Preparing For the Upcoming Cancer Registry Changes: Time Is Short, but Support is Available
By Susan Mackenzie, MRA
For those of us working in the cancer registry profession, you are likely very much aware of the significant changes upon us that will dramatically alter the way we work and how we collect required data for the registry. The upcoming changes are extensive, and most of us are probably not ready. In fact, based on what myself and my team at MRA are hearing, this is entirely the case.
Before we get into that, though, let’s first review some of the anticipated registry changes. They include:
• 223 new data items
• 137 new site-specific data items
• 24 new radiation treatment data items
• 18 new American Joint Committee on Cancer TNM 8th edition data items
• 16 new geocoding data Items
• 3 new grade data items and new grade assignment methodology requirements
• Medicare beneficiary identifier changes
The following are specific changes to existing data items:
• Extensive field name changes
• Extensive field length changes include many
• Extensive changes to the code set and/or coding instruction
• Multiple NAACCR record layout changes
Regarding field location changes in transfer record layout (start/stop position), all of these data items are affected. Additionally, the new 2018 ICD-O-3 histology code and behavior code will experience many new updates, including 31 new ICD-O-3 histology codes, 18 behavior codes changes (some new reportable and some no longer reportable histology/behavior), and 114 new histology terms added.
However, what might be most daunting are the new cancer staging requirements including directly coded stage and/or derived stage from standardized API/DLL. Despite the technicalities, the staging and data collection alone is massive, especially concerning ovary and breast cancers, based on how the data is collected. The data collection for staging is likely to be a significant canyon that must be crossed based on the likely amount of the data that must be collected and reported. Changing parameters on how to collect this specific data keep changing. Preparation is key.
Everybody across the country in the cancer registry industry is dealing with how to approach these new rules, so there’s strength in our numbers and in our ability to navigate what’s to come. So, while Jan. 1, 2018, has come and gone and the excitement is in full crescendo since we’re well past the initially expected rollout, the cancer registry changes have been the works and expected for about two years, so it’s not like any of this has caught us unaware.
We all understand some of the most apparent obstacles include the enormous amount of change we’ll be facing – as detailed above, as well as the fact that some of the software vendors that we work with for data collection may not be immediately able to respond once the final changes and guidelines have been released. Additionally, we understand that all of us are likely to experience some slowdown in processes once the changes go into effect, but we can still prepare, educate ourselves and be ready when the time comes.
That likely is our best defense. Harkening back to our experiences in school and college, it is like we’re in the final run of the semester and exams are quickly approaching. Thus, we need to study, stay informed and stay up to date on what’s going to be expected of us. That might mean following along with industry publications, attending free webinars and online seminars where the latest information is being discussed, reading fresh Commission on Cancer materials as they are released, and turning to industry resources like the Standards for Oncology Registry Entry (STORE) Manual, which was published on Aug. 15, 2018, and is available and ready to use. These are just some of the resources available for our betterment.
Any change can be painful or at least distracting and time-consuming, but as a community, we can serve each other for the better. To that point, I am always happy to help as a resource during this time of upheaval, as is my team at MRA. I’ve been working in the field for more than 21 years, and we have resources serving organizations with cancer registries from all over the country.
While this time of change may be difficult and there’s much to consider, there are plenty of resources available to navigate the field, and there are plenty of resources to support your navigational efforts. Even if you are not ready for the coming changes, you still have a bit of time to get caught up, and we can help.