means a new growth of tissue or cells
The aggregation of cases into fewer categories for analysis is called
classification
ICD-O
coding manual for oncology; published by WHO
Hospital registry
collects info about all cancer patients in a particular institution
Population registry
collects info about all cancer patients who are residents of a particular state or geographic area.
central registry
collects info from several facilities that submit data to a central office
KRAS (K-ras)
colon and other carcinomas
C-Change
composed of the nation's key cancer leaders from government, business, and non-profit sectors; it shares information; helps identify barriers, gaps, and opportunities related to its mission; seeks agreement on critical national priorities and supportive actions; and facilitates independent and collaborative efforts to achieve common goals
A trauma registry is an example of a ____ registry.
concurrent
You are working for a private hospital and performing FU on a patient. Which would be the best potential source for FU information?
contact the pateint
CE
covered entity
Compression
cyst changes shape with transducer pressure
Sebaceous cyst
cyst filled with sebum and oil
Arises from Terminal duct lobular unit (TDLU)
cyst, fibroadenoma, carcinoma
Typically, more than ______% of all cancers are histologically confirmed. Select one: a. 30 b. 50 c. 75 d. 90
d. 90
Currently in the United States, which governing agencies set reporting standards for hospital and population-based registries? Select one: a. American College of Surgeons (ACoS) Commission on Cancer (CoC) b. National Program of Cancer Registrars (NPCR) c. Surveillance, Epidemiology, and End Results (SEER) d. All of the above
d. All of the above
What device protects a registry's network from external intrusion? Select one: a. LAN b. Virtual Private Network c. Encryption application d. Firewall e. Server
d. Firewall
Wireless access points can be configured to limit access to specific computers, which can be identified by a unique __________ address. Select one: a. LAN b. WAN c. Ethernet d. MAC
d. MAC
Participation in the cancer program accreditation program is __________. Select one: a. Required by JCAHO b. Required by NAACCR c. Required for all hospitals that treat cancer patients d. Voluntary
d. Voluntary
A combination of active and passive casefinding is _____ system in registries today. Select one: a. a rarely used b. an outdated c. an experimental d. commonly used
d. commonly used
NPCR sets standards for
data completeness, timeliness, and quality, and they established a required data set with a uniform reporting format.
DEERS
defense enrollment eligibility reporting system
the investigation of cancer frequencies & patterns in a defined population
descriptive epidemilogy
Extent of disease
detailed description of how far the disease has spread from the primary site of a cancer
A cross sectional study:
determines prevalance
interoperability
developing connectivity among systems
Radiation oncologists
doctors who specialize in using radiation to treat cancer
Phase IV clinical trials are most often conducted by
drug companies
The process of encoding textual material and converting it to scrambled data that must be decoded to be understood is called
encryption
In 1992 Congress Public Law 1992
established the National Program of Cancer Registries
analytic epidemiology
explores etiologic relationships
3 types of cance conferences
facility wide-general departmental- focus on speciality site specific- focus on site
clinical
facility-based registry reporting
A Guide to Interpretation of the Code of Ethics
for CTRs; addresses; serving employers honestly, declining favors that might influence behavior, and avoiding commercializing one's position
Prognosis
forecast as to the probable results of an attack of a disease; the prospect as to recovery from a disease as indicated by the nature and symptoms of the case
FCCP
freestanding cancer center program
The way values for a variable are distributed is called the:
frequency distribution
FTRO
fundamental tumor registry operations
A firewall_____ controls info that comes into and exits the computer network
gatekeeper
cancer cluster
greater-than-expected number of cancer cases that occurs within a group of people in a defined geographic area over a period of time
data sets
groups of data that are predominantly influenced by what data is necessary to meet the goals and objectives of the registry, and what available standards may prevail
HACP
hospital associate cancer program
The general types of caner registries:
hospital, central, and specific purpose
desmoplasia
host response of tumor invasion. Thick echogenic halo
Behavior
how a tumor acts
Differentition
how much or how little a tumor resembles the normal tissue from which it arose; is stated by the pathologist in several ways for instance; low, moderate, poor, or undifferentiated (low closely resembles normal tissue whereas undifferentiated has little or no resemblance to normal tissue)
The pyriform sinus is located in the
hypopharynx
Concept of sentinel node
if the Sentinel node is clear the rest of the basin is clear
IR
incidence rate
The Public benchmark report
includes the 11 most commonly diagnosed tumors in the US
cancer register is
information system designed for the collection, storage, mgmt., and analysis of data on persons with cancer
INCP
integrated network cancer program
IACR
international association of cancer registries
active follow-up
involve contacting the patient's physician to track the patient's outcome
Ewing sarcoma
is a less common type of bone cancer, which can also cause bone pain. It is most often found in young teens. The most common places for it to start are the bones in the pelvis, the chest wall (such as the ribs or shoulder blades), or in the middle of the long leg bones
NCDB
is a multi-hospital national oncology cancer outcomes database for more than 1,500 COC-accredited cancer programs in the US and Puerto Rico.
cancer registry
is a particular type of disease registry with a focus for reporting information about the disease of cancer
Summary staging
is a required data item for facilities and central registries participating in the National Program of Cancer Registries (NPCR) of the Centers for Disease Control and Prevention (CDC).
standardized cancer data
is necessary to ensure that information on trends in incidence, mortality, and survival is readily available for planning and evaluation; to evaluate that cancer patient care is consistent and conformant with national guidelines; and so that disparities in the provision or outcome of treatment and services can be identified
American College of Surgeons Commission on Cancer (CoC)
is one of the longest standing voluntary accreditation organizations when it comes to cancer programs.
AJCC membership
is reserved for those organizations whose mission or goals are consistent with those of the AJCC.
8 y/o with Swiss cheese breast mass
juvenile papillomatosis
One of the biggest challenges to cancer registrars will continue to be
keeping up with changes in data collection, coding, and reporting standards
municipal ordinances
laws passed by city governments
Passive follow-up methods performed by central registries includes:
linkage with state death certificates, with state health files and with hospital discharge summaries
record linkage
linking all patients from a certain small area with the same type of cancer
Rotter's nodes
lymph nodes located between the pectoral muscles. Part of the axilla node group Level 2
The body contains 3 circulatory systems. They are the arterial, venous and
lymphatic
Measures of central tendency are:
mean, median, mode
MPRA
medical patients rights act
MC
medium-sized clinic
Which of the following specimens, when positive, would be considered cytologic diagnostic confirmation of malignancy?
needle aspiration of tumor
to shrink the tumor to increase the possiblity of resectability
neoadjuvant treatment is given
Ferritin
neuroblastoma
Neoplasm
new growth
8 or more deficiencies at survey or 3 or more at initial survey=
non-accreditation
Comedo type
noninvasive type of cancer that causes ductal distention filled with a cheese-like material and calcifications
NAACCR
north american association of central cancer registries
Possible
not ambigous
incidence
number of new cases in the population-measures appearance of disease
Pediatric oncology nurses
nurses who specialize in caring for children with cancer
OCR
office for civil rights
Bx needle within lesion
optimal needle placement during biopsy
The Common Rule
or Case law-Made by judges when they apply previous court decision to current cases
Secondary Site
organ or tissue of the body to which a neoplasm migrates
Primary site
organ or tissue of the body where a neoplasm originates
OPTN
organ procurement and transplantation network
The CoC will design and conduct of a special study:
periodically
Generally the largest component of a cancer registry budget
personnel
small community hospital
primarily diagnoses cancer and sends the patient elsewhere for treatment
The p value is the:
probability that a difference as large as that observed would occur by chance alone
Cancer conferences at a community hospital should be primarily
prospective
PHI
protected health information
cancer registry role
provide necessary information that is used in the fight against cancer
The performance measurement system
provides a quantitative measure of an aspect of patient care that can be used as a guide to monitor and evaluate the quality and appropriateness of health care delivery. The system is part of the Continuous Quality Improvement process.
reference date
provides the start date of data collection; is always January 1 of any given year; this is used by both hospital and central registries
1 -2 deficiencies at the time intial accreditation=
provisional accreditation
NPCR was established by
public law 102-515, aka the Cancer Registration Amendment Act.
summary staging system
published by SEER in 1977; categorized the extent of disease into five categories: in situ, local, regional, distant, or unknown
ACS
published the first code manual used in cancer registries, "Cancer Facts and Figures"
A capital budget is prepared for:
purchase of major equipment
4 types of computerized edits checks
range and allowable-1-9 codes for male, female, etc. inter-item checks-male pt should not have gyn ca inter-record checks-same demographics for pt w/mult primaries/sequences inter-database checks-compares hospital abstract w/central registry database, e.g. death certs
Thelarche
rapid breast enlargement which begins at puberty
RCA
rapid case ascertainment
crude rates
rates that are calculated for a total population (e.g. all ages combined)
Class of case
registry term describing whether a case can be included in the statistical analysis of the database and based on where the initial diagnosis and treatment of the patient occurs. (Analytic or non-analytic)
bilateral
relating to right and left sides of the body or of a body structure
Is the ratio of the observed survival rate to the expected rate for a group of people in a general population comparable to the patient group
relative survival
a patient has urine cytology suspicous for urothelial carcinoma is the case repotable?
reportable if there is confirmation by positive path and/or by clinical diagnosis
all updated f/u info
reported to the NCDB
limited-duration prevalence
represents the proportion of people alive on a certain day who had a diagnosis of the disease within the past x years
PL 102-515
required that each NPCR-funded central registry be supported by state law that authorizes the registry and regulations that provides a strong foundation for each NPCR registry and assures that the data can legally be collected and made available for program planning evaluation and research.
A study analyzing data that has already been collected is termed
retrospective
A tumor of fleshy tissue is called a
sarcoma
What arises from the mesodermal tissue:
sarcoma
Pathology
scientific study of the nature of disease, its causes, processes development and consequences, more specifically, the microscopic examination of tissue
STAR
search, tracking and registry system
SCH
small community hospital
registry infrastructure
tends to reflect the magnitude of the problem at the societal level and the resources that society has agreed to expend, the complexity of the problem and the amount of data required for understanding and resolution, and the points at which information and practice intersect to affect outcomes for individuals; composed of organizations supporting and funding registries, defining and monitoring data standards, collecting, reporting, and transmitting data
ACOS/COC accreditation demonstrates
that a facility has established performance measures for high quality cancer care.
Ten Cities Cancer Survey
the NCI's first attempt to estimate cancer incidence for the entire country; happened in 1937; directed by Harold F. Dorn; was conducted over a period of three years in a convenience sample of 10 areas, mostly urban, comprising about ten percent of the country's population; served as a baseline for evaluating cancer trends in subsequent national cancer surveys
federalism
the US form of government; power is divided between a large, central government and smaller, state governments
Standardization
the ability to collect date the same way as another facility does, via city, state, or country
The CPU of the computer is:
the brain of the computer
HACP
the facility accessions 100 or fewer newly diagnosed cancer cases each year and has a limited range of diagnostic and treatment services available on-site
john graunt
the guy who invented the science of medical epidemiology and stats
direct observed survival method
the method that requires that all subjects be available for survival throughout the complete interval of interest
observed survival rate
the proportion of persons in a defined population who remain alive during a specified time interval
The Connection
the quarterly association newsletter by the NCRA
surveillance informatics
the systematic application of information and computer science and technology to cancer surveillance practices, research, and learning
standards of care
these are often based on standard business practices, providing clear indication of which actions are considered reasonable by the industry
formal agreements
these are often set up between central registries for data exchanges so that residents diagnosed or treated in other states are included
standard-setting organizations
these consist of national government agencies, medical and professional organization, organizations that represent multiple interests in cancer registration and organizations that have an indirect link to cancer data such as the American Cancer Society
constitutional laws
these laws are embodied in the US constitution, but also in the constitutions of the 50 individual states; they refer only to the relationship between citizens and their government, not to the relationship between private entities whether they are persons or businesses
TNCS
third national cancer survey
WHO
this org defined the standardization of cancer registration for disease classification; they publish ICD-O
CS Task Force
this org was created in 1998 to address the issue of discrepancies in staging guidelines among the three major cancer staging systems used in the US
Organ Sharing Registry
this registry administers the OPTN, established by the congress in the national organ transplant act of 1984
technique to evalute how each task afffects the registry
time motion study-
Which of the following is an appropriate release of cancer registry data?
to other treating hospitals for continuity of patient care
Ultimate Goal of Collecting Cancer information
to prevent and control cancer and improve patient care
Targeted sonography
to scan only the suspicious area
NCDB was established
to serve as a comprehensive clinical surveillance resource in the US.
Prevalence
total number of people in a population with disease. Measures existence of disease
Any Cancer registry can create additional data itmes for its own use
true
Cancer registrars are considered experts on cancer
true
In-situ
tumor confined to the organ of origin without invasion; the tumor has not gone beyond the organ's basement membrane
trauma/disaster registries
types of registries that track care rendered to and effects on persons subjected to harmful external events
covered entity
under HIPAA, this is a health care plan, a healthcare clearinghouse, or a health care provider who transmits any health information in electronic form for financial and administrative transactions; these can be hospitals, laboratories, or even a private practice physician
UDS
uniform data standards
Breast cancer most frequently spreads by _____.
via blood or hematogenous route
Third National Cancer Survey
was conducted by the NCI in 1969-f; in addition to analyses by demographic variables and by site, histologic diagnosis, and stage of disease, the survey included questions on a 10% sample of cases in regard to treatment, duration of hospitalization, cost of medical care, and the economic impact on the family; a special survey on skin cancer was conducted in four of the 10 areas too; it was the last survey of its kind
NCCCS
was created in 1993 to coordinate cancer surveillance activities within the US through communication and collaboration among major national cancer organizations, ensuring that the needs of cancer patients and the communities in which they live are fully served, that scarce resources are maximally used, and that the burden of cancer in the US is adequately measured and ultimately reduced
How do you calculate a ratio:
(A divided by B)
in 2012 ACOS/COC required of all registry staff performing case abstraction
- Must hold a CTR - or, pass the CTR w/in 3 years of date hired.
Non-Hodgkin Lymphoma
- about 5% of childhood cancers -Occurs in younger children, but rare in under 3. - Grow quickly and require intensive treatment, but children respond better to treatment than adults.
two steps of record linkage
- blocking - matching
main components of a registry budget
- capital expenses - salaries and benefits - supplies - fixed costs
CDC provides support to NAACCR to
- develop uniform data standards for data collection, determine guidelines for registry operations, and print and distribute an annual statistical report. - provide education and training to CCRs.
Three priority areas of the Canadian Partnership Against Cancer
- expansion of Coe surveillance data collection, particularly in the area of stage data - improving analytic capacity in the surveillance community - increasing access to and use of registry data
responsibilities of central registry staff
- guiding the patient linkage process for incoming reports with questionable matches to existing patients on the central registry database - manual geocoding efforts - reviewing submitted abstracts for selected code accuracy and agreement with submitted text - manual tumor consolidation to ascertain if multiple primaries exist across multiple source reports - data item consolidation if multiple sources reported information regarding the same tumor
types of central registries
- incidence-based - population-based - multihospital (not population-based)
death clearance process in CCRs
- linking all death records from the state's vital stats office to registry records to identify patients in the registry who have died - review of positive matches, possible matches and nonmatches
Criteria to Earn CoC Accreditation
- meet rigorous quality standards set by the CoC - provide access to the full scope of multidisciplinary services required to screen, diagnose, treat, rehabilitate, and support patients with cancer and their families - make prevention and early detection services available to the community - provide services on-site, by referral, or through coordination with other facilities or local agencies - submit data annually to the NCDB
Brain and central nervous system tumors
- second most common cancers in children, making up about 21% of childhood cancers - start in the lower parts of the brain, such as the cerebellum or brain stem - can cause headaches, nausea, vomiting, blurred or double vision, dizziness, and trouble walking or handling objects
Rhabdomyosarcoma
- starts in cells that normally develop into skeletal muscles - can start in the head and neck, groin, belly (abdomen), pelvis, or in an arm or leg. - may cause pain, swelling (a lump), or both - the most common type of soft tissue sarcoma in children. It makes up about 3% of childhood cancers.
Rhabdomyosarcoma
- starts in cells that normally develop into skeletal muscles - can start nearly any place such as in the head and neck, groin, belly (abdomen), pelvis, or in an arm or leg. - may cause pain, swelling (a lump), or both - the most common type of soft tissue sarcoma in children. It makes up about 3% of childhood cancers.
Neuroblastoma
- starts in early forms of nerve cells found in a developing embryo or fetus - This type of cancer occurs in infants and young children. It is rarely found in children older than 10. - can start anywhere but is usually in the belly (abdomen) and is noticed as swelling. It can also cause bone pain and fever
Leukemia
- the most common childhood cancers, AML and ALL - account for about 31% of all cancers in children - may cause bone and joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, weight loss, and other symptoms
goals of the registry
- to determine what data items are collected - the rapidity of data collection - whether follow-up is conducted - the uses to which the data are put
How does the CDC use cancer data?
-It uses incidence data to review and report on the burden of cancer and to provide aggregate data to national organizations and for public use. - Collaborates with state registries and researchers to conduct research projects.
Invasive Lobular Carcinoma
-Originates and fills the entire lobule -Extends beyond the lobule
Standard 2.2 Nursing Care
. Oncology nursing care is provided by nurses with specialized knowledge and skills. Competency is evaluated annually.
The
...
six areas of cancer control
1. primary prevention 2. screening 3. early diagnosis 4. treatment 5. rehabilitation 6. palliative care
The elevation plane focus of a 10 MHz transducer is at what depth?
1.5 CM
Percentage of breast CA including Invasive Lobular Carcinoma?
10 %
What percentage of analytic case load are required to be reviewed by the cancer registry quality control coordinator annually?
10%
Normal skin line should not measure more than?
2 mm -greater than this is abnormal
Most common age of cyst to develop in breast
35-50 years old
NPCR-funded registries cover
45 states, D.C, and 3 US territories -96% of the US population.
CoC requires ___ number of years of retention of cancer committee minutes and grids, quality study results, outcomes analysis and reports.
5
Cancer in North America (CINA) includes data on more than ___ million cancer cases
6
THE NATIONAL CANCER DATA BASE IS AN EXAMPLE OF
A NON POPULATION BASED CANTRAL REGISTRY
Adenocystoma
A benign tumor involving glandular cells in the form a cyst.
Adenoliposarcoma
A malignancy involving glandular cells and fat cells.
Standard 3.1 Patient Navigation Process.
A patient navigation process, driven by a community needs assessment, is established to address health care disparities and barriers to care for patients. Resources to address identified barriers may be provided either on-site or by referral to community-based or national organizations. The navigation process is evaluated, documented, and reported to the cancer committee annually. The patient navigation process is modified or enhanced each year to address additional barriers identified by the community needs assessment.
E8: Systemic Therapy Services
A policy or procedure is in place to guide the safe administration of systemic therapy provided either onsite, at locations that are facility owned, or at locations that are contracted by the facility or are supervised by members of the facility's medical staff (physician offices).
E9: Clinical Trial Information
A policy or procedure is used to provide cancer-related clinical trial information to patients.
Tumors are classified into two main types. What are these two types?
A. Benign tumor - sometimes called benign neoplasm B. Malignant tumor - sometimes called malignant neoplasm
which organization is the administrative sponsor of the AJCC
ACoS
Fibroadenomyolipoma
AKA Hamartoma
THE VESSELS THAT CARRY OXYGENATED BLOOD FROM THE HEART TO THE EXTREMITIES ARE
ARTERIES
The facility provides postgrad medical education in at least 4 program areas. >500 annual caseload
Academic comprehensive cancer program
AJCC
American Joint Commission on Cancer
Publishes systems of classification of cancer including staging (AJCC CA staging manual and the Collaborative Stage Data Collection System), end result reporting to be used by health professionals for selecting the most effective treatment, determining profnosis and continuing evaluation of cancer control.
American Joint Commission on Cancer (AJCC)
Standard 4.5 Quality Improvement Measures.
Annually, performance levels are met for each of the specified quality improvement measures as defined by the Commission on Cancer.
STANDARD 4.5 QUALITY IMPROVEMENT MEASUREMENT
Annually, performance levels are met for each of the specified quality improvement measures as defined by the commission on cancer
Standard 4.8 Quality Improvements.
Annually, the quality improvement coordinator, under the direction of the cancer committee, implements 2 patient care improvements. One improvement is based on the results of a completed study that measures cancer patient quality of care and outcomes. One improvement can be identified from another source or from a completed study. Improvements are documented in the cancer committee minutes and shared with medical staff and administration.
If a mass is isoechoic with surrounding tissues, what maneuver would accentuate the mass to make is show up better?
Apply harmonics
The mammary ridges (milk line) extend from ______ to ______.
Axilla - inguinal region (Common site for polythelia)
The artery that supplies the outer half of the breast is?
Axillary artery
Breast sonography utilizes what display mode?
B-mode
How would you classify a new growth that appears to be spreading and ulcerated? A. Probably benign tumor or benign neoplasm B. Probably a malignant tumor or malignant neoplasm C. Can't say
B. - Probably malignant tumor The description "spreading and ulcerated" sounds like a malignant condition. However the malignancy of a tumor can only be determined by microscopic examination of the cells taken from that tumor.
Which of the following malignancies would most likely be classified as sarcomas? A. Cancer of the colon B. Malignancy arising in muscle C. Cancer of the skin or the lip D. Gallbladder malignancy E. Malignant bone tumor
B. Muscle E. Bone
A patient was found to have a tumor. It had been slowly enlarging for five years, but there apparently was no evidence of invasion or metastases. The tumor probably is: A. Malignant. B. Benign C. Can't say
B.- Benign Benign tumors may grow in size. However, microscopic examination is necessary to rule out malignancy.
Indicate classification and vessel: Hemangioma
Benign-Blood
Word Root: Oste
Bone
Breast examination begins with (important to do)
Breast Self Examination (BSE)
Which types of cancer are evaluated by the clinical checks?
Breast and colorectal cancer
THE NATIONAL PROGRAM OF CANCER REGISTRIES IS A FUNCTION OF
CENTERS FOR DISEASE CONTROL & PREVENTION CDC
Standard 1.4
Cancer Committee Meeting The cancer committee meets at least once each calendar quarter.
caDSR
Cancer Data Standards Repository
Multicentric carcinoma
Cancer lesions found more than 5cm distance or bilaterally. Warrants whole breast examination
Standard 2.3 Risk Assessment and Genetic Counseling.
Cancer risk assessment, genetic counseling, and testing services are provided to patients either on-site or by referral, by a qualified genetics professional.
The process of monitoring incidence & mortality of cancer is called
Cancer surveillancw
COG
Children's Oncology Group
What is the most active organizations in the US for establishment and approval of hospital cancer programs
CoC - Commission on Cancer
The facility accessions more than 100 but fewer than 500 per year
Community Cancer program
Papilloma
Cystic structure with solid component (w/Doppler)
A CROSS SECTIONAL STUDY
DETERMINES PREVALENCE
METHOD OF CALCULATING SURVIVAL
DIRECT METHOD
Cancer Incidence in Five Continents (CI5) Monograph CI5 databases CI5 I-IX and CI5 Plus GLOBOCAN
Data
During pregnancy breast will ____.
Demonstrate increase fluid and blood flow
Name facility sources used to identify cases
Disease indices; pathology and laboratory reports; patient logs and other similar resources
STANDARD 1.3 CANCER COMMITTEE ATTENDANCE
Each required member or the designated alternate attends at least 75% of the cancer committee meetings held during any given year
These malignancies would all arise in ______ tissue.
Epithelial
What did the National Cancer Act enacted in 1971 do?
Established SEER and directed NCI to collect and report CA data to congress
Facility Oncology Registry Data Standards
FORDS
Each city has created rules and guidelines for cancer data collection
False
Studies utilizing RCA data do not require IRB approval. Select one: True False
False
Submission of Class of Case 6 is required
False
T or F The current edition of the AJCC cancer staging manual is the sixth edition
False
True or False: Chapter 3 of ICD-9 is for neoplasms.
False -- Chapter 2
True or False: NOS stands for Never Otherwise Stated
False -- False "Not Otherwise Specified"
True or False: SNOMED's topography section is the same as ICD-O-2.
False -- It is completely different than ICD-O-2
Cancer programs who do not publish and disseminate an annual report or other report detailing patient or program outcomes will receive a deficiency rating for that standard. Select one: True False
False. *For Commendation only, not required.
When setting the TGC control for breast imaging, what tissue should be a medium level of gray?
Fat
Standard 5.3
Follow-Up of All Patients 80% follow-up from reference date
Standard 5.4
Follow-Up of Recent Patients 90% follow-up rate for patients diagnosed in the last 5 years.
Standard 5.3 Follow-Up of All Patients.
For all eligible analytic cases, an 80% follow-up rate is maintained from the cancer registry reference date.
CanReg
Free software that was developed to provide the basis of an operational cancer registry from data entry to analyses of cancer incidence information
Non hospital based program offering at least 1 cancer related treatment modality
Freestanding cancer center program
The primary site for a Krukenberg tumor usually
GI tract
_________ is the assignment of a census tract code to the patients residence at diagnosis
Geo-coding
______is used for the study of cancer clusters or other surveillance by the CCR, and it's necessary to code residence at diagnosis at most specific level possible.
Geocoding
Central Cancer Registries calculate _____ and ____ rates.
Incidence and mortality
The organization that wons, operates, leases or is part of a joint vnture with multiple facilties providing integrated cancer care. There is no minimum caseload
Integrated network cancer program
The artery that supplies oxygenated blood to the inner/medial portion of the breast is ?
Internal thoracic artery
IARC
International Agency for Research on Cancer
IACR
International Association of Cancer Registries
UICC
International Union Against Cancer
IARC
International agency for research on cancer
United States Cancer Statistics
Is a co-production of CDC and the National Cancer Institute(NCI). The report summarizes the incidence of cancer for the US by census region.
The Connection
Is a quarterly NCRA newsletter
SEER Cancer statistics review
Is a report on cancer trends and the data is widely used by researchers, then media, and the public.
Indicate classification and tissue: Liposarcoma
Malignant--Fat
Clark Level staging
Melanoma based on depth of invasion
Word Root: Mening
Membrane
**Mondor's disease
**Thrombophlebitis of a superficial vein in the breast
Metastatic bone cancer
- A cancer that starts somewhere else in the body and then spreads to the bones. - Is more common then primary bone cancer b/c there are many types of cancer that can spread to the bones.
National Cancer Act of 1971
- AKA the War on Cancer in the US. - The act directed the National Cancer Institute to collect, analyze, and disseminate all data useful in the prevention, diagnosis, and treatment of cancer and report those findings to congress. - Experts recommended collecting both population-based incidence and survival data for the same set of patients. - established SEER.
Leukemia
- Cancers of the bone marrow and blood - the most common childhood cancers, AML and ALL - account for about 30% of all cancers in children - may cause bone and joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, weight loss, and other symptoms
Childhood v. Adult Cancer
- Childhood cancers are often the result of DNA changes in cells that take place very early in life, sometimes before birth. - Not strongly linked to lifestyle or environmental risk factors. -Tend to respond better to chemo.
Differences in International v. US registries
- Different physician attitudes toward cancer registration. - Lack of trained registry personnel - Different health care delivery systems, - records used for surveillance purposes and not necessarily clinically focused. - Lack of basic health services
CCS
- One of the oldest cancer stakeholder organizations in Canada and serves to coordinate the activities of the many volunteers, as well as cancer patients, families, and survivors who want to make a difference in how cancer affects Canada. - a national group supported by a network of community-based volunteers dedicated to reducing the burden of cancer and improving the quality of life for those living with cancer - provides a secretariat and resources to coordinate the annual publication of Canadian Cancer Statistics
Canadian partnership against cancer
- The organization that has been created to implement the vision for national cancer control - it works collaboratively with a wide range of stakeholder orgs and interested parties across the country to address key areas of focus that have been identified as critical for cancer control
Lymphoma
- These cancers start in certain cells of the immune system called lymphocytes; most often grow in lymph nodes and other lymph tissues, like the tonsils or thymus - can cause weight loss, fever, sweats, tiredness (fatigue), and lumps (swollen lymph nodes) under the skin in the neck, armpit, or groin. - 2 main types of lymphoma are: Hodgkin lymphoma (sometimes called Hodgkin disease) and non-Hodgkin lymphoma
specialized children's cancer centers
- These centers are often members of the Children's Oncology Group (COG) - All of these centers are linked to a university and most are connected with a children's hospital - These centers offer the most up-to-date-treatment by conducting clinical trials
MECC
- Was established through an official agreement of the ministries of health of Cyprus, Egypt, Israel, Jordan, Turkey, and the Palestinian authority - it's objective is to reduce the incidence and impact of cancer in the Middle East through the solicitation and support of collaborative research
NAACCR
- a professional organization with 128 member organizations including registries from all 50 states and 3 US territories, 13 Canadian provinces and territories, and other major cancer organization and individuals involved in standard-setting and cancer registration activities - it develops and promotes uniform data standards for cancer registration by overseeing the UDS committee that promotes standardized data transmission - certifies population-based registries that meet national data quality standards for producing accurate cancer statistics - aggregates and publishes data from CCRs - promotes the use of cancer surveillance data and systems for cancer control and epidemiologic research, public health programs, and patient care to reduce the burden of cancer in North America - founded in 1987 - receives grant funding from CDC to provide education and training to those in the cancer registry field, especially those at CCRs - Data submission to this org is voluntary, but its certification is recognized as a symbol of excellence - modeled after IACR
registry
- a structured system for the collection, storage, distribution, and analysis of a defined segment of health data on individuals - a traditional one accumulates information on the experience of many individuals with a specific health condition or procedure, facilitating the generalization of individual experience to broader populations - they support the delivery of certain routine health services, such as vaccinations, by maintaining and updating records on individuals who have received these services
registry
- a structured system for the collection, storage, distribution, and analysis of a defined segment of health data on individuals. May be population-based or facility- specific. - a traditional one accumulates information on the experience of many individuals with a specific health condition or procedure, facilitating the generalization of individual experience to broader populations - they support the delivery of certain routine health services, such as vaccinations, by maintaining and updating records on individuals who have received these services
casefinding audits
- a type of audit that involves independently identifying all cases diagnosed and/or treated at a facility that are eligible for reporting to the central registry, usually for a sample time period - casefinding procedures are reviewed to ensure that all areas where a patient may be identified are included in the process - after reconciliation efforts, the number of tumors that matched expressed as a percentage of all tumors identified at audit provides an estimate of case completeness for the audited facility - patients that have multiple cancer records are reviewed
Retinoblastoma
- accounts for about 3% of childhood cancers - usually occurs in children around the age of 2, and is seldom found in children older than 6. - In an eye with retinoblastoma, the pupil often looks white or pink. This white glare of the eye may be noticed after a flash picture is taken
AJCC
- an organization whose objectives include the development and publication of schemas or standards to classify cancers, including anatomic staging, multiple prognostic factors, and end results reporting - the coding schemas are designed for use by clinicians for the purpose of treatment selection, estimation of prognosis, and ongoing assessment of cancer control interventions - established in 1959 to develop a system of clinical staging for cancer that was acceptable to the American medical profession - comprised on six founding organizations, and eleven liaison organizations - member orgs generally demonstrate involvement or activity in one or more of the following areas: cancer epidemiology, patient care, cancer control, cancer registration, professional education, research, and biostatistics - established on 1/9/1959 to develop a system of clinical staging for cancer that was acceptable to the American medical profession - composed of six founding orgs, five sponsoring orgs, and 11 liaison orgs; all these generally demonstrate involvement or activity in one or more of the following areas: cancer epidemiology, patient care, cancer control, cancer registration and surveillance, professional education, research and biostatistics - has embraced the TNM system to describe the anatomic extent of cancer at the time of initial diagnosis and before the application of definitive treatment - has committees: executive, education and promotions, finance, informatics, membership and bylaws, and site-specific task force - its mission is to provide the worldwide leadership in the multidisciplinary development, dissemination, and maintenance of evidence-based systems for the classification and management of cancer in collaboration with organizations dedicated to cancer surveillance - publishes the Cancer Staging Manual
reabstraction audits
- audits that identify specific problem areas in need of improvement/accuracy and is done by comparing the original source document to the coded data submitted to the CCR - include independently reabstracting a random sample of case records reported by the facility from the actual source patient medical records and comparing the reabstracted data with the data already in the registry, looking for accuracy - its goal is to describe the level of agreement between the data reabstracted from the source records and the data in the central registry
recoding audits
- audits that involve independently recoding particular data items from abstracted text that was submitted to the central registry by the reporting facility, rather than reviewing actual source documents - the goal is to describe the level of agreement between the data recoded from the submitted text and the data in the central registry
purposes of record linkage
- casefinding - linking in new patient reports to the registry database - duplicate detection - passively obtaining follow-up info - improving info on a case - analytic purposes - conducting special studies
three types of audits
- casefinding audits - reabstraction audits - recoding audits
incidence rate
- defined as the measurement of disease frequency over a specified period of time - it is also used to determine the burden of disease in a population and how the risk of disease varies in different subgroups of the population - numerator includes only newly diagnosed cases during a given time period - denominator includes only individuals in the same population who are "at risk" for the disease during the same time period
elements of a case definition
- description of the condition, procedure, or other subject of interest - date at which data collection starts, for the entire registry and for each case in the registry - date at which data collection ends, generally for each case in the registry, but potentially for the entire registry - population covered, including mandatory versus voluntary inclusion of eligible participants - identification of persons within the registry; personal identifiers retained versus anonymous data - time orientation: prospective, retrospective, or concurrent
CLP (Cancer Liaison Physicians/Program)
- directs the activities of the network's 65 volunteer state chairs responsible for managing state-based cancer activities and their respective groups of CLPs appointed in local facilities to support the activities of the CoC and ACS - an organization that forms a cancer control/communication network of approx. 1600 surgeons and physicians who are each linked to individual hospitals and provide oversight for various programs of the hospital cancer program, notably including the cancer registry, as well as the use and quality of the data
CoC
- established in 1922; the first US organization to establish standards to ensure quality, multidisciplinary, and comprehensive cancer care delivery in healthcare settings - publishes "Patient Care Evaluation Studies" - a branch off the ACoS; it represents hospital cancer registries - not a federal agency; has operated a voluntary system of accreditation for hospital cancer programs since 1932 - requires that a cancer registry be a mandatory component of their accredited program - is a consortium of professional organizations dedicated to reducing the morbidity and mortality of cancer through education, standard setting, and the monitoring of quality care - has an accreditation committee made up of three sub-committees: program review, field staff, and recruitment/retention - has 36 mandatory standards for accreditation
NCRA
- established in 1974; since 1983, it's certification process has promoted standardization in the collection and use of cancer data through examination and certification of cancer registrars and other cancer data specialists; published the main textbook for this class; awards accreditation to formal education programs that provide entry-level professional preparation with a major emphasis in CRM - this organization establishes education standards, develops courses of study for registry professionals, disseminates information, and is involved in programs and activities to improve and standardize cancer registration - a membership organization representing cancer registry professionals - has five key areas of focus: education, administration, certification, communication, and advocacy - membership can be active, associate, honorary, honorary life, inactive, international, student or sustaining
SEER Extent of Disease coding system
- formed the basis for the Collaborative Staging System - implemented in 2004 as part of the effort to simplify and standardize the rules and guidelines for collecting cancer data in the US
Childhood cancers
- generally refer to those occurring in patients 0—14 years old and in some cases may extend to age 30 based on the type of disease - Common tumors are sarcoma, leukemia, and teratoma - very few can be staged using the AJCC Manual for Staging - are analyzed by type rather than origination site - are often the result of DNA changes in cells that take place very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors. - tend to respond better to treatments such as chemotherapy - make up less than 1% of all cancers diagnosed each year - is the second leading cause of death in children (after accidents)
Childhood cancers
- generally refer to those occurring in patients 0—14 years old and in some cases may extend to age 30 based on the type of disease - Common tumors are sarcoma, leukemia, and teratoma - very few can be staged using the AJCC Manual for Staging,caertain pediatric cancers have their own staging or classifications. - are analyzed by type rather than origination site - are often the result of DNA changes in cells that take place very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors. - tend to respond better to treatments such as chemotherapy - make up less than 1% of all cancers diagnosed each year - is the second leading cause of death in children (after accidents) -Subsets for analyses using unique histological types of cancers and age are beneficial.
benchmark reports
- have been released in two formats 1. one is explicitly designed to facilitate public use 2. the other is targeted for use by CoC-accredited cancer programs as a tool by which to evaluate and compare the cancer care delivered to patients diagnosed or treated, or both, at their facility - the public ones are limited in scope to the 11 most commonly diagnosed and treated solid tumors in the US
three main types of cancer registries
- hospital-based - population-based - specialty
non-hospital registry sources
- hospitals without a cancer registry - clinics - physician offices - pathology laboratories - nursing homes - vital records
central cancer registries
- identifies all individuals with a diagnosis of cancer residing in the defined population - is considered a population-based registry - uses reporting sources such as physician offices and pathology laboratories to identify cases - uses data to monitor the distribution of cancer among communities, ethnicity, age and other demographic groups - sizable databases that store important confidential info about large numbers of patients with cancer - have an emphasis of epidemiology and public health - designed to determine cancer patterns among various populations or subpopulations, to monitor cancer trends over time, to guide planning and evaluation of cancer control efforts, to help prioritize health resource allocations, and to advance clinical, epidemiologic, and health services research - often represented by SEER and NPCR
Retinoblastoma
- is a cancer of the eye. - accounts for about 2% of childhood cancers - usually occurs in children around the age of 2, and is seldom found in children older than 6. - In an eye with retinoblastoma, the pupil often looks white or pink. This white glare of the eye may be noticed after a flash picture is taken
TJC (The Joint Commission)
- its mission is to continuously improve the safety and quality of care provided to the public through the provision of healthcare accreditation and related services that support performance improvement in healthcare organizations - overseen by the ACoS; was called the JCAHO until 2007 - awards accreditation to healthcare organizations that meet their minimum standard - its overall future goal is to coordinate data demands and prioritization of critical measurement by the various public and private sector entities to minimize data collection burden and eliminate redundancies for healthcare organizations, maximizing the consistency and usefulness of the data
council on certification
- made up of an administrator and up to eight reps (these are elected positions to administer and manage NCRA's certification program) - to be eligible for a rep position, they must be an active CTR certificant with a minimum of 3 years experience, shall not hold employment in any educational services related field that provides education to future registrars
nonreportable cases
- malignant neoplasms - epithelial carcinomas of the skin - papillary and squamous cell carcinomas of the skin - basal cell carcinomas of any site except the genital sites
Primary Bone cancers
- occur most often in older children and teens, but they can develop at any age. They account for about 3% of childhood cancers - Two main types: Osteosarcoma and Ewing sarcoma.
Bone cancers
- occur most often in older children and teens, but they can develop at any age. They account for about 4% of childhood cancers - Osteosarcoma is most common in teens, and usually develops in areas where the bone is growing quickly, such as near the ends of the long bones in the legs or arms. It often causes bone pain that gets worse at night or with activity. It can also cause swelling in the area around the bone. - Ewing sarcoma is a less common type of bone cancer, which can also cause bone pain. It is most often found in young teens. The most common places for it to start are the bones in the pelvis, the chest wall (such as the ribs or shoulder blades), or in the middle of the long leg bones.
basic data items for CCRs
- patient identification and demographics - cancer identification - hospital-specific data - stage and prognostic factors - treatment: first course and subsequent - follow-up - death - edit overrides - system administration - patient, hospital and physician - narrative text
three classifications of laws
- private/civil - public/criminal - administrative
UDS Committee
- provides a formal means for reviewing and recommending the addition of new data items or proposed changes in data codes for existing data items submitted by standard setters or NAACCR members to ensure comparability of data across North America - works in conjunction with the NAACCR Cancer Registration Steering Committee (CRSC) to ensure coordination among all organizations regarding the development and implementation of standards and data items - a committee of NAACCR that compiles coding, editing, and data exchange standards, including remaining unresolved issues, which are published and disseminated by NAACCR
NCDB
- renowned as the largest clinical registry in the world; contains more than 25 million cases accessioned from 1985-2008 - a nationwide oncology outcomes database for more than 1500 CoC-approved cancer programs in the US and Puerto Rico that includes approximately 75% of all newly diagnosed cases of cancer in the US; this data is then used to explore trends in cancer care, to create regional and state benchmarks for participating hospitals, and to serve as the basis for quality improvement - was established to serve as a comprehensive clinical surveillance resource in the US - is located at the ACoS and requires cancer data from all of the accredited cancer programs - all reported data is staged using the AJCC staging system - is particularly interested in treatment patterns
Brain and central nervous system tumors
- second most common cancers in children, making up about 26% of childhood cancers - start in the lower parts of the brain, such as the cerebellum or brain stem - can cause headaches, nausea, vomiting, blurred or double vision, dizziness, and trouble walking or handling objects
Agenda for Change
- started by TJC in response to critics who believed that TJC was more concerned with policy documentation and minutiae in hospital manuals than with the actual quality of the care delivered - launched in 1987 - this movement demanded greater efficiency in the delivery of services and insisted on objective evidence of the effectiveness of care; TQM/CQI - has 4 underlying concepts 1. patient outcomes are influenced by all of the activities of a healthcare organization 2. continuous improvement in the quality of care should be a priority of healthcare organizations 3. TJC should focus on those activities of healthcare organizations that are most important to the quality of care 4. traditional assessments of compliance with standards should be complemented by the accredited organization's collection, analysis, and feedback of data that reflect their actual performance in undertaking key activities - consists of the Framework for Improving Performance: design, measurement, assessment, and improvement/innovation
Wilms tumor
- starts in one, or rarely, both kidneys - most often found in children about 3 to 4 years old, and is uncommon in children older than age 6 - can show up as a swelling or lump in the belly (abdomen) - Sometimes the child might have other symptoms, like fever, pain, nausea, or poor appetite
SEER*Rx
- the Interactive Antineoplastic Drugs Database - developed as a one step lookup for coding oncology drug and regimen treatment categories in cancer registries
3 Major Cancer Staging Systems
- the TNM stage groupings of the AJCC - the Extent of Disease (EOD) system of the SEER program - the SEER summary stage system
Connecticut Tumor Registry
- the first truly population-based registry in the US - founded in 1941, but registered cases back to 1935 - because of this, the State Medical Society formed a Tumor Study Committee to coordinate cancer control activity in the state, which was instrumental in getting state legislation passed which created a Division of Cancer and other Chronic Diseases in 1935 - the oldest continuous state cancer registry in the US - first published incidence data in 1947
SEER
- the only comprehensive source of population-based information in the US that includes stage of cancer at the time of diagnosis and patient survival data - has played a significant role in formalizing cancer registration systems, coding and definition of data items, abstracting rules, and training - collects data from selected states and geographical areas that it has contracts with - conducts audits of the non-profit medical program-oriented organization that contract to collect data for it - performs active follow-up of patients - publishes the "self instructional manuals for Tumor Registrars" - its two primary objectives have been to monitor trends in cancer incidence in population groups defined by demographic and geographic characteristics, and to provide continuous information on changes in stage at diagnosis and therapy and consequent changes in survival
HIPAA
- was enacted by Congress on April 2001 to answer the pleas of the healthcare industry to simplify and reduce the skyrocketing costs of healthcare administration; covered entities had until April 14, 2003 to fully comply; small health plans had until April 14, 2004 to comply - promotes "good business" for the healthcare industry by pursuing the most effective and efficient use of modern information technology - also calls for the implementation of commonsense privacy and security protection of the personal patient information reflected in the data to temper the risks posed by the powerful information technology - it is a federal law that protects patient confidentiality and PHI
VA central cancer registry
- was established in 1995 as an adjunct project by the office of the national coordinator for cancer programs to ascertain compliance in data collection at the VA's medical centers, and as a method for testing and resolving issues with data extraction tools for the releasing of data to the state central cancer registries - it's ultimate goal is the use of it's collected data for analysis by physicians, health officials, and researchers within the VA community making decisions about healthcare policy and implementation, physician and staff recruitment, equipment and space needs, patient referral patterns, treatment outcomes, and unmet patient needs
Department of Veteran's Affairs (VA)
- was established on March 15, 1989 - responsible for providing federal benefits to veterans and their families - the second largest of the 15 cabinet departments and operates nationwide programs for health care, financial assistance, and burial benefits - manages the largest medical education and health professions training program in the US
EDITS
-A software application developed by the CDC which checks the validity of certain data items and is used to create record layouts and maintain look-up tables, among other uses. It is widely used by all registries and software vendors. - Plays a crucial role in the quality of data by using computer programs to compare the coded data to the coding rule and identify possible errors. - All cancer registry files must run and pass all EDITS before submitting to the CoC or the central cancer registry.
NAACCR
-Is a professional group that develops and promotes uniform data standards and provides education and training. - Certifies population-based registries, aggregates and publishes data from central cancer registries, promotes the use of cancer surveillance data and systems for cancer control, and provides epidemiologic research for public health programs.
ICD-O-3
-Is published by the WHO and is used by registries all over the world. - Includes instructions that pertain specifically to international cancer registries. -A major difference is that international registries use different multiple primary rules then US registries.
Purposes of NCRA
-Providing educational opportunities for continuous learning. -advancing knowledge of all technologies that influence cancer data. -Establishing standards on education for registrars. -promoting the value of the certified registry professional. supporting professional standards and ethics of registrars.
Ductal Cacinoma In Situ (DCIS)
-Stage 0 Cancer -Common breast CA that develops within the ducts without invasion of basement membranes -An area with microcalcifications and shadowing but no distinguishable mass
Purpose of NPCR
-To provide funds and technical assistance to improve cancer registration and cancer surveillance throughout the US. - Monitors the nation's cancer burden and the information provides focus areas for limited resources to be used effectively.
Hodgkin Lymphoma
-accounts for 3% of childhood cancers. - More common in early adulthood(15-40, ususally in 20s) and late adulthood(after 55). - Rare in children under 5. - Very similar in children and adults
A suspense file contains the following information (4)
-patient name -patient identifier -date of first contact -primary site
Analytic cases all require follow up except for:
-residents of a foreign country -case reportale by agreement -patients whose age exceeds 100 -patients diagnosed afer 01/2006 and classified as class of case 00
Standard 4.4 Accountability Measures
. Annually, performance levels are met for each of the specified accountability measures as defined by the Commission on Cancer.
Standard 2.1 College of American Pathologists Protocols
. College of American Pathologists (CAP) protocols are followed to report the required data elements in 90% of the eligible cancer pathology reports each year.
Standard 4.2 Screening Programs
. Each year, the cancer committee provides at least 1 cancer screening program that is targeted to decreasing the number of patients with late-stage disease. The screening program is based on community needs and is consistent with evidence-based national guidelines and evidence-based interventions. A process is developed to follow up on all positive findings.
The reportable list must include all malignancies dx'd and/or initially treated at the reporting institution and which meet the criteria for analytic cases. The current ICD-O should be used to establish a reportable ist
...
To be eligible for CoC survey, ___year of data must be sumitted to NCDB
1 yr
To be eligible for CoC survey, facility must have at least ___year of services and ___ years of cancer registry cases in the database with ___ year of follow-up.
1 yr 2 yrs 1 yr
NCRA's Strategic objectives categories
1. Education/professional development. 2. Credentialing. 3. Recruitment and retention. 4. Member and customer services 5. Advocacy. 6. Administration and finance
4 main cornerstones of the COC Standards
1. Multidisciplinary cancer committee which provides administration of the cancer program. 2. Multidisciplinary cancer conferences which provides consultative services to patients. 3. Evaluation of quality outcomes and improvements. 4. Cancer registry which is the monitor of the cancer program.
Can you think of some of the information that you might look for in a medical chart in order to determine extent of disease?
1. Organs or tissues involved by direct extension 2. Distant site involvement via the blood stream or lymphatic system. 3. Regional or distant lymph node involvement 4. Metastasis by seeding or implantation of cancer cells
After the patient is entered into the registry files, follow-up procedures are initiated. You have already learned some of the reasons for patient follow-up. List at least two of them.
1. To ensure early detection of any recurrence of the malignancy. 2. To insure that early detection of the occurrence of any type of malignancy (a second primary site) 3. To obtain information needed to assess the results of various types of treatment. 4. To obtain "end results" information, such as: a. How long the patient has lived b. How well the patient has lived or "quality of survival" c. Whether the patient has expired and whether death was due to the cancer 5. To maintain continuity of patient care (cancer management)
editing process of the NCDB
1. evaluates the quality of the data reported for each case 2. all cases that did not fail any of the "rejection edits" are evaluated and scored depending on which and how many of the specified single and interitem edits a case fails (0 = problem-free, 1-199 are expected to be reviewed, corrected, and resubmitted) 3. production of an edit report for each of the years included in every data transmission made by a CoC-accredited cancer program registry
What are the CoC's reasons for changing a reference date (3)?
1. high error rate or gap in data 2. high lost to follow up rate 3. hospital merger
goals and objectives of registries
1. incidence surveillance 2. survival surveillance 3. analytic research 4. clinical research 5. patient care surveillance 6. professional education for clinicians and others 7. enumeration of caseload studies 8. community and state outreach and public policy 9. evaluation of cancer control initiatives
4 Main Cornerstones of the CoC Standards
1. multidisciplinary cancer committee which provides administration of the cancer program 2. multidisciplinary cancer conferences which provides consultative services to patients 3. Evaluation of quality outcomes and improvements 4. Cancer registry which is the monitor of the cancer program
penalties for violating the Professional Practice Code of Ethics
1. rendered ineligible to be nominated for or elected to an office in the association 2. suspension of NCRA membership 3. revocation of NCRA membership 4. revocation of the CTR credential
purposes of the Administration Simplification rule
1. to protect and enhance the rights of consumers by providing them access to their health information and controlling the inappropriate use of that information 2. to improve the quality of health care in the US by restoring trust in the health care system among consumers, health care professionals, and the multitude of organizations and individuals committed to the delivery of care 3. to improve the efficiency and effectiveness of health care delivery by creating a national framework for health privacy protection that builds on efforts by states, health systems, and individual organizations and individuals
Hospital Associate Cancer Program (HACP)
100 or fewer cases a year and has a limited range of diagnostic and treatment service available on-site. other services available by referral. clinical research not required participation in training of resident physicians is optional
Right Breast lesion in Upper Outer Quad, clock position?
11 o'clock
DST (Disease Site Teams)
13 of these conduct research using NCDB resources, develop focused studies, develop educational interventions, evaluate quality of cancer registry data, and collaborate with other national leaders in cancer care; each one is multidisciplinary in composition and represents various cancer sites
Annual update to the Survey Application Record (SAR) must be done ___days prior to survey
14 days
According to the Commission on Cancer, Cancer Conference presentations must present ____ of all analytic patients?
15%
What year was the CoC established
1922
Cancer data collection began in the US in what year
1926
Year CoC accreditation of hospitals established
1930
What year was SEER established
1973
Surveillance, Epidemology , End Results
1973 the National Cancer Institute established the SEER program.
What year was NCRA established
1974
In what year was the first edition of the Cancer Staging Manual published.
1977
What year was NAACCR established
1987
In what year did congress pass the Cancer Registries amendment act, which established the National Program of Cancer Registries
1992
What year was NPCR established
1992 by Congress via the Cancer Registries Amendment Act
HIPAA (Health Insurance Portability and Accountablity Act was enacted in ____ by_____
1996, by Congress
Multifocal carcinoma
1st lesion is confirmed CA. 2nd lesion is found close by (with 5 cm distance)
According to the American College of Surgeons Commission on Cancer, for Quality Improvement, at least ______ patient care improvements must be implemented each year.
2
How many CEs must you have to maintain the CTR certification
20 or more every 2 years.
what year was the Version1 of the collaborative staging system released
2004
SEER covers
26% of the US population.
According to the American College of Surgeons Commission on Cancer, commendation is given for the CTR(s) attending a national or regional cancer related educational activity once every _______ years and all other registry staff members must attend and educational activity annually.
3
How many different types of registries are there?
3
Which CoC standard is defined as complete data for all analytic cases submitted to the NCDB in accordance with the annual call for data?
3.6
___% of hospitals in the the U.S. are CoC accredited
30%
The CoC program standards 2012 contains ___ different standards.
34
Cancer Registries Amendment Act (Public Law 102
515)-This act is federal legislation that established the National Program of Cancer Registries (NPCR) and granted authority to the Centers for Disease Control and Prevention (CDC) to provide funds to states and territories for the purpose of enhancing existing population-based registries, develop registries where none existed, create model legislation and regulations for states to enhance visibility of registry operations, set standards for completeness, timeliness, and quality as well as provide necessary training.
The AJCC is comprised of
6 founding organizations, 4 sponsoring organizations, and 11 liaison organizations.
Abstracting data is usually performed within a particular time period. ACoS requires cases to be abstracted ___________ from the date of 1st contact.
6 months
what is the revision cycle for the AJCC cancer staging manual
6-8 years
cancer is the disease of aging with majority of cases occuring in persons over the age of
65
The optimum operating frequency for a broad-bandwidth transducer is?
8 MHz
There are ___categories of cancer programs at the CoC
9
___________ follow up rate is maintained for all analytic patients diagnosed within the last five years, or from the cancer registry reference date whichever is shorter
90%
Standard 5.4 Follow-Up of Recent Patients.
A 90% follow-up rate is maintained for all eligible analytic cases diagnosed within the last 5 years or from the cancer registry reference date, whichever is shorter.
Standard 4.3 Cancer Liaison Physician Responsibilities.
A Cancer Liaison Physician serves in a leadership role within the cancer program and is responsible for evaluating, interpreting, and reporting the program's performance using the National Cancer Data Base (NCDB) data. The CLP, or an equivalent designee, reports the results of this analysis to the cancer committee at least four times a year.
STANDARD 4.3 CANCER LIAISON PHYSICIAN RESPONSIBILITIES
A Cancer Liaison physician serves in a leadership role within the cancer program and is responsible for evaluating, interpreting and reporting the programs performance using the National Cancer Data Base (NCDB) data. The CLP, or an equivalent designee, reports the results of this analysis to the cancer committee at least four times a year
Advanced Breast Biopsy Instrument (ABBI)
A biopsy device that uses stereotactic mammography for localization Most accurate diagnosis
E3: Cancer Conference Policy
A cancer conference policy or procedure is used to establish the annual cancer conference activity. Cancer conferences improve the care of patients with cancer by providing multidisciplinary treatment planning and contributing to physician and allied medical staff education.
A tumor is defined in terms of two basic characteristics. A cancer or malignant tumor possesses these two characteristics plus a third one. Describe in your own words this third characteristic.
A cancer, or malignant neoplasm, is composed of cells that are growing at an uncontrolled rate and that tend to spread or metastasize to other areas of the body.
The starting point for international cancer registries
A conference in Copenhagen in 1946 where the recommendations were accepted by the WHO and resulted in the establishment of epidemiological cancer registries worldwide.
Incision
A cut; a wound produced by cutting
GLOBOCAN
A database that provides access to the 2008 estimates of the incidence of, and mortality from 27 major cancers worldwide
PHAC
A federal government organization charged with protecting the health and safety of Canadians, including specific target areas such as disease surveillance
Obstruction of a lactiferous duct in a lactating woman can lead to the development of?
A galactocele
Canadian council of cancer registries
A group of representatives from each p/t registry and core staff from statistics canada that manage the CCR
CIHI
A independent, non profit, national organization that works to provide standardized, high quality health information for improving the health of Canadians
Fibromyosarcoma
A malignant tumor involving fibrous-like as well as muscle tissue.
Adenomyosarcoma
A malignant tumor involving glandular cells and cells that compose the muscles.
Cystadenocarcinoma
A malignant tumor involving glandular epithelial cellsin the for of a sac (or cyst).
What is the national cancer database?
A nationwide, facility based oncology data set
A prospective Cancer Conference case is:
A newly diagnosed patient & treatment not yet started and A newly diagnosed and treated patient who may need additional treatment and A previously diagnosed patient for whom supportive or palliative care is needed
CHI
A nonprofit organization aimed at working with all levels of government and healthcare organizations and technology providers to promote the use of EHRs in Canada; contributed to the identification of potential technology solutions and best practices, as well as the establishment of important infrastructure components such as data transmission standards
E4: Oncology Nurse Leadership
A nurse provides leadership for oncology patient care across the care continuum.
E12: Nutrition Services
A policy or procedure is in place to access nutrition services either on-site or by referral.
E11: Rehabilitation Services
A policy or procedure is in place to access rehabilitation services either on-site or by referral.
E10: Psychosocial Services
A policy or procedure is in place to ensure patient access to psychosocial services either on-site or by referral.
CONCORD study
A study that compares population-based relative survival from cancer using data from cancer registries in 31 countries representing 5 continents; includes North America, Australia, Japan, Algeria, Cuba, and Brazil, as well as all regions of Europe.
Choose the statement below that best describes the term remission: A. The patient is asymptomatic but continues on chemotherapy. B. The malignant neoplasm was removed by surgery and the patient is receiving radiation therapy every week. C. Surgery for stomach cancer revealed that the malignancy had spread to the liver. Therefore, chemotherapy was initiated following surgery.
A. Remission means free of symptoms but not necessarily free of disease. Because of the possibility of residual tumor, the patient continues to receive chemotherapy.
Cancer begins by involving only a small number of cells within the primary site. As these cells multiply, they involve a wider area within the organ or tissue of origin. The resultant mass or tumor compresses, invades, and destroys adjacent normal tissues. A. This is spread by direct extension to organs ____ to the primary site. B. Any contiguous growth into neighboring tissues or organs is called involvement by _____.
A. Adjacent B. Direct extension
When comparing the similarities and differences between the three germ layers, it can be said that: (TRUE or FALSE) a. Carcinomas can arise in tissue that has been derived from any one of the three germ layers. b. Sarcomas can arise in tissue that has been derived from either the ectoderm or the mesoderm. c. Assuming that a structure of the body contains both an epithelial lining and supporting or connective tissue, either a sarcoma or carcinoma could arise in that structure.
A. False. Carcinomas begin in the epithelial tissue which is derived from the ectoderm and endoderm. B. False. C. True. If both epithelial and connective tissues comprise a body structure, a carcinoma could begin in the epithelium and/or a sarcoma could start in the connective tissue.
By definition a tumor has two basic characteristics. Describe these characteristics.
A. New growth of cells; a mass of tissue composed of new cells B. No known useful physiological function
In the following examples select the primary and secondary site that would be recorded on the abstract form: A. Patient has cancer of the prostate gland with regional lymph node involvement. B. Exploratory surgery was performed which showed cancer of the ovaries with metastases to liver and regional lymph nodes. C. Biopsy revealed malignant tumor in the breast, but examinations for metastses proved negative.
A. Primary: Prostate gland Secondary: Regional nodes B. Primary: Ovaries Secondary: Liver and regional lymph nodes C. Primary: Breast Secondary: None
both are different bodies ACOS-scientific education of surgeons & parent orgz of CoC
ACoS CoC
What is the primary foundation/financial underpinning of data collection for cancer registration in the US?
ACoS/CoC accredited cancer program
American Joint Committee on Cancer AJCC-TMN Lead the Collaborative Staging Task Force in develp of CS
AJCC
The staging basis is an important descriptive in which staging system
AJCC
Which organization has played a leadership role in the oversight of cancer staging for most solid tumors seen in clinical practice
AJCC
which organization is the administrative sponsor for the collaborative stage data collection system
AJCC
The AJCC publishes
AJCC Cancer staging manual and the Collaborative Stage Data Collection System.
Pathologic Staging
AKA surgical stagingrelies on what is learned about the cancer during surgery. Often this is surgery to remove the cancer and nearby lymph nodes, but sometimes surgery may be done to just look at how much cancer is in the body and take out tissue samples. In some cases, the pathologic stage may be different from the clinical stage (for instance, if the surgery shows the cancer has spread more than it was thought to have spread before surgery). The pathological stage gives the health care team more precise information that can be used to predict treatment response and outcomes (prognosis).
Standard 4.4
Accountability Measures Each year, performance levels defined by the CoC are met for each accountability measure.
Standard 5.6
Accuracy of Data Each year, the cases submitted meet the quality criteria specified in the Call for Data; cases with errors or rejected cases are corrected and resubmitted by the deadline specified in the Call for Data.
Glandular breast tissue contains all the following structures:
Acini, TDLU, Lactiferous ducts, Epithelial/myoepitheleal cells NOT FAT
Treatment are often used in combo with each other. That type of therapy is called
Adjuvant
Females more likely to develop fibroadenoma
African-American
Which of the following types of malignant neoplasms would be example of sarcoma? A. A malignant tumor arising in fibrous tissue B. A malignant tumor arising in cartilage C. A malignant tumor composed of fatty tissue D. A malignant tumor arising in lymph nodes
All are examples of sarcomas.
The collection of international data
Allows the study of migrant data and extensive comparisons among varied ethnicities and nationalities that greatly expand the knowledge of the disease.
AACCR
American Association of Central Cancer Registries
ACS
American Cancer Society
ACoS
American College of Surgeons
ACoS CoC
American College of Surgeons Commission on Cancer
Before being known as the AJCC, what was the group called
American Joint Committee for cancer staging and end results reporting
AJCC
American Joint Committee on Cancer
ARRA
American recovery and reinvestment act
Excision
An act of cutting away or taking out
Clinical Staging
An estimate of how much cancer there is based on the physical exam, imaging tests (x-rays, CT scans, etc.), and tumor biopsies. For some cancers, the results of other tests, such as blood tests, are also used in staging. The clinical stage is a key part of deciding the best treatment to use. It's also the baseline used for comparison when looking at the cancer's response to treatment.
UICC
An international group which connects public health scientists and practitioners, epidemiologists, public health educators, behavioral scientists, and investigators to move the cancer control agenda forward in communities worldwide.
KRAS
An oncogne (when mutated helps turn normal cells into cancer cells) . Mutations of KRAS indicate a patient may not respond to anti-epidermal growth factor receptr drugs Cetuximab (Erbitux) or panitumaumab (Vectivix). Prognostic indicator for colorrectal cancer.
International association of cancer registries
An organization whose aims are to improve cancer incidence and survival information; to standardize definitions, coding, and reporting; and to foster the exchange of scientific research between countries
Right Breast ARad 2:00 1A, where is the lesion?
Andtiradial scan of the Right Breast, Upper Inner Quadrant near the nipple under the skin
Standard 1.10
Annual Education Activity Each year, 1 educational activity is offered to physicians, nurses, and allied health professionals; the activity focuses on the use of stage, prognostic factors, and evidence-based treatment guidelines in treatment planning.
MONITORING COMPLIANCE WITH EVIDENCE-BASED GUIDELINES
Annual study includes- 1.A site specific Sample -involves all cases from that site, to a maximum of 300 cases -Is based on an identified need, concern, or problem -Is based on uncommon cases such as cases not generally presented at cancer conference *10 % random review of the annual analytic case load; maximum review of 300 cases for any facility *Review of a single treatment for a specific cancer site(such as neoadjuvant therapy for breast cancer,radiation therapy for breast conservation 2.A determination that the first course of therapy is concordant with an evidence based national treatment guideline and or prognostic indicators, when available 3. Reporting format that permits analysis and provides an opportunity to recommend performance improvements
Standard 5.6 Accuracy of Data.
Annually, cases submitted to the National Cancer Data Base (NCDB) that were diagnosed on January 1, 2003, or later meet the established quality criteria and resubmission deadline specified in the annual Call for Data.
STANDARD 4.4 ACCOUNTABILITY MEASURES
Annually, performance levels are met for each of the specified accountability measures as defined by the commission on cancer
STANDARD 4.8 QUALITY IMPROVEMENTS
Annually, the quality improvement coordinator under the direction of the cancer committee, implements 2 patient care improvements. One improvement is based on the results of a completed study that measures cancer patient quality of care and outcomes. One improvement can be identified from another source or from a completed study. Improvements are documented in the cancer committee minutes and shared with medical staff and administration
HIPAA was approved 8/14/2002. When were covered entities required to fully comply with HIPAA rules?
April 14, 2003
Internationally based cancer registries
Are usually population based and carry the burden of cost for data collection.
AFIP
Armed Forces Institute of Pathology
Standard 1.9 Clinical Trial Accrual.
As appropriate to the cancer program category, the required percentage of patients is accrued to cancer- related clinical trials each year. The clinical trial coordinator or representative reports clinical trial participation to the cancer committee each year.
STANDARD 1.9 CLINICAL TRIAL ACCRUAL
Asappropriate to the cancer program category, the required percentage of patients is accrued to cancer-related clinical trials each year. The clinical trial coordinator or representative reports clinical trial participation to the cancer committee year.
Diagnostic procedures
Aspiration BX Needle BX Incisional BX
Select the term that could be used as the name for a malignant neoplasm which consists of two types of cells--cells of cartilaginous connective tissue and cells of mucinous tissue. A. Chondromyxofibroma B. Chondromyxosarcoma C. Myxochondroma D. Myxochondrosarcoma
B and D. These types of tumor are know as mixed cell tumors.
Sometimes the name given to a malignant tumor will also describe the type of cells involved. For example, a cancer that arises in glandular tissue might be called: A. Myeloma B. Adenocarcinoma C. Epithelioma
B. Adenocarcinoma Cancers often are named for the type of cells involved.
Choose the diagnostic statement below that does not contain anatomical site information: A. Cancer of the cervix as determined by a Papanicolaou test. B. Malignant tumor with possible metastatic characteristics. C. Benign tumor of the stomach located during exploratory surgery.
B. Does not contain anatomical site for the tumor - meaning organ, bone or tissue named.
Surgery, radiation, chemotherapy, and immunotherapy can be used together or separately to control, modify or eliminate the growth of cancer. When used in this fashion, they are forms of treatment. Some surgical procedures, however, are diagnostic in that their purpose is to aid in the identification of the disease. Chose from the following the procedure that is a form of treatment: A. A surgical incision into the abdomen (laparotomy) to visually inspect a suspected malignancy B. The excision of part of the lung plus chemotherapy to control the spread of lung cancer C. A surgical biopsy and/or x-ray to diagnose a bone tumor
B. The excision and chemotherapy The use of surgery to remove the primary lesion supplemented by chemotherapy to control possible metastasis. (The location and spread of the cancer are two factors the physician considers before determining the best method of treatment)
NAACCR GUIDELINES STATE THAT STAFFIGN NEEDS FOR STATE/CENTRAL REGISTRIES SHOULD BE
BASED ON THE ESTIMATED ANNUAL CASELOAD OF THE REGISTRY
Indicate classification and tissue: Adenoma
Benign -- Glandular
Indicate classification and tissue: Chondroma
Benign--Cartilage
Indicate classification and tissue: Lipoma
Benign--Fat
Indicate classification and vessel: Lymphangioma
Benign--Lymph
Indicate classification and tissue: Myoma
Benign--Muscle
Methods that offer histology findings
Biopsies (excisional, incisional, Core BX) NOT FNA
Most common cancer in women
Breast CA
Invasive Ductal Carcinoma aka IDC
Breast CA likely to have a suspicious, irregular border
BIRADS
Breast Imaging Reporting and Data System Classifications: 0- inconclusive 1 - normal breast tissue (negative) 2 - Benign 3- Probably benign 4 - Suspicious of malignancy 5 - Highly suggestive of malignancy 6 - Proven malignancy (+ findings on bx)
MRI of breast is most widely acceptable to evaluated
Breast implant ruptures
Which of the following types of information might be considered end results information? A. The number of cancer cases diagnosed during the past year, arranged by anatomical site, by stage of disease and by age of patient. B. The cost and length of time required to diagnose various types of cancer. C. The number of people surviving five years after treatment for various types of cancer. D. The number of former cancer patients who have been followed during the past year who were free of disease.
C and D. - Forms of "end results" A - is a frequency distribution of cancer cases and B is a cost analysis of actual costs and time.
A new mass of tissue that has been growing in size for two months is probably: A. A benign tumor B. A malignant tumor C. Either benign or malignant D. Neither benign nor malignant
C. - Either benign or malignant Both benign and malignant tumors may grow. However, benign tumors may stop growing of their own accord. This is quite unlikely for a malignant neoplasm. A biopsy and microscopic examination must be made to determine specifically whether a tumor is malignant or benign.
Which of the following statements best describes a cancerous condition? A. The neoplasm appeared two months ago and has doubled in size since that time. B. The neoplasm ceased to grow after a two-month period. C. After the first occurrence of the neoplasm, a secondary site of neoplasm appeared. D. The new growth appeared to have no planned physiological function.
C. Best describes the condition of spread or metastasis which is the main distinction between benign and malignant neoplasms.
Indicate which of the following would be a cystic malignant growth of glandular epithelium. A. Adenocarcinoma B. Cystadenoma C. Cystadenocarcinoma
C. Cystadenocarcinoma
Which of the activities described below might be involved in making a diagnosis? A. Forecasting the probable outcome of the disease. B. Providing special care to combat the disease. C. Distinguishing one disease from another.
C. Distinguishing one disease from another. This is but one aspect of the total process of diagnosis. Some diseases have similar symptoms, especially during early stages. Therefore, it is necessary to identify a patient's particular disease. This is often deemed as a "differential diagnosis". A. represents prognosis B. represents treatment
Which of the following statements best describes the difference between a malignant tumor and a benign tumor? A. Malignant tumors grow much larger than benign tumors B. Malignant tumors grow much faster than benign tumors C. Malignant tumors spread to other organs; benign tumors do not spread to other organs.
C. Malignant tumors spread to adjacent organs and tissues or metastasize to distant sites. Benign tumor do not do this, which is the most important distinction between benign and malignant tumors.
Which patient in the list below will never have a recurrence of cancer? A. A person who has just been treated for colon cancer B. A person who was treated for colon cancer three years ago C. A person who was treated for colon cancer seven years ago D. All of the patients have the same probability of recurrence. E. None of the above patients can be absolutely certain of never having a recurrence.
C. None of these persons can be absolutely certain of never having a recurrence. However, the longer the patient has lived without a recurrence, the greater the probability that there will be no recurrence.
WHAT IS A DESCRIPTIVE ANALYSIS TO EVALUATE CANCER OCCURRENES IN A CERTAIN LOCATION OR DURING A CERTAIN TIME PERIOD CALLED
CANCER CLUSTER
Standard 2.1
CAP Protocols 90% of eligible pathology reports include the required data items as specified in the site-specific CAP protocols.
NPCR is a program of the
CDC
Which agency developed the EDITS software used as part of the quality improvement process of cancer registry data
CDC
Which organization is authorized to administer the NPCR?
CDC
EDITS
CDC software that is free of charge; developed to improve the quality of data; it checks the validity of certain data items and is used to create record layouts and to maintain look-up tables among other uses; is widely used by all registries and software vendors
Paul Coverdell Stroke Registries
CDC-supported program to implement state-based stroke registries, eight prototype registry projects funded in 2001 and 2002, including evaluation of emergency transportation, emergency department services, and in-hospital services
Center for Disease Control and Prevention Nat'l Program of Cancer Registries funds state cancer registries monitor trends over time determine cancer patterns in populations guide planning & evaluation of cancer control programs help set priorities for allocating health resources advance research
CDC/NPCR
Standard 4.3
CLP Responsibilities The CLP uses NCDB data to evaluate and interpret program performance; program performance is reported to the cancer committee at least 4 times annually.
NCDB GETS DATA FROM
COC ACCREDITED CANCER PROGRAMS
QUALITY REPORTING TOOLS
CP3R Cancer Program Practice Profile Reports
CDOH
California department of health
CHI
Canada health infoway
CCR
Canadian cancer registry
CCS
Canadian cancer society
CCCR
Canadian council of cancer registries
CIHI
Canadian institute for health information
CPAC
Canadian partnership against cancer
Establishing the quality improvement priorities of the institution's cancer program is the responsibility of the ___________.
Cancer Committee
Per the Cancer Program Standards, different goals for the cancer program are set annually by the:
Cancer Committee
Standard 1.3
Cancer Committee Attendance Each required cancer committee member or designated alternate attends 75% of meeting annual.
Standard 1.2
Cancer Committee Membership The cancer committee is multidisciplinary. Category specific members are: Clinical research rep. Genetics/counselor (if provided on site) Palliative care team (if provided on site) Rehab rep
Periodic follow-up examination of the cancer patient is an essential component of his/her _____ _____.
Cancer Management It is important to remember that management of a cancer patient does not end with treatment. At periodic intervals throughout the patient's life, the patient should be examined so that any recurrences of the original cancer or growth of new types of cancer (second primaries) may be discovered. The quality of survival (the capacity of assuming the activities of normal life) is of great importance in planning treatment. Physicians want not only to keep the patient alive but to allow for the most normal life after therapy.
Standard 1.11
Cancer Registrar Education All registry staff participate in annual educational activity.
Public Law 102-515 is also the ____Act
Cancer Registration Amendment Act
Standard 5.1
Cancer Registry Credentials Case abstracting is performed by a CTR
Standard 1.6
Cancer Registry Quality Control Plan The cancer committee establishes and implements a registry quality control plan each year. The plan addresses all required criteria.
CSB
Cancer Surveilance Branch of NPCR/DCPC; Composed of Operations Research and Technical Assistance(ORTAT), Data Analysis and Support(DAST), and SRT-Surveilance Research Team
E2: Cancer Committee Authority
Cancer committee authority is established and documented by the facility. Program success depends on an effective multidisciplinary cancer committee. The cancer committee is responsible for goal setting, planning, initiating, implementing, evaluating, and improving all cancer-related activities in the program. The facility may use any method that is consistent with program organization and operation to document the authority of the cancer committee. The program provides the bylaws, policy or procedure, or other sources that set forth the cancer committee's authority for the cancer program.
A malignant tumor
Cancerous or Harmful tumor
If a tumor is malignant, the terms _____ or _____ is added to the root. This indicates that the tumor is cancerous or malignant.
Carcinoma or Sarcoma
All malignant neoplasms arising from the lining of such organs as the external ear and nasal cavity would be called ________.
Carcinomas
Cancers arising from epithelial cells are classified as ______.
Carcinomas
For the present, we will distinguish two general types of tissue: (1) epithelial and (2) nonepithelial. In a previous block of instruction, you learned about two general types of malignancies: carcinomas and sarcomas. Which one of these is associated with malignancies arising in epithelial cells?
Carcinomas These are the most common of all malignant neoplasms. On the other hand, the general term sarcoma is used to describe malignancies that arise in connective tissue. Connective tissue is used here in the very general and broad sense to include all nonepithelial tissues--bone, muscle, blood, and cartilage, for example.
Word Root: Chondr
Cartilage
Standard 5.1 Cancer Registrar Credentials.
Case abstracting is performed by a Certified Tumor Registrar.
A system for locating every patient who is diagnosed and/or treated with a reportable cancer at a Facility.
Casefinding
Per Cancer Conference policy, cases presented to the Cancer Conference may include:
Cases newly diagnosed and treatment not yet initiated
CDC
Center for Disease Control and Prevention
The National Program of Cancer Registries (NPCR) is a function of
Center of diease control and prevention (CDC)
the national program of cancer registries (NPCR) is a function of
Centers for disease control and prevention (CDD)
Name and social security # are sent to ______ during state case transmittal
Central Cancer Registry
_______ registries can be regional, state, multi-state, provincial or national
Central registries
The term designating a benign tumor of the brain covering.
Cerebral memingioma
Standard 1.9
Clinical Trials Accrual 6% of the number of annual analytic cases; 8% of the number of annual analytic cases for commendation. Coordinator/representative reports on activity yearly.
____enables accredited cancer programs to report data on patients with breast and colon cancer concurrently to facilitate quality improvement measures that will encourage good-quality, evidence-based care in a timely manner at the local level.
CoC's RQRS or Rapid Quality Reporting System
Cancer Registers
Collect statistics, treatment strategies, and develop public health initiatives
What are the 2 official sources of Federal Government Statistics and data to Congress for The Report to the Nation
Combined SEER and NPCR data
CoC
Commission of Cancer
CoC
Commission on Cancer
RQRS CP3R Special Studies (PCORI Special Study for Lung, Breast, & Colon Cancers) professional organization dedicated to improving lives of cancer patients
Commission on Cancer
Standard 5.7
Commission on Cancer Special Studies The program participates as specified by the Coc.
The facility accessions 500 or more cases/year
Comprehensive Community Cancer Program
The process that starts when the patient is in the hospital and usually is completed by the time the first course therapy has begun and health records are sent for filing is called
Concurrent data collection
which state was the first to start collecting cancer incidence data
Connecticut
US military health system
Consists of the office of the assistant secretary of defense for health affairs, the medical depts of the army, navy, marine corps, Air Force, coast guard, joint chiefs of staff, the combatant command surgeons, and TRICARE providers
Because of the disease of cancer is an ongoing process or an ordered sequence of biological events continuing throughout the lifetime of the patient, it must be viewed as biological _____.
Continuum
Breast mass that is palpable, tender, movable, compressible, and associated with the menstrual cycle is most likely?
Cyst
On a Mammo which is seen as a water density ?
Cyst, fibroadenoma, and Carcinoma
Bright, dense lesion on Mammo can be:
Cyst, fibroadenoma, or Carcinoma
A recent lump under the skin of the thigh which was found to contain new cells or tissue would be called a tumor or neoplasm. Which of the statements below probably describes a neoplasm? A. A swelling around the ankle that was found to contain "old blood". B. A callus on the finger of a baseball player C. A recent swelling about a scratch D. A recent lump under the arm that feels as if it contains fleshy material
D. - A lump under the arm. It most nearly meets the definition of a tumor or neoplasm-namely, that it is a mass of new cells having no directed physiological function.
Standard 5.5
Data Submission Complete data for all cases submitted each year as specified in the Call for Data.
5 areas of quality for a cancer program
Data quality, Accountability measures, assessment of evalutation, studies of quality & quality improvements
The collection of data items maintained by the registry
Data set is
Process of linking all death records from the state's vital statistics office to identify patients in the registry database who have died.
Death clearance
______________ is the process of linking death certificates from the state to the registry records
Death clearance
Extent of Disease
Detailed description of how far the disease has spread from the primary site.
STANDARD 1.1 PHYSICIAN CREDENTIALS
Diagnostic and treatment services are provided by or referred to the leadership and cancer program evaluation and management team physicians who are currently board certified, or the equivalent, in their general specialty or are in the process of becoming board certified
Standard 1.1 Physician Credentials
Diagnostic and treatment services are provided by or referred to the leadership and cancer program evaluation and management team physicians who are currently board certified, or the equivalent, in their general specialty or are in the process of becoming board certified.
E6: Diagnostic Imaging
Diagnostic imaging services are provided either on-site or by referral. The program identifies the diagnostic imaging services available either on-site or by referral.
Latest procedure and the greatest. like robotics
Didactic
DAD
Discharge abstracting system
Most common type of non-invasive cancer
Ductal Cacinoma In Situ (DCIS)
Standard of care for the protection of others agains unreasonable risk
Duty of Care
The process for cancer casefinding from independent path lab is
E-path reporting
THE STUDY OF DISTRIBUTION AND DETERMINANTS IN THE HUMAN POPULATION
EPIDEMIOLOGY
Standard 1.3 Cancer Committee Attendance.
Each required member attends at least 50% of the cancer committee meetings held during any given year.
Standard 4.6 Monitoring Compliance with Evidence-Based Guidelines.
Each year, a physician member of the cancer committee performs a study to assess whether patients within the program are evaluated and treated according to evidence-based national treatment guidelines. Study results are presented to the cancer committee and documented in cancer committee minutes.
STANDARD 4.6 MONITORING COMPLIANCE WITH EVIDENCE-BASED GUIDELINE
Each year, a physician member of the cancer committee performs a study to assess whether patients within the program are evaluated and treated according to evidence-based national treatment guidelines. study results are presented to the cancer committee and documented in cancer committee minutes
STANDARD 1.11 CANCER REGISTRAR EDUCATION
Each year, all members of the cancer registry staff participate in 1 cancer-related educational activity other than cancer conferences
Standard 1.11 Cancer Registrar Education.
Each year, all members of the cancer registry staff participate in 1 cancer-related educational activity other than cancer conferences.
STANDARD 4.7 STUDIES OF QUALITY
Each year, based on category, the quality improvement coordinator, under the direction of the cancer committee, develops, analyzes and documents the required studies that measure the quality of care and outcomes for patients with cancer
Standard 4.7 Studies of Quality.
Each year, based on category, the quality improvement coordinator, under the direction of the cancer committee, develops, analyzes, and documents the required studies that measure the quality of care and outcomes for patients with cancer.
Standard 5.5 Data Submission.
Each year, complete data for all requested analytic cases are submitted to the National Cancer Data Base (NCDB) in accordance with the annual Call for Data.
STANDARD 1.12 PUBLIC REPORTING OF OUTCOMES
Each year, the cancer committee develops and disseminates a report of patient or program outcomes to the public
Standard 1.12 Public Reporting of Outcomes.
Each year, the cancer committee develops and disseminates a report of patient or program outcomes to the public.
STANDARD 1.5 CANCER PROGRAM GOALS
Each year, the cancer committee establishes, implements, and monitors at least 1 clinical and at least 1 programmatic goal for the endeavors related to cancer care, Each goal is evaluated at least twice annually. The evaluation is documented in cancer committee minutes
Standard 1.5 Cancer Program Goals.
Each year, the cancer committee establishes, implements, and monitors at least 1 clinical and at least 1 programmatic goal for the endeavors related to cancer care. Each goal is evaluated at least twice annually. The evaluation is documented in cancer committee minutes.
STANDARD 1.4 CANCER COMMITTEE MEETINGS
Each year, the cancer committee meets at least once each calendar quarter
Standard 1.4 Cancer Committee Meetings.
Each year, the cancer committee meets at least once each calendar quarter.
STANDARD 1.10 CLINICAL EDUCATIONAL ACTIVITY
Each year, the cancer committee offers at least 1 cancer-related educational activity, other than cancer conferences, to physicians, nurses, and other allied health professionals. The activity is focused on the use of AJCC or other appropriate staging in clinical practice, which includes the use of appropriate prognostic indicators and evidence-based national guidelines used in treatment planning.
Standard 1.10 Clinical Educational Activity.
Each year, the cancer committee offers at least 1 cancer-related educational activity, other than cancer conferences, to physicians, nurses, and other allied health professionals. The activity is focused on the use of AJCC or other appropriate staging in clinical practice, which includes the use of appropriate prognostic indicators and evidence-based national guidelines used in treatment planning.
STANDARD 4.1 PREVENTION PROGRAM
Each year, the cancer committee provides at least 1 cancer prevention program that is targeted to meet the needs of the community and should be designed to reduce the incidence of a specific cancer type. The prevention program consistent with evidence-based national guideline for cancer prevention.
Standard 4.1 Prevention Programs.
Each year, the cancer committee provides at least 1 cancer prevention program that is targeted to meet the needs of the community and should be designed to reduce the incidence of a specific cancer type. The prevention program is consistent with evidence-based national guidelines for cancer prevention.
STANDARD 4.2 SCREENING PROGRAMS
Each year, the cancer committee provides at least 1 cancer screening program that is targeted to decreasing the number of patients with late-stage disease. The screening program is based on community needs and is consistent with evidence-based national guidelines and evidence-based interventions. A process is developed to follow-up on all positive findings
Casefinding and electronic transmission from hospital based/independent pathology labs to the Central Registry
Epath reporting
What type of tissue is derived from the ectoderm and the endoderm?
Epithelial tissue is derived from both endoderm and the ectoderm.
What did the Cancer Registries Amendment Act PL102-515 of October 1992 do?
Established NPCR (CDC) providing funds to states to develop legislation providing financial and technical assistance to state public health departments.
What is the National Program of Cancer Registries (NPCR) administered by (CDC)
Established by Congress through the Cancer Registries Amendment Act in 1992, and administered by the Centers for Disease Control and Prevention (CDC), the National Program of Cancer Registries (NPCR) collects data on the occurrence of cancer; the type, extent, and location of the cancer; and the type of initial treatment. These data represent 98 percent of the United States population.
ENCR
European national cancer registry
Which would NOT be a good indication for performing a breast sonogram?
Evaluate a mass for microcalcifications (Best seen on Mammo)
Pediatric cancer program (PCP)
Example TCH provides on to children or the pediatric oncology program within a larger CoC. may be associated with a medical school & participate training pediatric residents. offers full range diagnositc & treatment services. clinical research no min caseload
The technique used by the tumor registry to record the degree to which cancer has spread from its primary site to other locations throughout the body is called determining the _____ __ _____.
Extent of Disease
Tumor growing outside of the bone:
Extraosseous Ewings
THE WAY VALUES FOR A VARIABLE ARE DISTRIBUTED
FREQUENCEY DISTRIBUTION
According to the CoC Standards, Cancer Committee authority is established and documented by the:
Facility
FORDS
Facility Oncology Registry Data Standards
A future direction of cancer registry computer systems will be to replace DBMSs with systems for harvesting the increasing power, size, and complexity of fourth and fifth generation computing hardware. Select one: True False
False
Assessing edits on a regular basis increases the time to review cases before submission
False
In CoC-accredited cancer programs, cancer committees must meet at least every other month. Select one: True False
False
Rejected cases meet the specified data quality criteria in CoC Standard 3.7
False
True or False: SNOMED stands for Systematized Nomenclature of Medical Entities and Diseases.
False -- It stands for Systematized Nomenclature of Medicine
True or False: The ICD-9-CM is used for coding death certificates in the United States.
False -- The ICD-9 published by WHO must be used for coding death certificates.
True or False: ICD-O-2 has two main sections: Topography and Morphology
False -- There are five main sections besides the two mentioned, Introduction and Instructions, Alphabetic index and Differences in Morphology between first and second editions.
True or False: The revised ICD-O, Second Edition, topography section is based on the Ninth revision of the International Classification of Diseases (ICD-9)
False -It is based on ICD-10
Word Root: Lip
Fat
What would NOT be seen following radiation?
Fat regeneration
Most common solid mass seen in women younger than 30 years old?
Fibroadenoma
In addition to running the NCDB metafile what other practice is beneficial to perform before NCDB file submission
GenEdits Plus
In addition to running the NCDB metafile, what other practice is beneficial to perform before NCDB file submission?
GenEdits Plus
Labeled the germ layer and tumor type: Epithelial tissue
Germ Layer: Ectoderm Endoderm Tumor type: Carcinoma
Labeled the germ layer and tumor type: Fibrous connective tissue
Germ Layer: Mesoderm Tumor type: Sarcoma
Labeled the germ layer and tumor type: Nerve tissue
Germ Layer: Ectoderm Tumor type: Carcinoma
Labeled the germ layer and tumor type: Muscular tissue
Germ Layer: Mesoderm Tumor type: Sarcoma
Labeled the germ layer and tumor type: Vascular tissue
Germ Layer: Mesoderm Tumor type: Sarcoma
Word Root: Aden
Gland
Standard 1.5
Goals The cancer committee sets at least 1 programmatic and 1 clinical goal each year. Each goal is evaluated twice annually, and the evaluation is documented.
Stage of Disease
Grouping cases with similar prognoses into broad extent-of-disease categories, e.g. localized, regional and distant spread.
Taller than wide
Growing across tissue planes. Sonographic characteristics of malignancy suggest that a tumor is invasive.
TABLES IN A REPORT SHOULD
HAVE AS MUCH WHITE SPACE AS POSSIBLE SURROUNDING THE ROWS AND CELLS
HCN
Health card number
population based registries receive cancer data from
Hospital & independent path labs
collects info about all cancer patients in a particular insitutition
Hospital Registry
The facility accessions 100 or less cases/year. limited services
Hospital associate cancer program
Echogenicity of breast structures
Hyperechoic - dense fibroglandular tissue Fat - medium gray shade Most benign tumors - hypoehoic or isoechoic to fat Malignant tumors are NOT hyperechoic to fat (markedly hypoechoic)
International Association of Cancer Registries fosters exchange of information between cancer registries internationally
IACR
International Agency for Research on Cancer coordinates research across countries and organiz WHO/IARC Classification of Tumors (blue book)
IARC
published 2000 & implemented in USA regstries beginning with cases diagnosed on or after 1/1/01
ICD-O-3
CD117 or KIT
IHC stain detects expession of KIT gene in tumor tissue-oncogenic mutation prognostic indicator for GISTs
Health card number (HCN)
Identifying numbers given to all Canadian residents so that their health records are properly ascertained; they facilitate patient identification and record linkage
Goals of Hospital-based registries
Improve patient care conduct clinical research provide admin info
Contiguous
In contact, adjacent Example: Cancer of the stomach with uninterrupted spread to the esophagus. (Non-comtiguous -- not in contact or not adjacent; for example, breast cancer that has metastasized to the brain).
In order to receive a commendation for Standard 1.9 (Clinical Trial Accrual): Select one: a. the required Commendation percentage of patients is accrued to cancer-related clinical trials each year. b. the annual patient accruals to cancer-related clinical trials are monitored and reported to the cancer committee c. a report of the annual patient accruals to cancer-related clinical trials is documented in the cancer committee minutes d. all of the above
In order to receive a commendation for Standard 1.9 (Clinical Trial Accrual): Select one: a. the required Commendation percentage of patients is accrued to cancer-related clinical trials each year. b. the annual patient accruals to cancer-related clinical trials are monitored and reported to the cancer committee c. a report of the annual patient accruals to cancer-related clinical trials is documented in the cancer committee minutes d. all of the above Correct
What can only be done in a population-based registry?
Incidence & mortality rates
what can only be done in a population based registry
Incidence & mortality registries
What type of info that is collected by a central registry is available for public access
Incidence of cancer
What type of information that is collected by central registry is available for public access?
Incidence of cancer
If the image is too dark, what is the first adjustment to make?
Increase gain
IACR
International association of cancer registries
UICC
International union against cancer
Most common cause of bloody nipple discharge?
Intraductal Papilloma
A young patient presents with a bloody nipple discharge. This is most likely associated with?
Intraductal papilloma
radiation therapy is used most often as definitive treatment for
Invasive carcinoma of the cervix
ACCOUNTABILITY MEASURE
Is the standard of care based on clinical trial evidence
A standoff pad thicker than 1cm is NOT recommended because?
It affects the optimal placement of the fixed elevation plane focus
What date requires CTRs abstract cases?
January 1, 2015
Cancer of the bile duct:
Klatskins tumor
Tumor arising in the stomach and metastasizing to the ovaries:
Krukenberg tumor
ONE OF THE MOST COMMON SITS OF METASATIC SPREAD OF CANCER
LIVER
most common cancers of children
Leukemia Brain and other central nervous system tumors Neuroblastoma Wilms tumor Lymphoma (including both Hodgkin and non-Hodgkin) Rhabdomyosarcoma Retinoblastoma Bone cancer (including osteosarcoma and Ewing sarcoma)
On a CC mammo view, a mass that is lateral to the nipple will actually ______ than it appears on the MLO view.
Lie Lower (Remember MULD)
Transducer most appropriate for breast imaging?
Linear 10 to 13 MHz (optimal 7 to 10MHz)
The functional portion of the breast is found within the ____.
Lobe
AIUM recommends the following scanning planes in Breast sonography:
Long, Trans, radial, and anti-radial
Optimal flow setting for Color Doppler evaluation of a solid mass?
Low velocity
Breast CA can mets to:
Lung, liver, and bone
Tonsils are masses of what kind of tissue:
Lymphoid
Ann Arbor staging
Lymphoma
MEASURES OF CENTRAL TENDENCY
MODE MEDIAN MEAN
Indicate classification and vessel: Hemangiosarcoma
Malignant--Blood
Indicate classification and tissue: Adenocarcinoma
Malignant--Glandular
Indicate classification and vessel: Lymphangiosarcoma
Malignant--Lymph
Indicate classification and tissue: Myosarcoma
Malignant--Muscle
Indicate classification and vessel: Angiosarcoma
Malignant--Type of vessel not specified (could be blood or lymph)
Word Root: Myelo
Marrow
Breslow depth of invasion staging
Melanoma based on tumor thickness in mm
MECC
Middle East cancer consortium
Standard 4.6
Monitoring Compliance with Evidence-Based Guidelines A physician member of the cancer committee performs a study to assess that nationally recognized treatment guidelines are used in the formulation of the first course of treatment for patients newly diagnosed with cancer each year.
Axillary nodes
Most commonly involved in Metastasis of lymph nodes
Invasive Lobular carcinoma
Most frequently missed by Mammo and US
MLO view
Most valuable mammo view in evaluating the pectoral fascia
What best describes the NCDB (CoC)
Multi-hospital central cancer registry
Word Root: My
Muscle
*North American Assoc of Central Registries *collaborative umbrella organization for cancer registries, gov agencies, professional assoc, & private groups of North America interested in enhancing quality & use of cancer registry data. *most central registries in the US & Canada are members *establishes consensus on standards *trains cancer registry professionals *certifies central registries
NAACCR
All population-based central cancer registies in the U.S. and Canada are _____members
NAACCR
National standards for completeness, timeliness, and quality of central cancer registry data are established by
NAACCR
Which national agency publishes cancer incidence in North America
NAACCR
NAACCR certification
NAACCR reviews data for completeness, timeliness, and accuracy and the data is given a gold or silver certification. Data that meets the requirements is published in Cancer Incidence in North America. The certification is recognized as a symbol of excellence.
What is the backbone of the NCDB metafile?
NAACCR standard edits
What is the backbone of the NCDB metafile
NAACR standard edits
*Nat'l Coordinating Council for Cancer Surveillance *ACS; ACoS CoC, AJCC, CDC/NPCR, NDCB, NC, SEER, NCRA, NAACCR *purpose to coordinate cancer surveillance activities w/i US thru communication & collaboration among major Nat'l cancer orgzs
NCCCS
Which is an example of a central registry that is NOT a population based?
NCDB
if facility is CoC accredited the Registry must submit to
NCDB & State registry
A non-population based central registry
NCDB (National Cancer Data Base)
All ACoS/COC accredited programs must submit data to the
NCDB and it receives about 70% of all newly diagnosed cancer cases in the US and contains about 29 million records.
Nat'l Cancer Institute Surveillance Epidemiology and End Results (SEER) source of incidence and survial data from population-based cancer registries covering approx. 28% US population
NCI
What are the 2 main funding sources in the U.S. for population-based cancer registries?
NCI and CDC
The facility secures a NCI peer reviewed cancer center support grant. There is no minimum caseload
NCI designed comprehensive cancer center program
caBIG
NCI's Cancer Bioinformatic Grid
Which of the following groups originally got together to form the American Association of Central Cancer Registries
NCI, ACoS, American Association of Cancer Institutes, and the ACS
Which organizations have established guidelines and standards for cancer reporting?
NCI, SEER, NPCR, NAACCR, CoS
NCIP
NCI-designated comprehensive cancer center program
*National Cancer Registrar Association *establishes stds of education for cancer registrars *professional organization *certification process (CTR) ; 20 CE's in two-year cycle. *member organization
NCRA
*National Program of Cancer Registries *National Cancer Registries amendment Act (Public Law 1023-515) passed and created NPCR *authorizes the Ctr of Dz Control & Prevention (CDC) to provide funds to states & territories to enhance existing cancer registries & implement new ones
NPCR
Some Central Registries report to SEER, all others report to ________
NPCR
Which standard setting organization bases its data set on the goal of cancer control and surveillance?
NPCR
Central registries report to what 3 national agencies
NPCR (CDC) and SEER (NCI) and NAACCR (Canada)
NPCR-CSS
NPCR Cancer Surveillance System; provides feedback to the states on completeness and data quality
Two federally funded national population based registries
NPCR and SEER
NPCR-CSS
NPCR cancer surveillance system
NPCR-CSS
NPCR-Cancer Surveilance System
NBCCEDP
National Breast and Cervical Cancer Early Detecton Program
*mandated collection, analysis, & dissemination of data useful in prevention, dz, & tx of cancer. *led to establishment of SEER (Surveillance, Epidemiology, and End Results) program. *SEER based w/I Division of Cancer Control & Population Sciences at Nat'l Cancer Institute (NCI).
National Cancer Act of 1971
The War on Cancer (Act)
National Cancer Act of 1971
Amastia
No development (absence) of breast tissue
Advantage of Ultrasound vs Mammo
No superimposition of tissues
Muscle and fat tissues are composed of what types of cells?
Nonepithelial cells
NAACCR
North American Association of Central Cancer Registries
NACCR
North American Association of Central Cancer Registries
What is the Standard setting organization that guides central registries
North American Association of Central Cancer Registries NAACCR
Invasive Ductal CA, NOS means:
Not Otherwise Specified (NOS)
Standard 2.2
Nursing Care Care is provided by nurses with specialized knowledge and skills; competency is evaluated annually.
Stage grouping
Once the values for T, N, and M have been determined, they are combined, and an overall stage is assigned. For most cancers, the stage is a Roman numeral from I to IV, where stage IV (4) is the highest and means more cancer is present than in the lower stages. Sometimes stages are subdivided as well, using letters such as A and B
The SEER program coding and staging manual is required to be used by_____
Only facilities that report data to SEER
Standard 2.4
Palliative Care Services Palliative care services are provided either on-site or by referral.
Which benign mass can cause a patient to present with a bloody nipple discharge?
Papilloma
A patient was diagnosed as having a breast cancer and a lung cancer. The lung was called a metastatic site. Where in the body did the lung cancer begin--that is, where was its primary site?
Primary Site - Breast The cancer began in the breast. Calling the lung a metastatic site is the same as saying that the lung tumor is a "secondary" tumor. It is composed of cells that came from some other place in the body.
What artifact may cause structures to look deeper than they actually are?
Propagation speed error artifact (ex. in silicone)
American Urologic Staging (AUS)
Prostate cancer
Excluding skin cancers, the 3 three most common cancers in men are
Prostate, Colon & Lung
P/T
Provincial/territorial
Standard 3.2
Psychosocial Distress Screening The cancer committee develops and implements a process to assess an address the psychosocial distress of patients with cancer.
Standard 1.12
Public Reporting of Outcomes Cancer committee develops and disseminates a report of patient outcomes to the public each year. This standard is for Commendation only.
Health Information Technology for Economic and Clinical Health Act (HITECH)
Published July 2009 meaningful use of a certied EHRs to quality for medicare and medicaid incentive payments stunder in 2011 under the economic stimulus law
Standard 4.5
Quality Improvement Measures Each year, performance levels defined by the Coc are met for each QI measure.
____is an acceleration of the central cancer registry's reporting process for selected cancers reductin the reporting time for selected info such as demographics, physicians, and pathology report findings. It supports population-based epidemiology research, and facilitates cancer prevention and control research that requires early contact with patients.
RAC or Rapid Case Ascertainment study protocols
Standard 5.2
RQRS Participation Participates in RQRS, submits all eligible cases for all valid performance measures, and adheres to RQRS terms and conditions.
Recoding particular data items from abstracted text that was submitted to the central registry by the reporting facility, rather than reviewing actual source documents.
Recoding audit
A requirement for a diagnosis of Hodgkin disease is the presence of
Reed-Sternberg cells
DoD cancer registries
Registries that primarily focus on active duty service members, families of service members, and retires presenting to the DoD military treatment facilities for health care
DoD cancer registries
Registries that primarily focus on active duty service members, families of service members, and retires presenting to the DoD military treatment facilities for health care; a multi-hospital national cancer registry
Active casefinding
Registry personal retrieving source documents (path reports or Rad Onc reports). Running reports from HIM dept. indices (including all Diag codes & procedures codes assiged to every pts) benefit: method is more thorough & accurate
The survival calculation method that eliminates the need to know cause of death by comparing cancer survival to survival rates in the general population is called
Relative
PL 102-515
Requires funded stated to authorized, establish and regulate central cancer registries
When a patient with an unusual primary site or histology is being presented at Cancer Conference this is a good opportunity to:
Research the registry database and the Internet to present a report at the meeting
Standard 2.3
Risk Assessment and Genetic Testing & Counseling Risk assessment, genetic testing and counseling are provided either on-site or by referral, by qualified genetics professional.
Which natioanl organization contracts with non-profit, medially oriented organizations to collect and report cancer data
SEER
Which national agency's data is used by the American Cancer Society to create statistical reports?
SEER
Cancers arising from connective tissue are classified as ______.
Sarcomas
Standard 4.2
Screening Program Each year, 1 screening program is offered to decrease the number of patients with late-stage disease. Patients with positive findings are followed.
_____ governs the operational and technical mechanisms necessary to protect patient information
Security
In some cases the disease of cancer will start at one location or site in the body and spread or metastasize to other areas of the body. The place where the cancer started is the first location and would be called the primary _____.
Site
Melanoma
Skin cancer most common cancer to mets to the breast
In malignancies the A/P to Transverse ratio denotes:
Spread across or through imaging plane
To adequately image the nipple (w/o drop out) use ____.
Stand off pad
STUDIES OF QUALITY
Study topics and methods used to monitor studies of quality are set by the QI coordinator and the cancer committee and documented in the cancer committee minutes and shared with the medical staff and administration
Polythelia
Supernumerary nipple
SEER
Surveilance, Epidemiology and End Results Program
SEER
Surveillance, Epidemiology and End Results
Standard 3.3
Survivorship Care Plan The cancer committee develops and implements a process to provide a comprehensive treatment summary and follow-up plan to patients who are completing treatment; the process is monitored, evaluated, and reported to the cancer committee each year.
A CHARACTERISTIC OF HISTOGRAM
THE HEIGHT OF EACH BAR IS PROPORTIONAL TO THE NUMBER OF OBSERVATIONS
THE SQUARE ROOT OF A VARIANCE OF DATA IS CALLED
THE STANDARD DEVIATION
ORYX
TJC's initiative to integrate performance measures into the accreditation process; signified the finality of the Performance Measurement Initiative in 1997 when it was announced
Majority of Breast CA arise from what structure?
Terminal duct lobular unit (TDLU)
What is The American College of Surgeons (ACoS) Commission on Cancer (CoC)
The American College of Surgeons (ACoS) Commission on Cancer (CoC) is a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard setting, prevention, research, education, and monitoring quality of care. CoC receives data directly form hospitals.
What is The North American Association of Central Cancer Registries (NAACCR)
The North American Association of Central Cancer Registries (NAACCR) is a collaborative umbrella organization for cancer registries, governmental agencies, professional organizations, and private groups in North America that are interested in enhancing the quality and use of cancer registry data.
What was the first federal law enacted to protect patient privacy?
The Privacy Act of 1974
What is Surveillance, Epidemiology and End Results (SEER) Program administered by (NCI)
The Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute is an authoritative source of information on cancer incidence and survival in the United States. SEER collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 26 percent of the United States population.
QUALITY IMPROVEMENT MEASURES
The cancer committee ensure that partients with cancer are treated according to nationally accepted Quality Improvement measures as measured by compliance with the current CoC quality reporting tools
STANDARD 1.6 CANCER REGISTRY QUALITY CONTROL PLAN
The cancer committee establishes and implements a plan to annually evaluate the quality of cancer registry data and activity. The plan includes procedures to monitor and evaluate each component
Standard 1.6 Cancer Registry Quality Control Plan.
The cancer committee establishes and implements a plan to annually evaluate the quality of cancer registry data and activity. The plan includes procedures to monitor and evaluate each component.
STANDARD 1.7 MONITORING CONFERENCE ACTIVITY
The cancer coordinator monitors and evaluates the cancer conference activities and reports findings to the cancer committee at least annually
Saskatchewan
The location of one of the earliest population-based registries in North America; began in 1932 as a part of a new, comprehensive cancer-control program
ACTUR
The mandated software used by DOD registries; is military specific and includes documentation of the sponsor's SSN, branch of service, and active duty status.
STUDIES OF QUALITY
The quality improvement coordinator is under the direction of the cancer committee
ACRN
The regional data sharing and epidemiological studies organization of Asia that started in 2010
ACTUR
The required DoD data set; is military specific and includes documentation of the sponsor's SSN, branch of service, and active duty status
Statistics Canada
The second generation of the national system of reporting in Canada; shifted to being people-oriented in 1992
Medicare
The system that originated in Saskatchewan in 1947 for universal healthcare in Canada
1995
The year canada became a formal part of NAACCR
Beinign sonographic characteristics
Thin echogenic pseudo capsule well circumscribed hyperechoic
National Cancer Act 1971
This Federal legislation required the collection, analysis, and dissemination of data for use in the prevention, diagnosis, and treatment of cancer.
The Privacy Act of 1974
This act is federal legislation that allows persons the right to discover if information about them is being collected by the government, the right to review and receive a copy of said information, correct or amend their information, and exercise control over disclosure of that information.
1-7 deficiencies at survey=
Three year reaccreditation with contingency
What is the function of a central Registry
To perform as a data repository for a state Monitor cancer incidence trends & mortality Evaluate cancer control initiatives
What is a function of the central registry?
To perform as a data repository for a state; monitor cancer incidence trends and mortality; evaluate cancer control initiatives
According to the CPS 2012, five elements are key to the success of a CoC-accredited program. Select one: True False
True
Case finding is a system utilized to identify all eligible reporting cases
True
CoC does not require text in the abstract, therefore the reporting text guidelines usually come from the state cancer registry following NAACCR guidelines. T or F?
True
Complete recoding of all physician staging, delayed treatment, follow up information, and other data pertinent to the case being submitted to NCDB should be collected.
True
Electronic pathology reporting systems are based on the ability to scan documents for key terms to determine reportability. Select one: True False
True
Extent of disease is a detailed description of how for a tumor has spread the site of origin
True
In combo RT and surgery, the surgery is to remove the gross tumor & then RT is used to treat the mirco residual cells
True
NAACCR standard metafiles are crucial to central registry reporting
True
National Cancer Institute (NCI) has set a priority of Quality of cancer care by ID, developing, applying, and evaluating quality of care measures
True
No facility specific patient information can be released unless authorized under law
True
T or F Collaborative staging was originally developed to provide a translation between the TNM staging system of the AJCC and the SEER summary staging system
True
T or F NCRA is a founding and Sponsoring Member of NAACCR
True
*Union for International Cancer Control *advance science & medical knowledge in research, dx, tx, & prevention of cancer (campaign against cancer thruout the world) *emphasis on professional & public education *international non-govm't assoc.
UICC
The patient was admitted to the hospital complaining of weight losss, a persistent cough, and shortness of breath. He was diagnosed as having cancer of the lung and was referred to a radiologist for radiation therapy. Would you say this patient received treatment?
UNCERTAIN. A form of treatment was prescribed, but the statement contains no evidence that the treatment actually was administered. Presumably it was. However, when abstracting a medical chart, you must be careful to distinguish between a prescription and a statement of treatment. Don't assume that a person has been treated unless it says so on the medical chart.
DHHS
US department of health and human services
Speed of sound through silicone is one half speed of sound through soft tissue
US will improperly place the chest wall behind the silicone too deep (Propagation speed error)
The NAACCR committee responsible for providing a formal mechanism for reviewing and recommending proposed changes in data codes and/or the addition of new items to ensure that data remain comparable among central registries is the:
Uniform Data Standards Committee
The NAACCR committee that evaluates new data items and codes is
Uniform Data Standards Committee
Right Breast 2 o'clock lesion. What Quad?
Upper Inner Quadrant (UIQ)
Carcinoma arises most commonly in what Quad?
Upper Outer (UO)
Quadrants of the Breast
Upper Outer (UO) Upper Inner (UI) Lower Inner (LI) Lower Outer (LO)
VACCR
VA central cancer registry
Word Root: Angi
Vessel
The facility provides care to military veterans. There is no minimum caseload
Veterans affairs cancer program
Va registry focus
Veterans and their families.
DATA FOR A REPORT SHOULD BE PRESENTED
WITH FULL DOCUMENTATION AND WITH THE CAPABILITY FO STANDING ALONE
Automated central tumor registry
Was established in 1986 by the assistant secretary of defense for health affairs to satisfy the ACoS CoC requirements for a comprehensive cancer data reporting system
ENCR
Was established in 1989 to improve the quality, comparability, and availability of cancer incidence data and develop a basis for monitoring cancer rates in the European union
As far as you know, are tissues from the endoderm exclusively epithelial?
YES.
Can carcinomas arise in an organ derived from the endoderm and an organ derived from the ectoderm?
YES.
The patient was admitted to the emergency room because of bleeding from a small ulcer of the skin of the face. The emergency room surgeon recommended total excision of the lesion to which the patient agreed. The resulting specimen was sent to pathology and diagnosed as basal cell carcinoma. Did this patient received treatment?
YES. Removal of an entire small tumor, for whatever purpose, is called an excisional biopsy.
NAACCR is governed by
a Board of Directors
Accredited cancer programs must have registry abstraction performed by
a CTR or supervised by a CTR
ORYX
a TJC system that integrates performance measures into the accreditation process.
What documents are used in a reabstracting study
a blank abstract and the original medical record
top-down budget
a budget that is prepared by top management, passed down to primary departments and then subdepartments
bottom-up budget
a budget where subdepartmental managers or supervisors submit annual budgets to management to be approved; they are then forwarded up through the chain of command where they are appended to the departmental budgets
annual call for data
a call for data by the CoC's NCDB that is sent to all CoC-accredited cancer programs in the autumn of each year; data is requested for as many as 5 years at the time of each call, to facilitate obtaining the most recent data available, as well as follow-up recurrence and survival data for previously reported patients
collaborative stage data collection system
a carefully selected, medically relevant set of data items that describe how far a cancer has spread at the time of diagnosis; known as CS
clearinghouse
a central agency for the collection, classification, and distribution especially of information;
case consolidation
a combination of automated functions that the cancer registry software can perform and manual functions that can only be done by the cancer registrar; patient records from multiple sourced are matched, abstracts are filled out and duplicates are removed; is a major responsibility of central cancer registries
Breast Health Registry
a database that was established by the Providence St. Vincent Medical Center in Portland, OR; exemplifies a facility registry initiative designed to gather all pieces of information about women's breast care into one comprehensive database
US County Cancer Incidence Dataset
a dataset by the NPCR that consists of aggregate cancer incidence rates and counts for major cancer sites for selected counties in the US; its purpose is to provide aggregated county-level data for cancer control planning, policymaking, and monitoring
Pediatric Cancer Program
a facility that provides care only to children and may be associated with a medical school and participate in training pediatric residents; There is no minimum caseload requirement.
US Eye Injury Registry
a federation of individual state eye injury registries that documents serious eye injuries; it was formed in 1988 and is located in Birmingham, AL; receives financial support from the Helen Keller Eye Research Foundation
visual review
a form of quality control that involves record-by-record evaluation by visual inspection; discrepancies are identified and corrected
medium-sized clinic
a full-service facility that diagnoses, treats, and also provides ongoing primary patient care
DHCP Oncology Program
a hospital-based cancer registry software program fully integrated into the medical centers' main computer system for capturing cancer incidence in a uniform and consistent way
Cancer
a malignant tumor
caBIG
a network that enables all constituencies in the cancer community, such as researchers, physicians, and patients, to share data and knowledge; its mission is to develop a truly collaborative info network that accelerates the discovery of new approaches for the detection, diagnosis, treatment, and prevention of cancer, ultimately improving patient outcomes
The National Cancer Data Base is an example of:
a non-population based central registry
FCCP
a nonhospital-based program and offers at least 1 cancer-related treatment modality; full range of diagnostic and treatment services is available by referral; no minimum caseload requirement
SEER*Stat Bridge
a plug-in for ArcMap (part of the ESRI ArcGIS Desktop Suite) that helps users import data from SEER*Stat to make a map
NAACCR
a professional organization that develops and promotes uniform data standards for cancer registration; provides education and training; certifies population-based registries; aggregates and publishes data from central cancer registries; and promotes the use of cancer surveillance data and systems for cancer control and epidemiologic research, public health programs, and patient care to reduce the burden of cancer in North America ALL population-based central cancer registries in the US and Canada are NAACCR members
security awareness program
a program that addresses the security education needs of all employees, contractors, and users as appropriate
HER2 (human epidermal growth factor receptor 2)
a protein on the surface of cancer cells that accepts growth signals. A lack of overexpression indicates patient may not respond to certain therapies such as Herceptin (trastuzumab), which is designed to "turn off" or deregulate the overexpression of HER2.
Standards for Cancer Registries, Vol. III: Standards for Completeness, Quality, Analysis, and Management of Data
a publication by NAACCR; provides central registry guidelines for data security amongst other things
SEER Cancer Statistics Review (CSR), 1975-2006
a publication by SEER that includes tables showing cancer statistics by race, sex, age, and year of diagnosis for the major cancer sites and for all cancers combined; an annual report published online that contains the most recent incidence, mortality, prevalence, lifetime risk and survival statistics
Cancer Stat Fact Sheets
a publication by SEER that is a collection of statistical summaries for a number of common cancer types
State Cancer Profiles
a publication by SEER that is a comprehensive system of dynamic maps and graphs enabling the investigation of cancer trends at the national, state, and county level
Fast Stats
a publication by SEER that links to tables, charts, and graphs of cancer statistics for all major cancer sites by age, sex, race, time period. The statistics include incidence, mortality, survival and stage, prevalence, and the probability of developing or dying from cancer
Annual Report to the Nation
a publication by SEER that provides an annual update on cancer occurrence and trends in the US
Cancer Query Systems
a publication by SEER that provides more flexibility and a larger set of cancer statistics than Fast Stats with ability to customize the format of the output into tables, graphs, and delimited format
Cancer Mortality Maps and Graphs
a publication by SEER that that shows geographic patterns and time trends of cancer death rates for the time period 1950-1994 for more than 40 cancers
Cancer in North America (CINA)
a publication from NAACCR that includes data from 70 central population-based registries to reflect 100% population coverage of Canada and the US
performance measure
a quantitative measure of an aspect of patient care that can be used as a guide to monitor and evaluate the quality and appropriateness of healthcare delivery; screens or flags in a performance measurement system to indicate which areas require more detailed analysis
accounting of disclosure
a record (kept for the most recent 6 years of disclosure) of "what, where, when, to whom, and for what purpose" any PHI was disclosed without patient consent; this includes data submissions to state and central cancer registries that are covered under law and to researchers conducting special studies
National Exposure Registry
a registry maintains from 1986-1999 and now archived, listed persons with low-level exposures to certain hazardous substances, and included sub-registries focusing on specific chemicals
central registry for child abuse and neglect
a registry that aids social services agencies in the investigation, treatment, and prevention of child abuse cases and to maintain statistical information for staffing and funding purposes
National Marrow Donor Registry
a registry that began operation in 1986, established by the US Navy as directed by congress after the passage of the National Organ Transplant Act in 1984; it uses an electronic infrastructure, STAR, to collect donor and cord blood unit information needed for donor search, manage and facilitate all donor searches, and track patient and donor status after transplant
prospective registry
a registry that collects information on the health status of a defined population over a long period
Tremolite Asbestos Registry
a registry that follows the health of residents of libby, MT, who were exposed to this very toxic form of asbestos
trauma registry
a registry that gathers data from and provides infrastructure support for designated trauma center facilities within the states
immunization registry
a registry that promotes and maintains records for pediatric immunization
organ and tissue donor registry
a registry that records willingness to donate organs/tissues on death
Lifelife Registry for Endovascular Aneurysm Repair
a registry that represents a collaboration among clinicians and industry to evaluate and report on long-term survival of endovascular graft patients with varying risk profiles
birth defects registry
a registry that tracks the incidence of birth defects, to support investigations into their causes, and to inform families of available services
COPD Foundation Registry
a registry that was established in 2007 to facilitate research initiatives and to promote the development of improved treatments and a cure for COPD
National Breast Implant Registry
a registry that was founded by the plastic surgery educational foundation in july 2000 to concurrently collect data on the patterns of use and the reasons for re-operations associated with breast implants
USCS
a report by the NPCR/CDC and NCI that contains the official federal government cancer statistics for more than 90% of the US population and for individual states; summarizes the incidence of cancer for the US by state and the US by census region
advance directive registry
a repository of advance directives or living wills, accessible to healthcare providers with patient consent
Journal of Registry Management
a scientific peer-reviewed NCRA publication
Superficial lesion extending from dermis is most likely
a sebaceous cyst
Frequency distributions consist of:
a series of classes (groups) & the # of observations for each interval
CI5
a series of monographs, published every 5 years, that has become the reference source of data on the international incidence of cancer
Benchmarking is defined as
a set of standards used to evaluate performance or quality
duty of care
a socially defined standard of care for the protection of others against unreasonable risks; arises from the foreseeability of injury to a third party and a reasonable expectation that the responsible party would prevent that harm
deduplication
a special type of record linkage where records in the same file are blocked, compared, and scored against each other, and high-scoring pairs are potential duplicates
OncoTrax
a standardized centrally maintained software program used by the VA to assure uniformity and consistency in data collection; a fully integrated program decentralized in its completeness to each VA medical centers' main computer system permitting the fully automated functioning of a paperless registry
OncoTrax
a standardized centrally maintained software program used by the VA to assure uniformity and consistency in data collection;paperless registry
prevalence
a statistic that identifies the level of burden of disease or health-related events on the population and healthcare system
HC*Calc (Disparities Calculator)
a statistical software designed to generate multiple summary measures to evaluate and monitor health disparities; one of its important functions is to facilitate the use of a range of HD measures so that researchers can explore their utility in different situations
the Nun Study
a study of aging and Alzheimer's disease, started in 1986 as a pilot study on aging and disability using data collected from the older School Sisters of Notre Dame living in Mankato, MN, and expanded in 1990 to include older Notre Dame sisters living in the midwestern, eastern, and southern regions of the US
Framingham Heart Study
a study that investigates the causes, prevention, and treatment of heart disease; began in 1948
case control studies
a study where cases of cancer are compared with similar people from the same population who do not have cancer (serving as the control group) for past exposures that may be related to the disease; these start with the cases and matching controls and look backward in time at possible risk factors
cancer registry
a system designed to collect information about the occurrence of cancer, the types of cancers that occur and their locations within the body, the extent of cancer at the time of diagnosis, and the kinds of treatments that patients receive
cancer registry
a system to collect and analyze defined reportable malignancies diagnosed or treated in a defined population, such as a facility or geographic area
e-path reporting
a term that was first used to connote the concept of automation of cancer casefinding from independent pathology laboratories
retrospective cohort
a type of study where the cohort is defined today to be some point in the past; rates of the disease in the cohort are then often compared to an expected rate, which is determined from registry data for the entire population
core measure set
a unique grouping of performance measures carefully selected to provide, when viewed together, a robust picture of the care provided in a given area
a disaster recovery plan is
a way to make sure computerized registry data is backed up every night and is easily recoverable
CAForum
a web-based inquiry and response system launched in 1999 by the CoC to provide uniform and consistent interpretation of CoC cancer program standards and to promote quality data abstracting
tort
a wrongful act committed against another resulting in injury to another's person, property, reputation, or the like, and for which the injured party is entitles to compensation; invasion of privacy is this, therefore cancer registry can be involved in it
Each year, the cancer committee offers at least 1 cancer-related educational activity, other than cancer conferences, to physicians, nurses, and other allied health professionals. The activity is focused on the use of: Select one: a. AJCC staging b. Clinical trial accrual c. SEER Summary Staging d. all of the above e. None of the above
a. AJCC staging
Case ascertainment methods where registry personnel screen source documents to identify reportable cases is: Select one: a. Active casefinding. b. Passive casefinding c. A combination of active and passive casefinding d. Rapid case ascertainment
a. Active casefinding.
Which of the following required cancer program coordinators can be filled by a cancer registrar who is currently abstracting. Mark all choices that apply. Select one or more: a. Cancer Conference Coordinator b. Quality Improvement Coordinator c. Cancer Registry Quality Coordinator d. Community Outreach Coordinator e. Clinical Research Representative or Coordinator f. Psychosocial Services Coordinator
a. Cancer Conference Coordinator c. Cancer Registry Quality Coordinator
Which of the following is not a use for the SAR? Select one: a. Design a cancer center b. Track program activities c. Customize the survey d. Report and analyze program activities across the country
a. Design a cancer center
A vertical column of a table in a relational database is knows as a(n) _________, and holds individual items such as a patient's social security or accession number. Select one: a. Field b. Record c. Attribute d. Architecture
a. Field
A computer network allows shared computer resources within an office, and is often referred to as a(n) __________. Select one: a. LAN b. WAN c. Ethernet d. MAC
a. LAN
What changes will technologic advances likely bring to cancer registries? Select all that apply. Select one or more: a. Registry data will be available closer to real time. b. lnteroperability will no longer be necessary. c. The registry data set will become more simplified . d. Cancer registration will become completely automated, eliminating the need for cancer registrars. e. Registry data will become even more clinically relevant and important.
a. Registry data will be available closer to real time. e. Registry data will become even more clinically relevant and important.
A disease index is a listing of patients seen in a hospital, both inpatient and outpatient, with ICD-9-CM diagnosis codes. Select one: a. True b. False
a. True
A reportable list is usually developed by the central registry, is composed of all the reportable case types collected by a cancer registry, and clarifies the types of diagnoses that are not reportable. Select one: a. True b. False
a. True
Any facility whose cancer committee develops and disseminates a report of patient or program outcomes to the public each year during the survey cycle will be awarded a commendation for Standard 1.12 (Public Reporting of Outcomes): Select one: a. True b. False
a. True
Cancer programs seeking CoC-accreditation must be accredited by a recognized federal, state, or local authority appropriate to the facility type. Select one: a. True b. False
a. True
Casefinding is a systematic method of identifying all potentially eligible cases that are to be included in the registry database. Select one: a. True b. False
a. True
Edits are the quality-control gatekeepers. Select one: a. True b. False
a. True
Edits contain the logic to edit each field. Select one: a. True b. False
a. True
If the pathology department is computerized and each report contains an ICD-O histology and behavior code, a computer listing of coded final histological diagnoses can be generated. Select one: a. True b. False
a. True
In the casefinding process, a suspense file is kept so that the status of casefinding can be ascertained at any time. Select one: a. True b. False
a. True
It is common for a cancer registry to receive multiple types of casefinding source documents that belong to the same patient, even if those source documents have the same admission (or source) date. Select one: a. True b. False
a. True
It is not recommended to have the pathology secretary send copies of reportable cases to the cancer registry. Select one: a. True b. False
a. True
Most government agencies only require malignant (ICD-O behavior codes 2 and 3) cases to be included in the registry. However, hospital cancer committees may require the registry to include benign/borderline or uncertain cases. Select one: a. True b. False
a. True
One way a Commission on Cancer (CoC)-trained consultant can assist a cancer program is by designing and implementing the cancer program quality improvement program. Select one: a. True b. False
a. True
Pathology reports can be used to identify potentially reportable cases for both hospital and nonhospital facilities. Select one: a. True b. False
a. True
Prior to the development of computerized data edits, registries were deciding their own rules for editing data. Select one: a. True b. False
a. True
Radiation oncology logs should be reviewed for new cases as well as for collecting follow-up. Select one: a. True b. False
a. True
Rapid case ascertainment is the process of identifying cases quickly for epidemiologic protocols. Select one: a. True b. False
a. True
Reference date refers to the effective date on or after which all reportable cases should be registered in a registry database. Select one: a. True b. False
a. True
Seven standards are eligible for commendation status per the Cancer Program Standards 2012. Select one: a. True b. False
a. True
The accuracy of surgery schedules as a source of casefinding depends on appropriate documentation of orders and diagnoses at the time of surgery. Select one: a. True b. False
a. True
The cancer conference coordinator is responsible for ensuring the discussion of stage, including prognostic indicators, and treatment planning using evidence-based treatment guidelines occurs during cancer conferences. Select one: a. True b. False
a. True
The cancer registry policy and procedure manual must specify that current CoC data definitions and coding instructions are used to describe all reportable cases. Select one: a. True b. False
a. True
The completeness of casefinding must be monitored for quality control purposes. Select one: a. True b. False
a. True
The criteria for eligible cases in a registry depend upon the governing agencies of the registry. Select one: a. True b. False
a. True
The error summary on the edit report might be important to the cancer registry manager because frequently encountered errors may mean that staff education is needed. Select one: a. True b. False
a. True
The most important software used by either the central or hospital registry is the DMS. Select one: a. True b. False
a. True
The purpose of an Edit Set is to group individual edits. Select one: a. True b. False
a. True
The survey is designed to be both educational and evaluative. Select one: a. True b. False
a. True
To ensure the accuracy of the codes used to identify cancer cases in the hospital, the registrar must determine what the hospital-specific guidelines are for coding certain diagnoses. Select one: a. True b. False
a. True
Some central registries utilize a _________ reporting requirement that provides researchers access to cancers of all sites throughout the population covered by the central registry. Select one: a. Two phase b. Three phase c. Six week d. Six month
a. Two phase
Can two different data standards be syntactically interoperable but not semantically interoperable? Select one: a. Yes. b. No. c. It depends.
a. Yes.
A firewall can be configured to __________. Mark all answers that apply! Select one or more: a. allow only certain types of network traffic b. allow only certain specific computers to reach the internal network resources c. prevent users from accessing a particular website d. provide a safe way for outside users to access web servers or other such resources
a. allow only certain types of network traffic b. allow only certain specific computers to reach the internal network resources c. prevent users from accessing a particular website d. provide a safe way for outside users to access web servers or other such resources
n order to receive a commendation for Standard 5.6 (Accuracy of Data): Select one: a. cases diagnosed on January 1, 2003, or later meet the quality criteria for the annual Call for Data on initial submission. b. identified errors in submitted cases and rejected records are corrected by the due date specified in the Call for Data. c. corrected cases are resubmitted to the NCDB by the due date specified in the Call for Data. d. All of the above
a. cases diagnosed on January 1, 2003, or later meet the quality criteria for the annual Call for Data on initial submission.
GenEdits, a computerized edit-checking software: Mark all choices that apply! Select one or more: a. improves the quality of the cancer data. b. standardizes the way data are checked for validity. c. is very expensive for registries to purchase. d. is only available in a DOS-based format.
a. improves the quality of the cancer data. b. standardizes the way data are checked for validity.
The advantage of active casefinding procedures is that this method: Select one: a. is more thorough and accurate b. costs less money c. is less time consuming d. requires fewer people involved in the process
a. is more thorough and accurate
ow many prevention programs are required to be provided each year in most CoC-accredited programs. Select one: a. one b. two c. three d. four
a. one
In order to receive a commendation for Standard 5.2 (RQRS), the facility must participate in in RQRS during the entire 3-year accreditation period and: Select one: a. submit all eligible cases for 25% of the valid performance measures b. submit all eligible cases for 50% of the valid performance measures
a. submit all eligible cases for 25% of the valid performance measures
The Accountability Measures standard requires Select one: a. the cancer committee to perform an annual review of the program's performance using the CoC quality reporting tools. b. the cancer committee to perform a quarterly review of the program's performance using the CoC quality reporting tools. c. performance levels be met for at least one of the specified accountability measures as defined by the Commission on Cancer. d. performance levels be within 10% of the rate of the specified by the Commission on Cancer.
a. the cancer committee to perform an annual review of the program's performance using the CoC quality reporting tools.
ACOS/COC accredited programs treat
about 70% of newly diagnosed cases annually in the US.
Athelia
absence of the nipple
CCCP
accessions 500 or more newly diagnosed cancer cases each year; provides a full range of diagnostic and treatment services either on-site or by referral; participation in cancer-related clinical research is required
CCP
accessions more than 100 but fewer than 500 newly diagnosed cancer cases each year and provides a full range of diagnostic and treatment services, but referral for a portion of diagnosis or treatment may occur
Remove Artifact in the near field by?
adding multiple focal zones
Considers only those deaths from a specific disease:
adjusted survival
professional practice code of ethics
adopted by the NCRA; outlines the principles of professional conduct and provides members of the association with definitive and binding guidelines of conduct
In comparing the risk of DX of CA in all males for populations w/diff. age distributions, the best measure:
age adjusted incidence rate
In comparing the risk of DX of CA in all males for populations w/diff. age distributions, the best measure is:
age-adjusted incidence rate
ASIR
age-specific incidence rates
ARRA of 2009
aka "economic stimulus bill"; includes 21 pages pertaining to health information privacy; it establishes the first federal requirements for reporting and notification of breaches of personal health data; its disclosure pertinent to cancer registries requires CEs using electronic health record systems to account for all disclosures when the patient so requests, including disclosures that HIPAA exempts, such as for treatment, payment, and operations
5-year budget
aka "strategic business plan"; is essential to allow time to prepare for growth and associated costs for added personnel, departments, and facilities; it is a plan to prepare for maintenance, updates of capital assets, and annual growth
time and motion study
allows registrars to see how many minutes are required to abstract a case, hours spent abstracting per year, and hours per year spent on other registry duties; helps to determine staffing needs and productivity requirements
ACS
american cancer society
ACos
american college of surgeons
AHIMA
american health information management association
AJCC
american joint committee on cancer
AMA
american medical association
Rapid reporting/case ascertainment
an abbreviated cancer report sent as soon as possible after diagnosis and is critical to some patient studies; this is especially important for those cases under special study with high morbidity or mortality rates; The goal is to reach the patient for firsthand interviews and perhaps tissue or blood samples while any lifestyle changes are still fresh in their minds
US Cancer Registries Amendment Act of 1992
an act that allocated money to fund and enhance registries in all states, under a program administered by the CDC, the NPCR
Agency for Toxic Substances and Disease Registries
an agency within the CDC, established in 1980 to implement health-related sections of laws that protect the public from hazardous wastes and environmental spills of hazardous substances, supports registries as data resources and also uses them to monitor long-term consequences for affected persons
Benign Tumor Cancer Registries Amendment Act
an amendment act based on testimony that supported the importance of data on benign tumors being included in cancer registries
Registry Plus
an application by the CDC that is mainly utilized by central cancer registries
blocking
an initial linkage step that reduces the number of record comparisons between data sources when matching takes place; it entails exact matching between the two data sources on key data items, creating smaller blocks of data that are more likely to match
performance measurement system
an inter-related set of outcomes measures, process measures, or both, that supports internal comparisons of organizations' performances over time and external comparisons of performances among organizations at comparable times
asynchronous online learning
an online learning environment that does not involve a coordinated live interaction between the instructor and participant
Alaska Native Tribal Health Consortium
an organization that collaborates with other organizations in the support of special registries to monitor and measure Alaska Native Health
OCR
an organization that enforces HIPAA's privacy rule, which protects the privacy of individually identifiable health info, and the security rule, which sets national standards for the security of electronic protected health info
Armed Forces Institute of Pathology
an organization that houses a DNA registry for all military personnel, to assist in identification of remains
Most central cancer registries require that _____ cases be abstracted and reported
analytic and non analytic
CoC requires ___ follow up of eligible analytic cases such as, date of last contact, first recurrence, progression of disease, cancer status, subsequent treatment
annual
NCRA ethics committee
any charges of unethical behavior or alleged violations are investigated by this committee and, if necessary, are brought before the Board of Directors for possible punitive action
HIPAA protects "individually identifieable health information", for example____
any info related to the condition of the patient treatment, billing name, address, ss#, phone #
a cancer program can receive a commendation if all abstracts
are completed within 6 monthsof the dat of 1st contact for every year
The Cancer Committee must have ___________ established and documented by the facility.
authority
ACTUR
automated central tumor registry
A facility may receive a commendation for Standard 2.2 (Nursing Care), if 25% of chemotherapy-trained nurses employed by the facility hold a current oncology nursing certification, regardless of whether the program fulfills the other criteria listed for the standard. Select one: a. True b. False
b. False
A single casefinding source is enough to provide a complete description of the patient's cancer experience. Select one: a. True b. False
b. False
According to the eligibility standards, diagnostic imaging and radiation therapy services must be available on site. Select one: a. True b. False
b. False
All activities (abstracting, follow-up, casefinding, etc.) in the cancer registry must be performed by a Certified Tumor Registrar. Select one: a. True b. False
b. False
All categories of cancer programs are required to develop and disseminate a report of patient or program outcomes to the public. Select one: a. True b. False
b. False
All registries have to use the same source documents in casefinding, but the procedures involved in their casefinding cycles are very different. Select one: a. True b. False
b. False
At least 15% of the cases presented annually at caner conference must be prospective. Select one: a. True b. False
b. False
Hospital-based cancer registries obtain death certificates from vital statistics government agencies in search for potentially missed cases. Select one: a. True b. False
b. False
Only hospital-based cancer registries are allowed to collect and report "reportable by-agreement" cases. Population-based registries, including the state central cancer registries, are forbidden to report these cases by federal law. Select one: a. True b. False
b. False
Only manual methods of reviewing pathology reports must include a way to track reports to ensure that each report has been included in the registrar's review. Select one: a. True b. False
b. False
A computer or dedicated hardware device that restricts access between a protected network and an external network is a(n) __________. Select one: a. WAN b. Firewall c. Ethernet d. MAC
b. Firewall
An abstract has an edit error that states the Surgery Summary of Scope of Regional Lymph Nodes (SurgSumScopeRegLN) field conflicts with the number of lymph nodes examined and number of lymph nodes positive. What kind of edit check is this? Select one: a. Allowable range check (edit) b. Interitem check (edit) c. Interrecord check (edit) d. Interdatabase check (edit)
b. Interitem check (edit)
The advantages of ___________________ casefinding include sharing the labor costs and burden of reporting with other departments. Select one: a. Active b. Passive c. Active and Passive d. Reporting requirements and mechanisms
b. Passive
What computer language is often used to create, update, and delete data from a database? Select one: a. C++ b. SQL c. JDBC d. Java e. XML
b. SQL
What is a SAR? Select one: a. Survey Application Reference b. Survey Application Record c. Survey Accreditation Reference d. Survey Accreditation Record
b. Survey Application Record
What group has members from all standard-setting organizations, and has as it's goal data standardization? Select one: a. American Association of Central Cancer Registries (AACCR) b. Uniform Data Standards Committee (UDSC) c. California Cancer Registry d. North American Association of Central Cancer Registries (NAACCR)
b. Uniform Data Standards Committee (UDSC)
A computer network that allows shared computer resources among geographically distinct locations is known as a(n) __________. Select one: a. LAN b. WAN c. Ethernet d. MAC
b. WAN
A metafile is: Select one: a. a big file. b. a set of instructions. c. a container.
b. a set of instructions.
All of the following are true of NAACCR data exchange standards, except they: Select one: a. define how data should be formatted to allow for exchange with another organization b. determine how data should be stored in a central registry database c. are essential for data exchange d. all are true of NAACCR data exchange standards
b. determine how data should be stored in a central registry database
An appeal of an Accreditation Award is appropriate: Select one: a. when new documentation of program activity has been created b. when the program was in compliance with the standard at the time of survey. c. after the issues have been addressed by the program d. any time after the survey has been completed
b. when the program was in compliance with the standard at the time of survey.
Which of the following graphs would best show a comparison between frequency distributions of two separate populations?
bar graph
C-Mic
burkitt's lymphoma
NCDB is funded
by ACoS and the American Cancer Society
How much of IT staff time should be devoted to the registry? Select one: a. 50% b. 75% c. 100% d. Doesn't really matter e. Whatever the IT department thinks
c. 100%
Standard setters may institute major changes every __________ years. Select one: a. 1 b. 2 c. 3 d. 5
c. 3
Approximately what percentage of cancer cases is histologically confirmed? Select one: a. 50 b. 80 c. 95 d. 100
c. 95
In order to receive a commendation for Standard 1.11 (Cancer Registrar Education): Select one: a. All cancer registry staff participate in a cancer-related educational activity each year b. All CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle. c. All cancer registry staff participate in a cancer-related educational activity each year and all CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle. d. All cancer registry staff participate in a cancer-related educational activity each year and attend a national or regional cancer-related meeting once during the 3-year survey cycle.
c. All cancer registry staff participate in a cancer-related educational activity each year and all CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle.
In order to receive a commendation for Standard 1.11 (Cancer Registrar Education): Select one: a. All cancer registry staff participate in a cancer-related educational activity each year b. All CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle. c. All cancer registry staff participate in a cancer-related educational activity each year and all CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle. d. All cancer registry staff participate in a cancer-related educational activity each year and attend a national or regional cancer-related meeting once during the 3-year survey cycle.
c. All cancer registry staff participate in a cancer-related educational activity each year and all CTR staff attend a national or regional cancer-related meeting once during the 3-year survey cycle.
A very common network technology is known as __________. Select one: a. LAN b. WAN c. Ethernet d. MAC
c. Ethernet
How often should a registry plan to replace desktop computers? Select one: a. Every year b. Every 2 years c. Every 3 to 5 years d. Every 6 to 1 0 years e. Only when the IT department is willing to do it
c. Every 3 to 5 years
The goal of ___________________ is to support and facilitate epidemiologic and clinical research. Select one: a. Passive casefinding b. Active casefinding c. Rapid case ascertainment d. A combination of active and passive casefinding
c. Rapid case ascertainment
Why is it important for laptop computers to be configured with disk encryption? Select one: a. Because they are small and portable. b. They often contain confidential information. c. They may be easily lost or stolen. d. Because they are so similar to desktop computers. e. They are often targeted by unauthorized users.
c. They may be easily lost or stolen.
In order to receive a commendation for Standard 1.3 (Cancer Committee Attendance), each required physician member must attend : Select one: a. at least 25% of the cancer committee meetings held during any given year. b. at least 50% of the cancer committee meetings held during any given year. c. at least 75% of the cancer committee meetings held during any given year. d. 100% of the cancer committee meetings held during any given year.
c. at least 75% of the cancer committee meetings held during any given year
In active casefinding procedures, registry personnel retrieve and screen the source documents, such as disease indices, pathology reports, and autopsy documents except: Select one: a. surgery schedules b. admission and discharge documents c. doctor prescriptions d. radiation oncology
c. doctor prescriptions
Who is responsible for establishing, implementing, and evaluating the clinical and programmatic goals? Select one: a. the CTR (certified tumor registrar) b. the CPM (cancer program manager) c. the cancer committee d. hospital administration
c. the cancer committee
define active follow up
calling or sending letters to physicans and patients
Late menopause
can increase breast cancer risks
Second leading cause of death in adults and children in the US, after heart disease
cancer
The process of Central cancer registry combining cases reported by multiple facilities
case consolidation
the inpatient medical record disease index is most useful for which cancer registry activity
case finding
Audit of facility casefinding data sources for a period of time.e.g., pathology reports, DI, etc.
case finding audit
Electronic pathology reporting systems are based on the ability to scan documents for key terms to determine
case reportability
Which of the following types of cancer cases, although included in your hospital cancer registry, would usually be EXCLUDED from a survival report of your hospital's cancer management experience?
cases diagnosed and receiving all of their first course of therapy prior to admission to your hospital
epidemiologic
central registry reporting
INCP
characterized by a unified cancer committee, standardized registry operations with a uniform data repository, and coordinated service locations and practicitioners
define passive follow up
checking medical records, checking obituaries, checking death clearance
Philadelphia chromosome
chronic myelogenous leukemia
Alb and SKC
chronic myelognous leukemia
CS
collaborative staging
Central cancer registries
collect cancer data on defined populations in a defined time period
population-based registries
collect data on all cancer cases in a defined population; main sources of info come from: (1) info from treatment facilities such as hospitals, cancer centers, private clinics and hospices; (2) information from diagnostic services, such as pathology laboratories; and (3) death certificate information from the vital statistics registration system *goals*: advancing clinical, epidemiological, and health services research on cancer; exploration of trends in cancer care; creation of regional and state benchmarks for hospitals; determination of cancer patterns among various populations or sub-populations; monitoring cancer trends over time; guiding planning and evaluation of cancer control efforts to help prioritize health resource allocations; improving patient care programs; research into the cause of cancer
special purpose registry
collects info on one aspect or one type of cancer. Examples include registries that collect info only on specific types of cancer, non hospital facilities, or one type of cancer patient.
non-population registry
collects information from multiple facilities not confined to a geographic area. This includes the NCDB and some large medical organizations/companies.
Carcinoembryonic antigens (CEA)
colon, breast, small cell lung carcinoma
Dukes staging
colorectal carcinoma based on depth of invasion in colon wall
CoC
commission on cancer
Oil cyst
common mass developing secondary to traumatic fat necrosis
confidential
communicated or effected secretly; entrusted with the confidence of another; denoting intimacy or confidence
CCP
community cancer program
According to the American College of Surgeons Commission on Cancer, designated coordinators are responsible for cancer conference, quality improvement, cancer registry data quality, and
community outreach
CCCP
comprehensive community cancer program
Edwin Smith and George Ebers papyri
contain descriptions of cancer and were written about 1600 B.C. but are believed to date from sources as early as 2500 B.C.
BIRADS category 2
cyst (benign findings)
Fibrocystic changes are:
cystic complex composed of multiple cysts
In order to receive a commendation for Standard 2.1 (College of American Pathologists Protocols): Select one: a. 90% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 90% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. b. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 90% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. c. 90% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. d. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee.
d. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee.
n order to receive a commendation for Standard 2.1 (College of American Pathologists Protocols): Select one: a. 90% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 90% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. b. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 90% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. c. 90% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee. d. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee.
d. 95% of cancer pathology reports include the required data elements as outlined in the CAP protocols and 95% of cancer pathology reports follow the synoptic format defined by the CAP cancer committee.
Why should central registries be concerned with registry data management systems used by their reporting hospitals? Select one: a. The majority of central registry data is first collected by the hospital data management system. b. Edit checks and coding rules may or may not be consistently implemented by hospital registry vendors. c. It may be important when coordinating transitions to new coding standards. d. All of the above e. None of the above
d. All of the above
The process of safeguarding data by copying or duplicating files onto computer media separate from the original location is: Select one: a. Compiling b. Clusters c. Graphic user Interface d. Backup
d. Backup
What does HL7 stand for, and what is it? Select one: a. Hell Level Seven is where registrars are tortured in Dante's Inferno. b. Hi Low Seven is a soft drink popular in the registry community. c. Hepatic Liver Seven is an advanced stage of liver cancer. d. Health Level Seven is a widely used data exchange standard in the healthcare industry. e. Help Language Seven is the seventh edition of a popular scripting language for help systems.
d. Health Level Seven is a widely used data exchange standard in the healthcare industry.
Which of the following are open-source database applications? Select one: a. Microsoft Access and Microsoft SQL Server b. Microsoft Access and MySQL c. MySQL and Oracle d. MySQL and Postgres e. Oracle and Postgres
d. MySQL and Postgres
What is most important to achieving interoperability with other data systems? Select one: a. Supporting patents on registry data standards b. Publishing registry data standards on the Web c. Entering registry data elements into the caDSR d. Supporting and adopting widely used data standards e. Being able to quickly develop custom interfaces
d. Supporting and adopting widely used data standards
"Residency at diagnosis" refers to the usual residence of the patient at the time of diagnosis of a reportable cancer. Which entity provides the rules and guidelines used by central registries to determine residency at diagnosis? Select one: a. U.S. Federal Bureau of Investigation b. U.S. Social Security Administration c. U.S. Postal Service d. U.S. Census Bureau
d. U.S. Census Bureau
__________ is a remote access connection that utilizes software that provides an authenticated, encrypted connection. Select one: a. LAN b. WAN c. DMZ d. VPN
d. VPN
In order to receive a commendation for Standard 1.9 (Clinical Trial Accrual): Select one: a. the required Commendation percentage of patients is accrued to cancer-related clinical trials each year. b. the annual patient accruals to cancer-related clinical trials are monitored and reported to the cancer committee c. a report of the annual patient accruals to cancer-related clinical trials is documented in the cancer committee minutes d. all of the above
d. all of the above
All of the following are true of the Accredited Cancer Program Performance Report except that it: Select one: a. provides the Accreditation Award b. identifies the facility, surveyor, and date of the survey c. provides a summary of the program deficiencies. d. identifies the program as an Outstanding Achievement Award recipient
d. identifies the program as an Outstanding Achievement Award recipient
Used to provide coding instructions, code definitions & the code options
data dictionary
Information in a request log may include:
data requested, intended use, topic, time period
cancer registrars
data specialists who collect cancer data from a variety of sources and report the resulting cancer stats to various healthcare agencies
the date that cancer is histologically or clinically established
date of diagnsosis
the data source for a central registry death certificate only case is the
death cert
An event of Interest is the outcome being measured; it may be ___________ or death related to a ____________
death due to any cause; specific cause of interest such as the cancer under study
DHCP
decentralized hospital computer program
US National Cancer Act of 1971
declared the war on cancer by budgeting monies to the NCI for research, detection, and treatment of cancer; established that the NCI director would be presidentially-appointed, and that the director would prepare and submit a bypass budget directly to the president of the US; also established the president's cancer panel and the National Cancer Advisory Board, directed the expansion and development of a coordinated cancer research program, authorized the first cancer centers, and established the International Cancer Research Data Bank, which resulted in the SEER program
privacy
defines the permissible means of access, use, and disclosure of the applicable patient information
Rules that are set by an authority
definition of a standard
DoD
department of defense
VA
department of veteran's affairs
Topography
description of regions of the body
functional modularity
developing programs that perform defined registry functions required across the spectrum of registries of a specific type, which can be interfaced with multiple database systems
A method of calculating survival is:
direct method
Tracking and maintaining disclosures is called___
disclosure accounting
Pediatric surgeons
doctors who specialize in performing surgery in children
Pediatric oncologists
doctors who specialize in using medicines to treat children with cancer
step assessment
documenting the amount of time and series of actions within a process; will produce a productivity level, an expected amount of work for a specific amount of time
patient merge process
during this process, a list of all possible patient matches is generated
reportable cancer
each form of in situ and invasive cancer( with the exception of basal cell and squamous cell carcinoma of the skin an cervix
development of generic registry programs
either as standalone systems or modules attached to larger electronic health record systems, which can be tailored to specific disease types
EDI
electronic data interchange
TJC's Agenda for change
embraced the industry's development of Total Quality Management(TQM) and Continuous Quality Improvement(CQI)
The geographic areas selected for inclusion in teh SEER program was based on their_____
epidemiologically signifigant population subroups.
The study of the distribution and determinants of disease in the human population is called:
epidemiology
IARC (International Agency for Research on Cancer)
est in 1965 by the WHO. Its mission is to coordinate and conduct research on the causes of cancer and develop cancer control strategies.
culture of confidentiality
established by organizations that routinely deal with confidential information; it reasonably sustains the privacy and security of the information; must permeate regular business activities to the extent that it is not simply a precaution to follow but is ingrained into the fabric of the org's routine operational practices, policies, strategic objectives and priorities.
residual tissue repository
established in 2003; was initiated to preserve pathology specimens associated with cancer cases in SEER registries that would otherwise be discarded and to use these specimens to test relevant hypotheses
specialty cancer registries
established to collect and maintain data from specific facilities about specific cancers; may also provide advocacy, educational opportunities for those who want to learn more about a particular type of cancer, and support for those who may suffer from it *sources*: patients who voluntarily self-enroll, only patients with certain familial cancers, only patients with a particular type of cancer, patients from private clinics and hospices *goals*: advancing clinical, epidemiological and health services research on cancer; providing advocacy and educational opportunities to cancer patients; gathering and disseminating epidemiologic data on a specific type of cancer; research into the cause of cancer
End results
evaluation of cancer therapy in terms of patient survival after treatment
Integrated Network Cancer Program (INCP)
example: MHHS the organization owns, operates, leases, or is part of a joint venture into multi facility providing integrated cancer care & offers comprehensive services. At least 1 facility is a HOSPITAL & all are part of the network are CoC accrediated characterized by unified cancer committee
E-Path
facilitates the process of efficiently collecting complete and accurate pathology information from hospital-based and free-standing pathology laboratories that report to SEER's centrally based cancer registries
cancer registrars monitor patients until they are cancer free
false
All structures in the breast should be compared to the mid-level echogenicity of ____.
fat
Lipoma is a tumor involving
fat
On Mammo which is not seen as a water density?
fat and calcifications
FIGO staging
female reproductive sites
1994, NPCR cooperative agreement
financial support and technical assistance to state health operations
FNA means
fine needle aspiration
Utah Cancer Registry
founded in 1966 by Charles R. Smart, M.D., who was an early advocate of cancer registries and their computerization; its primary purposes were to provide service to hospitals and physicians, to provide a mechanism to stimulate frequent physician examinations of patients for recurrent or secondary malignancies, and to serve as an educational resource for physicians treating cancer patients
Johns Hopkins Center for Hereditary Eye Diseases
founded in 1972; maintains a DNA registry of blood samples that are made available to interested investigators within the Johns Hopkins Medical Institutions, across the US, and throughout the world
Prospective cases include which of the following types of cases: Select one: a. Newly diagnosed and treatment not yet initiated b. Previously diagnosed, initial treatment completed, but discussion of adjuvant treatment or treatment for recurrence or progression is needed. c. Newly diagnosed and treatment not yet initiated. d. Previously diagnosed, and discussion of supportive or palliative care is needed. e. Choices a and c f. Choices b and d g. All of the above h. None of the above
g. All of the above
The Cancer Registry Quality Control Plan has procedures to monitor and evaluate which of the following: Select one: a. Abstracting timeliness b. Accuracy of Abstracted Data c. AJCC or other appropriate stage of the cases is discussed and documented for the five major sites seen at the facility d. Casefinding e. NCDB Data Submission f. Percentage of information coded as unknown g. All of the above h. None of the above
g. All of the above
GIS
geographic information systems
Casfinding Goals
goal central registry is to identiy & resigtry is to identify & register all reportable cases. Ensure complete Reporting Quality-control procedures completeness logs (# of cases found) by month and dept by month & year by year & Cancer site
security
governs the operational and technical mechanisms necessary to protect this information
Which set of rules is unique to the hematopoietic and lymphoid diseases rules?
grade coding rules
Macrocalcification measures:
greater than/ equal to 5 mm
Stage of disease
grouping cases with similar prognoses into broad extent of disease categories, (e.g., localized, regional and distant spread)
Describe characteristic of a Bar Graph? What type of data is used to display?
has a horizontal or X-axis which is used to show discrete categories, has a Vertical or Y-axis used to show the # or frequency of response used to display discrete categories data are displayed with a space between each category.
Rapid Response Surveillance Studies
has six categories: 1. Evaluating methodologic issues 2. Evaluating cancer treatment and outcomes 3. Monitoring screening practices 4. Monitoring health behaviors and risk factors 5. Linking databases 6. Improving technical aspects of registry operations - they are also a research resource for obtaining population-based comparisons for evaluation of biobehavioral and risk factors, screening patterns, and molecular or genetic surveillance to quantify the progress of cancer control at the population level
Ernest Codman
he established the first cancer registry in 1921; it was a bone sarcoma registry and its inherent data set introduced the role of cancer registry data standards for medical care in hospitals and among clinicians
HHS
health and human services
HIPAA
health insurance portability and accessibility act
Realiability refers to
how consistently different people will code the same circumtances the same way
work flow
how the work or info comes into the registry, is assimilated, and is disseminated
anatomic extent of disease
i.e. TNM staging
reportable list
id's dx that will be included in the registry database. Many standard-setters develop criteria for the reportable list
The parts of the small bowel are the duodenum, jejunum and
ileum
Human papillomavirus (HPV)
immunohistochemical staining -detection is favorable prognostic factor in subset of head and neck cancers-spec. oropharynx
cancer registries systematically collect data in an organized process. 5 fundamental data sets are?
incidence, site, histology/behavior, stage, treatment & survival
data set standards
include specifications for data items, codes, and storage format; comparable data must be consistent or "standard" to provide useful information for research and new technologies to diagnose and treat patients
Extent of Disease Coding (EOD)
includes schemes for all sites and histologies of cancer. It consists of a ten-digit code. It incorporates: three digits for the size of the primary tumor, two for the extension of the tumor, one more as a general code for lymph node involvement. Four more digits are used after these six: two digits for the number of pathologically positive regional lymph nodes, two more digits for the number of regional lymph nodes that are pathologically examined.
IRB
institutional review board
ICD-O
international classification of diseases for oncology
Linguine sign or Wavy line sign
intracapsular implant rupture seen on MRI
process monitoring
involves the tracking of statistical indicators over time to detect changes indicative of a need for intervention; it requires statistical evaluation to determine when the natural variability of these measures moves significantly outside its normal range of variation
Collaborative Stage Data Collection System
is a carefully selected, medically relevant set of data items that describe how far a cancer has spread at the time of diagnosis CS is sponsored by the AJCC in collaboration with the NCI SEER, CDC/NPCR, NCRA, NAACCR, ACoS CoC, and Canadian Cancer Society
Commission on Cancer (COC)
is a consortium of professional organizations dedicated to reducing the morbidity and mortality of cancer through education, standard setting, and the monitoring of quality care.
NCRA
is a non-profit professional organization for cancer registrars.
SEER
is a population registry that collects, compiles and disseminates data on specific geographic regions throughout the United States. SEER is a population registry whose data when combined with that collected by NPCR-funded State Central registries comprises data on 100% of cancer cases throughout the United States.
Journal of Registry Management
is a scientific peer-reviewed NCRA publication.
Registry Plus
is a software application developed by the CDC and has many applications such as Abstract Plus, Online Help, Link Plus, and others. It is mainly utilized by central cancer registries.
NCRA'S Council on certification
is elected by CTRs to oversee certification examinations and activities.
Osteosarcoma
is most common in teens, and usually develops in areas where the bone is growing quickly, such as near the ends of the long bones in the legs or arms. It often causes bone pain that gets worse at night or with activity. It can also cause swelling in the area around the bone.
MPRA
is no longer in effect as it was superseded by HIPAA; stressed that medical records needed to be handled with confidentiality, especially the disclosure of patient information without the patient's written consent; it did not cover the electronic transfer of medical records as it was hardly being used when it was enacted and it did not carry strong penalties for violations
End Results Group
issued four report in the 1950s/60s in an attempt to present survival figures on newly diagnosed cases from a number of state cancer registries and large hospital cancer registries in
Puerperal mastitis
lactating female with skin redness, tenderness, pain and swelling of breast
Phyllodes tumor
large, hypoehoic mass shaped like a leaf
regulations
laws made by agencies that have been approved to "enable legislation" by Congress or state legislatures; some of these agencies do impact caner registry work
case/common law
laws made by judges when they apply previous court decisions to current cases; it evolves on a case-by-case basis; the only state that does not follow this type of law is Louisiana, which bases its law on early French law
statutes
laws passed by legislative bodies, such as Congress or state legislatures; some of these laws do affect cancer registries
deterministic linkage
linkage that entails comparing data items between two records where the two records are considered a match only if the values on the matching items are identical; this approach tends to miss a significant number of true matches due to variations in data or missing data between the items being linked
probabilistic linkage
linkage that involves estimating the probability that two records represent the same person based on a linkage score; partial matching of data items is taken into account
Which is the only paired organ that is anatomically different?
lung
CK-BB
lung, breast, prostate, carcinoma
hospital-based registries
may be single hospital registries or collective (multi-institution) registries; they maintain data on all patients diagnosed and/or treated for cancer at a particular facility or facilities; their focus is on clinical care and hospital administration; use their data to support the requirements of the CoC *sources*: active follow-up info on registered patients, patients diagnosed and/or treated for cancer at a particular facility *goals*: evaluating clinical care and hospital administration; providing advocacy and educational opportunities to cancer patients; improving patient care programs
passive follow-up
may involve linking cancer patients with other databases such as vital records, motor vehicles or voter registration and many others; methods that do not require registry contact with hospitals, physicians, or individual cancer patients; used primarily to determine the patient's vital status and current date last seen alive or date of death
Tumor board
meeting of physicians trained in various disciplines that review the diagnosis of and propose therapy for a patient with some type of tumor
Most common primary CA to metastasize to the breast?
melanoma
Cytology
microscopic examination of cells obtained by aspirations, washings, scrapings and smears (i.e., Pap smear)
Histology
microscopic examination of tissue obtained by biopsy (excision of tissue sample), surgery or autopsy
Galactorrhea
milky discharge other than during pregnancy or lactation
The number of deaths due to cancer occurring during a given time period in a specific population refers to
mortality rate
State central registries are usually:
multi-purpose, population based, can provide incidence data
Immunoglobulins
multiple myeloma
Multifocal carcinoma
multiple tumors within one breast quadrant less than 5 cm distance.
To count the number of tumors as a single primary:
multiplicity
NaBIR
national breast implant registry
NCDB
national cancer data base
NCI
national cancer institute
NCRA
national cancer registrars association
NCCCS
national coordinating council for cancer surveillance
NIH
national institutes of health
NMDP
national marrow donor registry
NPCR
national program of cancer registries
Oncogenes, N-Mic, Neu
neuroblastoma
worrisome
no
____ is an example of a multi-hospital central cancer registry
non population based central e.g. NCDB
Uses all deaths regardless of cause of death:
observed overall survival
survival analysis programs
one of the more complicated output programs; uses actuarial (life-table) methodology and may provide an age-adjustment
CA-125
ovarian carcinoma
What is the most common cause of death from female pelvic malignancies?
ovary
NPCR
overseen by the CDC; developed as a result of Congress enacting the Cancer Registries Amendment Act in October 1992; through it, the CDC was given authority to: - provide funds to states and territories to enhance existing population-based cancer registries - plan and implement registries where they do not exist - develop model legislation and regulations for states to enhance viability of registry operations - set standards for completeness, timeliness, and quality - provide training - requires state laws from its members for state cancer reporting - was charged with establishing central cancer registries in states where they did not previously exist - supports CCRs in 45 states, DC, PR, and the US Pacific Islands - a few highlighted goals it requests from its member CCRs: timeliness at 12 months to be 90% and 95% at 24 months; quality of submitted data; audit every 5 years for each facility; e-reporting; physician offices and pathology lab reporting - it's purpose is to provide funds and technical assistance to improve cancer registration and cancer surveillance throughout the US
CA-19-9
pancreatic carcinoma
Biopsy needle best visualized in what plane
parallel to the skin and chest wall Sag with long axis of transducer
familial and site-specific cancer registries
participants are voluntarily self-enrolled or enrolled by physicians; in addition to maintaining a registry and doing research, they often act as patient advocates, and provide patient information and support.
2 types of casefinding methods
passive and active
The process performed by other health care professionals whom the registry relies on to notify the regstrar of potential reportable cases is
passive casefinding
Retrospective means
past
descriptive epidemiology
patterns of disease occurrences in a population
PCP
pediatric cancer program
What is the vertical axis on an actuarial survival graph?
percent surviving
PSEF
plastic surgery educations foundation
What are the two main types of Central Cancer Registries?
population based and multi-hospital or non-hospital based
The central cancer Registry that collects info on all residents of a defined geo area with a known census is called
population based registry
hospital cancer registries
population based; covering the entire population of a given geographic area such as a country, state, province, or county.
which are types of cancer registries
population-based, speciality cancer, hospital-based
Tail of Spence
portion of breast tissue extending into the axilla
At a specific point in time, the total number of patients living with a particular type of cancer is called
prevalance
health information privacy
prevents the unreasonable offense of a patients interest in restricting unnecessary knowledge of personal info provided by the patient to assist in diagnosis or treatment, or derived during medical car in furtherance of those healthcare objectives
The expected frequency with which an event will occur:
probability
output programs
programs that generate some form of patient record selection; can be based on patients that are due for a follow-up, frequency distributions and cross tabulations, incidence or mortality rate calculations, etc
Gleason's grade is a histologic grading system for which type of cancer?
prostate cancer
Prostate specific antigen (PSA)
prostatic cancer
individually identifiable health information
protected by HIPAA; refers to any information related to the condition of the patient, treatment, or billing that reasonably identifies the patient; it explicitly identifies the patient by name, identifier, address, SSN, phone number, or similar information, or if the content provides some info that permits reasonable deduction of the patient's identity.
gramm-leach-bliley act
protects consumers of financial institutions from unknown or deceptive use of their personal financial information and provides the opportunity to opt out of certain disclosure practices
public health service act
protects information obtained during drug or alcohol-related treatment at federally funded facilities from inappropriate use or disclosure
privacy act of 1974
protects the individually identifiable information held by the federal government from inappropriate use or disclosure; to provide that individuals be granted access to records concerning them that are maintained by federal agencies; and to establish a Privacy Protection Study Commission
CP3R (Cancer Program Practice Profile Reports)
provide CoC-accredited programs with comparative information to assess adherence to standard-of-care therapies for breast and colorectal cancers, including measures endorsed by the National Quality Forum (NQF) and developed in collaboration with the American Society of Clinical Oncology and the National Comprehensive Cancer Network
VACP
provides care to military veterans and offers the full range of diagnostic and treatment services either on-site or by referral, preferably to CoC-accredited cancer programs
FORDS (Facility Oncology Registry Data Standards) Manual
provides definitions and detailed instructions for coding patient diagnosis, treatment, and outcomes; also describes the types of cases that must be abstracted and followed, and explains the relationship among data items
NPCR Cancer Surveillance system (CSS)
provides feedback to the states on completeness and data quality. The aggregate data in CSS is disseminated in reports that track national and regional progress in reducing the cancer burden.
SEER*DMS (SEER Data Management System)
provides support for all core cancer registry functions, importing data, editing, linkage, consolidation, and reporting; improves cost efficiency and reduces duplication of effort in terms of system maintenance and administration
ability to review
provides the individuals with the ability to understand precisely what information an organization has accumulated about them and the accuracy of that information
age-adjusted incidence rates
rates that are calculated as an overall rate and are adjusted for age; sometimes known as standardized-rates; uses three methods to age-adjust: cumulative incidence, direct standardization, and indirect standardization
specific rates
rates that are calculated for subgroups of the population, such as age-specific, site-specific, or sex-specific
Reabstracting a sample of case records reported by a facility from the actual source patient medical records comparing the reabstracted data with the data already in the registry.
re-abstracting audit
NCI SEER Program
receives data in aggregate form and is analyzed with data from the National Center for Health Statistics on cancer related deaths. The information is used to determine a representative national cancer incidence, mortality rates, and survival rates.
Computer matching of central registry abstracts to vital statistics death certificates to update patient date of death would be an example of
record linkage
individually identifiable information
refers to information related to the patient, including the patient's address, treatment or the ability to deduct the patient's identity
electronic data interchange (EDI)
refers to the linking of computers via telephone lines or other communication methods; also sometimes referred to as teleprocessing, data communications, and electric commerce; can be both the means by which the hospital reports their data and the means by which the central registry provides follow-up information to hospitals and can save critical time spent on routine registry functions
SEER-Medicare data
reflects the linkage of two large population-based sources of data that provide detailed information about elderly persons with cancer
retrospective registries
registries that collect data on individuals with a definitive diagnosis, related to their diagnostic workup, treatment, and progression of disease
concurrent registry
registries that contain ongoing clinical research and evaluate specific events, procedures, or new treatments; ie. trauma registries
Unreliable info on cause of death survival but has accurate expected other cause mortality from general population for the cohort
relative survival
complete prevalence
represents the proportion of people alive on a certain day who previously had a diagnosis of the disease, regardless of how long ago the diagnosis was, or if the patient is still under treatment or is considered cured
basic science studies
research that may look at the mechanisms by which cells become cancerous or metastatic, identify markers for early detection or progression, or identify new methods of screening, treatment, and palliative care
The American Association of Central Cancer Registries became NAACCR when
several Canadian provinces sought membership and expressed interest in adopting the same standards
if a patient has a local recurrence & 2 years later has a distant mets the 1st date of recurrence
should never change
Silicone migration is signified by?
siliconized lymph node, snowstorm siliconoma NOT Stepladder sign
Which of the following procedures would be coded in Surgical Procedure of Primary Site?
simple mastectomy with axillary lymph node dissection
a patient is diagnosed with prostate adenocarcinoma in 2/2005 treated with RT. Returned 3/2010 following prostate BX showing adenocarcinoma is this a new single or recur
single prostate always single
Retinacula Cutis
small extensions of Cooper's ligaments found in the subcutaneous fat layer
Joinpoint Regression Program
software for the analysis of trends using joinpoint models, enabling the user to test that an apparent change in trend is statistically significant
CanSurv (Cancer Survival Analysis)
software to analyze population-based survival data
ComPrev (Complete Prevalence)
software used to calculate complete prevalence based on limited-duration prevalence statistics
Dev-Can (Probability of Developing or Dying of Cancer)
software used to calculate the lifetime risks for being diagnosed with or dying of cancer
ProjPrev (Projected Prevalence)
software used to take limited-duration prevalence statistics from SEER*Stat and apply them to a different population
Metastasis
spread of disease from one organ or part to another not directly connected with it
classification of the extent of disease is know as
staging
What software function is unique to hospital registries
submitting data to the American College of Surgeons National Cancer Database
Palliative treatment can include
surgery, radiation, pain management
SEER
surveillance, epidemiology, and end results
Once cases are ID this type of file should be created for the use in abstracting
suspense list
A group of signs & symptoms produced by a tumor or metastatic site:
syndrome
treatment using substance that travel through the blood stream reaching & affecting cells all over the body
systemic therapy
follow back
term used to describe steps taken to gather complete information for inclusion into the CCR if the case has not been previously registered
LDH
testicular carcinoma, melanoma
TJ Hooper Case
the case that provides legal precedent that a standard of care may exist even when current common business practice does not dictate that it exists
Task of Registry
the collection of data serving as a basis: (1) for an individual follow-up of patients; (2) for reliable morbidity statistics with a view to an accurate estimate of therapeutic results; and (3) for an accurate evaluation of variations in incidence of malignant neoplasms, secular as well as geographical, occupational, and so forth.
Grade
the degree of abnormality of cancer cells, a measure of differentiation, the extent to which cancer cells are similar in appearance and function to healthy cells of the same tissue type
ethics
the discipline dealing with what is good and bad and with moral duty and obligation; a set of moral principles
PCP (Pediatric Cancer Program)
the facility only provides care to children, or the pediatric oncology program is a component within a larger CoC-accredited facility; offers the full range of diagnostic and treatment services either on-site or through referral; required to participate in cancer-related clinical research focused on pediatric patients; no minimum caseload requirement.
ACAD
the facility provides postgraduate medical education in at least 4 program areas; accessions more than 500 newly diagnosed cancer cases each year; required to participate in cancer-related clinical research either by enrolling patients in cancer-related clinical trials or by referring patients for enrollment at another facility or through a physician's office
NCIP
the facility secures a NCI peer-reviewed cancer center support grant and is designated a comprehensive cancer center by the NCI
catchment area
the geographic area from which the population source of the central registry is drawn
incidence-only registries
the goal of these types of registries is determination of cancer incidence rates in different groups of people living in their defined geographic area; they provide incidence and trend data for a specific geographic area to assess the burden of cancer in that specific geographic area; may also collect data on healthcare providers and may support cancer research such as case-control studies and cohort linkage studies
case definition
the identification of the individuals about which data will be collected; may be expressed as both inclusion and exclusion criteria
statutory law
the legislation that requires state cancer reporting
matching
the linkage step performed online within the identified blocks of data
Wider-than-tall (benign characteristic)
the long axis of a mass is parallel to the skin/chest wall
TRICARE
the major component of the military health system providing access to high quality healthcare services, whereas maintaining the capacity to support military operations
life-table observed survival method
the method that allows including subjects who may have been lost to follow-up, or may be alive after several years of observation
A cancer incidence rate is
the number of new cancers diagnosed during a specified period of time per 100,000 population
part 164
the part of HIPAA that is considered its security and privacy portion; as cancer registrars deal with patients' PHI, they must be aware of the pertinent legal restrictions and procedures detailed in this part of the act
PCPC (Pediatric Cancer Program Component)
the pediatric component within a larger facility accessions a minimum of 50 newly diagnosed pediatric cancer cases each year; may be associated with a medical school and participate in training pediatric residents
professional ethics
the principles of conduct governing an individual or a group
follow-up
the process in which a cancer registry collects and records info on a yearly basis on each patient to update the database; its purpose is to evaluate the survival of groups of patients by various parameters
external benchmarking
the process of comparing performance on critical measures of patient care quality against others or the "best" in the industry; help hospitals assess where they are in comparison with other institutions, based on industry standards
abstracting
the process of converting the medical record information into standardized codes within a uniform data set
internal benchmarking
the process of reviewing performance on critical measures of patient care quality; help a hospital improve its own performance over time
mortality rate
the rate at which persons in the general population die of cancer during the time period of interest; provides a measure of the risk of death attributable to a disease until death
survival rate
the rate that shows the risk of dying among people who have the disease
relative survival rate
the ratio of the observed survival rate in the study population to the expected survival rate in the subset of the general population with the same characteristics as the study population; essentially the observed survival rate, adjusted because some of the subjects can be expected to die from causes of death other than that under study
Recurrence
the return of cancer that was not previously clinically apparent or the patient symptomatic, usually at a site distant from the primary. Local recurrence;return of the primary tumor itself. Regional recurrence; return of the tumor in an area beyond the limits of the original organ. Distant or disseminated recurrence; in an area remote from the original tumor.
Morphology
the science of structure and form without regard to functions; the name of the ICD-O code describing the specific type of tumor
cancer is
the second leading cause of death
The square root of the variance of data is called:
the standard deviation
reference date
the start date after which all eligible cased must be included in the registry
workload
the total amount of work or tasks; based on the overall caseload but also takes into consideration the additional responsibilities of a registry such as cancer conferences, cancer committees, studies, audits, reviews, training, and education
synchronous online learning
the type of online learning that happens in "real time" and involves coordinated live interaction with an instructor or facilitator
disease registry
the type of registry that supports quality improvements in treatment facilities through monitoring of therapies and outcomes
budgetary control
the use of the budget to regulate and guide activities requiring and using resources for the development of new services, expanding services, increasing revenues, or decreasing operating expenses
rapid case assertainment
the utilization of a diagnostic pathology report preceding the slower, traditional medical record-based process
a major difference between federal cancer registries and nongovernmental registries
the way the programs are organized
1971
the year President Richard Nixon declared war on cancer
1980
the year the NCI published data on 5-year survival rates from the same four registries as their 1976 report; showed a significant increase in 5-year survival rates in 17 of 35 sites in males and 26 of 35 sites in females
1983
the year the NCRA started a credentialing process for cancer registrars (CTR)
administrative laws
these laws should clearly delineate who, what, when and how of cancer reporting; they also list penalties for non-compliance
geocoding programs
these programs require a large reference file of street names and related information for the specific geographic area concerned
organ transplant registries
these registries, although not directly funded or managed by the federal government, are subject to federal statutory requirements
population-based registries
these types of registries serve multiple purposes such as combining incidence reporting with survival results, patient care, and various other research and cancer-control activities
HHS
this US Dept published a final Privacy Rule in December 2000 (later modified in August 2002); set national standards for the protection of IIHI by three types of covered entities: health plans, healthcare clearinghouses, and healthcare providers who conduct the standard healthcare transactions electronically; compliance was required as of April 14, 2003; compliance with the security rule was required as of April 20, 2005
geocoded residence at diagnosis
this data is used in a variety of analyses including access to care studies, stage at diagnosis, linking with other socioeconomic status variables, environmental and cancer cluster studies, and public health resource allocation studies
USCS Expanded Dataset
this dataset is hosted on the CDC website in WONDER
CDC
this organization has been the linchpin for the development or expansion of central registries in states not covered by the SEER program; collaborates with states and researchers to conduct research studies
zero-based budget
this type of budget is prepared as though it is being done for the first time; it starts with a base of zero; each department or subdepartment then looks at all expenses and justifies them at each budgeting cycle
pediatric cancer registry software
this type of registry should incorporate data items such as cytogenetics, FAB (French-American-British) classifications, congenital anomalies, and other areas of special interest in the study of childhood malignancies.
cohort studies
this type of study begins with identification of a group of cohort, with a known history of exposure; the exposures are then measured and the study subjects are investigated or are followed over time to determine disease status
current coding system
this version of the coding system describes the coding system currently used to code a specific data item
original coding system
this version of the coding system describes the response categories available to the coder when the data item was originally abstracted and coded
Most of the body lymph returns to the bloodstream via the
thoracic duct
non-analytic cases
those cases that were diagnosed and received their entire first course of treatment before admission to the reporting hospital
analytic cases
those cases that were diagnosed at the reporting hospital
NCDB is used
to compare treatment and thus provide information to improve the quality of care at the point of delivery.
How does the American Cancer Society use SEER data?
to create statistical reports and state-by-state cancer incidence projections.
RT kills cancer cells by damaging their DNA, these tumors are usually radiosensitive
true
general treatment is considered "first course"when it is planned at the time of initial diagnosis
true
surgery is the oldest form of treatment for cancer
true
the goals for abstracting are to have complete, accurate, and timely cancer data
true
the staging info must include the assesment of 3 complents: tumor, node, metastasis
true
Branch pattern
tumor extension growth along the ducts away from the nipple (do not confuse with ductal extension)
Estrogen and progesterone receptors are examples of what type of information coded in site specific factors?
tumor markers
Benign
tumors frequently enclosed in a sheath of tissue; not malignant or recurrent; favorable for recovery
Malignant
tumors that spread either by extension or metastasis and tend to become progressively worse and will result in death if left untreated
trauma/disaster registries
types of registries that track care rendered to and effects on persons subjected to harmful external events; a registry that gathers data from and provides infrastructure support for designated trauma center facilities within the states
computerized edits
typically check for completion of all required fields, allowable range, allowable values, and interfield consistency (such as primary site consistent with sex); they can test for invalid entries, such as an unusual site-histology combination, or flag unusual entries for review
Longest axis of a fibroadenoma
typically lies parallel to the skin (wider-than-tall)
HIPAA Privacy Rule
under this rule, patient authorization is required before releasing health information EXCEPT WHEN: - sending cancer data to the NCDB - sending cancer data to the state CCR - providing other health care facilities with patient treatment info - allowing state cancer registry staff to review patient records when necessary - This rule allows sharing information between facilities if both had a relationship with the patients - requires business agreements with entities that carry out health care functions on behalf of covered entities (vendors for contract services) while state and regional cancer registries are acting on behalf of the state, not the covered entity - a business agreement is necessary for ACoS/CoC accredited cancer programs to provide information for accreditation purposes - this rule requires the accounting of disclosures of protected health information for the patient when it is sent to the state cancer registry; accounting of disclosures are not required when it concerns treatment, payment and operations
UDSC
uniform data standards committee
UWPN
university of washington physicians network
proportional methodologies
useful where populations-at-risk are not available for the subgroups of interest
geocoding
using the patient's address to infer a geographic location and is widely used by population-based registries to aid in their investigation of cancer clusters; it is the main reason that central registries require street addresses, county codes, and zip codes of that patient at the time of diagnosis; it is an example of record linkage
surveillance period
usually begins at diagnosis and ends at death
Fibroadenoma
usually oval benign tumor, solid, hormone influence
Tumor associated antigen (TA-4)
uterine cervix
VACP
veterans affairs cancer program
ACTUR
was developed as part of the Defense Enrollment Eligibility Reporting System (DEERS) to facilitate interhospital usage by military beneficiaries, promote the cost savings associated with a single interhospital system, and provide the ability to produce automated reports and studies on a DoD-wide basis; The required DoD data set; is military specific and includes documentation of the sponsor's SSN, branch of service, and active duty status
AJCC
was established in 1959 to formulate and publish systems of classification of cancer, including staging and end results reporting.
ACS-CoC Steering Committee
was formed to address the ACS-CoC relationships by engaging in strategy development and educating ACS divisions and ACS field staff working in CoC-accredited cancer programs; this partnership has resulted in publication of a Commission on Cancer Guidebook
IACR
was formed to foster the exchange of information between cancer registries internationally and to improve the quality of data and comparability between registries; serves as a membership organization for cancer registries concerned with the collection and analysis of data on cancer incidence and with the end results of cancer treatment in defined population groups; publishes "Cancer in Five Continents"
error percentage threshold
when a submitted file contains more than a specified percentage of edit errors overall, the entire file is rejected due to this
death-certificate only (DCO)
when all attempts to gather more complete data fails, the case is retained in the central registry as one of these
Centralized Registry
xx
Facility Registry
xx
consistent with
yes
suspicious for (ambigous term that constitues a DX or not)?
yes
3 main types of health registries
• prospective registries • retrospective • concurrent registries
3 types of health registries
• prospective registries • retrospective • concurrent registries
