What s New. Maryland Cancer Registry E-Update SEPTEMBER By Kimberly Stern, MHA, CTR Program Manager, Maryland Cancer Registry

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1 SEPTEMBER 2015 Maryland ancer Registry E-Update Apubl i c a onbywe s t a tunde rc ont r a c twi t ht hedhmhont r a c t# DHMH-OPASS W hat s New? By Kimberly Stern, MHA, TR Program Manager, Maryland ancer Registry Tel#(410) Emai l :Ki mbe r l y. St e r n@mar yl and. gov Autumn is a second spring when every leaf is a flower. Albert amus I hope everyone had an enjoyable summer. Inside this issue: What s New Disease Index ID-10 asefindling list 4-9 ontent of a Pathology Report Submission 10 State ancer Data Meet the Staff Upcoming Event NAAR Webinar Schedule It has been a busy time at MR with another Registry Plus program conversion to complete in addition to the annual processing of your submitted data. It is with mixed emotions that I share that Dr. Lisa Gallicchio, ancer Registry Advisory ommittee (RA) hair, has accepted a position at the National ancer Institute and is no longer able to fill her role as RA hair. We sincerely thank Dr. Gallicchio for the leadership and vision she has provided RA through the years and wish her well in her new position. We are excited to announce that, Kala Visvanathan, MD is our newly appointed RA hairperson. Dr. Visvanathan is the Director of the ancer Epidemiology Track in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, and also the Director of linical ancer Genetics and Prevention Service at Johns Hopkins Sidney Kimmel omprehensive ancer enter. MR eagerly looks forward to working alongside Dr. Visvanathan to continue the mission of RA. 15 We are proud to announce that thanks to your efforts to submit data in a timely, comprehensive manner, MR has received notification from D National Program of ancer Registries (NPR) that it has been designated a 2014 Registry of Distinction and it s critical and high-quality data will be included in the official federal statistics on cancer incidence and mortality, United States ancer Statistics (USS). USS data are used to assess the cancer burden, inform and evaluate prevention efforts, and address disparities.

2 Page 2 ont. What s New By Kimberly Stern, MHA, TR Your efforts to submit data in a timely manner is highly appreciated and is particularly critical this year per NAAR directives that specify that 12- and 24-month data must be submitted in December As a result, MR will submit its 12-month NPR data alongside the 24-month data at the end of November 2015 (previously submitted January 31). We ask that you be mindful of this date change makes it even more critical that your data is submitted timely. I hope everyone has a chance to enjoy the flowers and leaves in the Fall season ahead. 2

3 Page 3 Q uality orner: 2013 Disease Index By Wilhelmina Ross, PA, MPH, TR QA Technical Specialist, Operations support Tel#: ; W ilhelminaro s@ westat.com 2013 Disease Index Thank you for submitting your 2013 disease index! We are in the process of reconciling the disease indices, so you should have received request for reconciliation for all non-match cases which should be submitted via Web Plus. Please do not attempt to reconciliation files back to the MR. is not a secure system to send patient identifying information. ontact Wilhelmina Ross at WilhelminaRoss@westat.com or if you have not received a request for reconciliation or are having difficulties getting the file back to us. If your facility is working on reconciliation, please continue your efforts so that we have time to process any missed cases for our data submission at the end of November. Reporting facility disease indices matched to the MR database within a range of 60% - 96%. Among those reconciled by the corresponding facility, we have noticed a pattern of facilities not reporting VIN cases. These cases are reportable to the MR as outlined in the Maryland state legislation noted below, even though these cases are not required by o. As a refresher, please refer to the table below that lists reportable cases to the MR. In addition, we have noticed that oncology, surgical, and radiation oncology visits for Maryland residents are not being reported to the MR if the facility has classified them as a consult only visit. This is an observation that will be further discussed with standard setters to determine eligibility for reporting or not. Stay Tuned!!! Table 1: Reportable ancer ases to the MR (from the Health-General Article 2-104, , and , Annotated odeofm aryland;42u.s.. 280(e) Reportable Diagnoses Any malignant and in situ tumor (behavior code 2 or 3 in ID-O-3). Intraepithelial neoplasia of the following sites (abbreviation and ID-O-3 codes): à vaginal squamous intraepithelial neoplasia (VAIN 8077/2), à vulvar squamous intraepithelial neoplasia (VIN 8077/2), and à anal squamous intraepithelial neoplasia (AIN III 8077/2), Any non-malignant primary intracranial and central nervous system tumor including juvenile astrocytoma for primary sites including the brain, the cauda equina, a cranial nerve, the craniopharyngeal duct, the meninges, the pineal gland, the pituitary gland, or the spinal cord. Neoplasm involving plasma cells (ID-9-M code 238.6). Squamous or basal cell cancer of genital skin sites. Exclusions (NOT reportable) Squamous or basal cell cancer of non-genital skin sites. ervical carcinoma in situ (IS) Intraepithelial neoplasia of the following sites (abbreviation, ID-O-3 code): à cervical squamous intraepithelial neoplasm (IN III, 8077/2), à prostatic glandular intraepithelial neoplasia (PIN, 8148/2) Borderline malignancy of the ovary (ID-9-M code 236.2). 3

4 Page 4 Q uality orner: omprehensive ID 10-M asefinding List (SEER asefinding List) OMPREHENSIVE ID-10-M asefinding ode List for Reportable Tumors (Effective 10/1/2015-9/30/2016) Please refer to your standard setter(s) for specific reporting requirements before using this asefinding list ID-10-M ODE^ 00._ - 43._, 45._ - 96._ 44.00, _, 44.19_ 44.20_, 44.29_ EXPLANATION OF ID-10-M ODE Malignant neoplasms (excluding category 44), stated or presumed to be primary (of specified site) and certain specified histologies 1 Unspecified/other malignant neoplasm of skin of lip Unspecified/other malignant neoplasm of skin of eyelid Unspecified/other malignant neoplasm skin of ear and external auricular canal 44.30_, 44.39_ Unspecified/other malignant neoplasm of skin of other/unspecified parts of face 44.40, _, 44.59_ 44.60_, 44.69_ Unspecified/other malignant neoplasm of skin of scalp & neck Unspecified/other malignant neoplasm of skin of trunk Unspecified/other malignant neoplasm of skin of upper limb, incl. shoulder 44.70_, 44.79_ Unspecified/other malignant neoplasm of skin of lower limb, including hip 44.80, Unspecified/other malignant neoplasm of skin of overlapping sites of skin 44.90, Unspecified/other malignant neoplasm of skin of unspecified sites of skin D00._ - D09._ In-situ neoplasms (Note: arcinoma in situ of the cervix (IN III-8077/2) and Prostatic Intraepithelial arcinoma (PIN III-8148/2) are not reportable). D18.02 Hemangioma of intracranial structures and any site D18.1 Lymphangioma, any site (Note: Includes Lymphangiomas of Brain, Other parts of nervous system and endocrine glands, which are reportable) D32._ Benign neoplasm of meninges (cerebral, spinal and unspecified) D33._ Benign neoplasm of brain and other parts of central nervous system D D35.4 Benign neoplasm of pituitary gland, craniopharyngeal duct and pineal gland 4

5 Page 5 ont. ID 10-M omprehensive asefinding List OMPREHENSIVE ID-10-M asefinding ode List for Reportable Tumors (Effective 10/1/2015 9/30/2016) Please refer to your standard setter(s) for specific reporting requirements before using the asefinding list ID-10-M ODE^ D42._, D43._ D D44.5 EXPLANATION OF ID-10-M ODE Neoplasm of uncertain or unknown behavior of meninges, brain, NS Neoplasm of uncertain or unknown behavior of pituitary gland, craniopharyngeal duct and pineal gland D45 Polycythemia vera (9950/3) D46._ Myelodysplastic syndromes (9980, 9982, 9983, 9985, 9986, 9989, 9991, 9992) D47.1 hronic myeloproliferative disease (9963/3) D47.3 Essential (hemorrhagic) thrombocythemia (9962/3) D47.4 Osteomyelofibrosis (9961/3) D47.7 Other specified neoplasms of uncertain/unknown behavior of lymphoid, hematopoietic (9965/3, D47.Z_ Neoplasm of uncertain behavior of lymphoid, hematopoietic and related tissue, unspecified D47.9 Neoplasm of uncertain behavior of lymphoid, hematopoietic and related tissue, unspecified D49.6, D49.7 Neoplasm of unspecified behavior of brain, endocrine glands and other NS 1 Note: Pilocytic/juvenile astrocytoma M-9421 moved from behavior /3 (malignant) to /1 (borderline malignancy) in ID-O-3. However, SEER registries will ONTINUE to report these cases and code behavior as /3 (malignant). 5

6 Page 6 ont. Supplemental ID-10-M NOTE: ases with these codes should be screened as registry time allows. Experience in the SEER registries has shown that using the supplemental list increases casefinding for benign brain and NS, hematopoietic neoplasms, and other reportable diseases. SUPPLEMENTAL LIST ID-10-M (Effective Dates: 10/1/2015 9/30/2016) ID-10-M ODE^ EXPLANATION OF ID-10-M ODE B20 Human immunodeficiency virus [HIV] disease with other diseases B97.33, B97.34, B97.35 Human T-cell lymphotrophic virus,( type I [HTLV-1], type II [HTLV-II], type 2 [HIV 2]) as the cause of diseases classified elsewhere B97.7 Papillomarvirus as the cause of diseases classified elsewhere 44.01, _, 44.12_ 44.21_, 44.22_ Basal/squamous cell carcinoma of skin of lip Basal/squamous cell carcinoma of skin of eyelid Basal/squamous cell carcinoma of skin of ear and external auricular canal 44.31_, 44.32_ 44.41, _, 44.52_ 44.61_, 44.62_ Basal/squamous cell carcinoma of skin of other and unspecified parts of face Basal/squamous cell carcinoma of skin of scalp and neck Basal/squamous cell carcinoma of skin of trunk Basal/squamous cell carcinoma of skin of upper limb, including shoulder 44.71_, 44.72_ Basal/squamous cell carcinoma of skin of lower limb, including hip 44.81, Basal/squamous cell carcinoma of skin of overlapping sites of skin 44.91, Basal/squamous cell carcinoma of skin of unspecified sites of skin D10._ - D31._, D34, D35.0, D35.1, D35.5_ D35.9, D36._ Benign neoplasms (see "must collect" list for reportable benign neoplasms) Note: Screen for incorrectly coded malignancies or reportable by agreement tumors Note: Borderline cystadenomas M-8442, 8451, 8462, 8472, 8473, of the ovaries moved from behavior /3 (malignant) to /1 (borderline malignancy) in ID-O-3. SEER registries are not required to collect these cases for diagnoses made 1/1/2001 and after. However, cases diagnosed prior to 1/1/2001 should still be abstracted and reported to SEER. 6

7 Page 7 ont. Supplemental ID-10-M SUPPLEMENTAL LIST ID-10-M (Effective dates: 10/1/2015-9/30/2016) ID-10-M ODE^ EXPLANATION OF ID-10-M ODE D3A._ Benign carcinoid tumors D37._ - D41._ Neoplasms of uncertain or unknown behavior (see "must collect" list for reportable neoplasms of uncertain or unknown behavior) Note: Screen for incorrectly coded malignancies or reportable by agreement tumors D D44.2, D44.6-D44.9 Neoplasm of uncertain or unknown behavior of other endocrine glands (see "must collect" list for D44.3-D44.5) Note: Screen for incorrectly coded malignancies or reportable by agreement tumors D47.0 Histiocytic and mast cell tumors of uncertain behavior D47.2 Monoclonal gammopathy Note: Screen for incorrectly coded Waldenstrom's macroglobulinemia D48._ Neoplasm of uncertain behavior of other and unspecified sites D D49.9 Neoplasm of unspecified behavior (except for D49.6 and D49.7) D61.18_ Pancytopenia D63.0 Anemia in neoplastic disease D64.81 Anemia due to antineoplastic chemotherapy D69.49, D69.59, D69.6 Other thrombocytopenia Note: Screen for incorrectly coded thrombocythemia D70.1 Agranulocytosis secondary to cancer chemotherapy D72.1 Eosinophilia (Note: ode for eosinophilia (9964/3). Not every case of eosinophilia is a malignancy. Reportable Diagnosis is "Hypereosonophilic syndrome.") D76._ Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue D89.0, D89.1 Other disorders involving the immune mechanism, not elsewhere classified Note: Review for miscodes 7

8 Page 8 ont. Supplemental ID-10-M SUPPLEMENTAL LIST ID-10-M (Effective Dates: 10/1/2015 9/30/2016) ID-10-M ODE^ EXPLANATION OF ID-10-M ODE E34.0 arcinoid syndrome E83.52 Hypercalcemia E88.09 Other disorders of plasma-protein metabolism, not elsewhere classified E88.3 Tumor lysis syndrome (following antineoplastic chemotherapy) G89.3 Neoplasm related pain (acute)(chronic) K Barrett's esophagus with high grade dysplasia K62.82 Dysplasia of anus (AIN I and AIN II) K92.81 Gastrointestinal mucositis (ulcerated) (due to antineoplastic therapy) N42.3 Dysplasia of prostate (PIN I and PIN II) N87._ N89.0, N89.1, N89.3 N90.0, N90.1, N90.3 O01._ Q85.0_ Dysplasia of cervix uteri (IN I and IN II) Vaginal dysplasia (VIN I and VIN II) Vulvar dysplasia (VAIN I and VAIN II) Hydatidiform mole Note: Benign tumor that can become malignant. If malignant, report as horiocarcinoma (9100/3, ) malignancy code in the range Neurofibromatosis (nonmalignant) (9540/1) Note: Neurofibromatosis is not cancer. These tumors can be precursors to acoustic neuromas, which are reportable R18.0 Malignant ascites R53.0 Neoplastic (malignant) related fatigue R59._ Enlarged lymph nodes R85.6 Abnormal findings on cytological and histological examination of digestive organs R87.61_, R87.62_ R92._ R97._ T38.8_, T38.9_ T45.1_ T45.8_, T45.9_ T66 T80.2_ Abnormal findings on cytological/histological examination of female genital organs Abnormal findings on diagnostic imaging of breast Abnormal tumor markers Poisoning by hormones and their synthetic substitutes Poisoning by, adverse effect of and under dosing of antineoplastic and immunosuppressive drugs Poisoning by primary systemic and hematological agent, unspecified Unspecified effects of radiation Infections following infusion, transfusion and therapeutic injection 8

9 Page 9 ont. Supplemental ID-10-M SUPPLEMENTAL LIST ID-10-M (Effective Dates: 10/1/2015 9/30/2016) ID-10-M ODE^ EXPLANATION OF ID-10-M ODE Y63.2 Overdose of radiation given during therapy Y84.2 Radiological procedure and radiotherapy as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure Z03.89 Encounter for observation for other suspected diseases and conditions ruled out Z08 Z12._ Z17.0, Z17.1 Z40.0_ Encounter for follow-up examination after completed treatment for malignant neoplasm Encounter for screening for malignant neoplasms Estrogen receptor positive and negative status Encounter for prophylactic surgery for risk factors related to malignant neoplasms Z42.1 Encounter for breast reconstruction following mastectomy Z Encounter for aftercare following bone marrow transplant Z51.0 Encounter for antineoplastic radiation therapy Z51.1_ Z51.5, Z51.89 Z85._ Z86.0_, Z86.01_, Z86.03 Z92.21, Z92.23, Z Z92.3 Z94.81, Z94.84 Encounter for antineoplastic chemotherapy and immunotherapy Encounter for palliative care and other specified aftercare Personal history of malignant neoplasm Personal history of in situ and benign neoplasms and neoplasms of uncertain behavior Personal history of antineoplastic chemotherapy, estrogen therapy, immunosuppression therapy or irradiation (radiation) Bone marrow and stem cell transplant status ^International lassification of Diseases, ID-10-M Tabular List of Diseases and Injuries, FY

10 Page 10 Q uality orner (Nonhospital) : ontent of a Pathology Report Submission By Debra Haegele, RHIT QA Technical Specialist, Non-Hospital Representative Tel#: ; DebraHaegele@ westat.com ontent of a Pathology Report Submission to the Maryland ancer Registry (MR) Pathology reports are currently submitted to the MR in two formats, a hard copy of the pathology report with attached patient demographic information and as an electronic submission. The electronic submission of pathology reports is completed either through the direct entry of data into WebPlus, a software program provided by the enter for Disease ontrol and Prevention (D), or uploaded as an HL7 file to the MR server. Each format requires that the same data elements be available in order to meet data requirements of the MR and other national organizations. ontent of a pathology report - According to the ode of Maryland Regulations (OMAR) governing cancer data collection, a cancer report to the MR contains the data items listed below. Reasonably contained patient demographic information Information on industry or occupation history of the patient Relevant information on: à Initial diagnosis including date of diagnosis (primary site, histology, behavior, grade) à Initial treatment à Extent of the disease à Extent of disease within 2 months of diagnosis if the information is available to the pathology Facility and other provider identification Other requirements as considered necessary by the Secretary of Health and Mental Hygiene Minimal data elements permitted in a submitted pathology report - When the data items listed above are not available to the pathology lab, MR will still accept the case submission. Pathology reports should contain a minimal of the following data elements: Reasonably contained patient demographic information Facility and other provider identification If available, relevant information on the: à Initial diagnosis including date of diagnosis (primary site, histology, behavior, grade) à Initial treatment à Extent of the disease à Extent of disease within 2 months of diagnosis if the information is available to the pathology Once a pathology case is submitted to MR (whether as a hard copy or electronically) there are multiple other processes completed by MR staff to ensure the submitted case meets all data standard requirements of MR, the North American Association of entral ancer Registries (NAAR), and other organizations that govern the content and completeness of each submitted cancer case. For additional information on MR reporting requirements please go to the Maryland Department of Health and Mental Hygiene, MR website at phpa.dhmh.maryland.gov/cancer/sitepages/mcr_regs.aspx 10

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13 Page 13 A nnouncement: Meet the staff Diane NG, MPH As an undergraduate majoring in Biology at the University of Maryland, Diane Ng was a pre-nursing student who, after graduation, began the first few days in nursing school before realizing that the path was not right for her. She made the decision to take some time off to re-evaluate her career goals and worked as a lab technician in the blood bank at University of Maryland Medical enter for two years while researching possibilities for higher education. It was during this time that she decided to study Epidemiology and in 2013, obtained her Master s in Public Health at the University of Maryland. During her two years in graduate school, Diane developed a particular interest in social determinants of health and health disparities. To that end, she worked as a Research Assistant on projects examining disparities in colorectal cancer screening among hinese and Korean Americans, and on a project researching childhood cardiovascular risk factor cohorts. For her final capstone thesis project, she conducted research examining the role of self-esteem as a mediator in the relationship between sexual minority status and depressive symptoms. Sexuality in minority populations are a another specific interest of Diane s and one of her ultimate goals is to work on studies that have an impact on these populations. She recently joined Westat as a Research Assistant in mid July 2015 after hearing about the company through classmates and friends. She shares that she s enjoyed her time at Westat working with the Maryland ancer Registry and is happy to be working with a great group of people who are supportive and truly love what they do. Diane looks forward to learning new things and gaining experience in her new position. Diane Ng, MPH Research Assistant, MR DianeNg@westat.com; Tel# Did you know At this time, we are inviting interested registrars to write an article for our E-Update letter. It could be written about what you do or have expertise in. It could also be to showcase your facility reporters, share news or updates. Even if you just have ideas of what you want to see on our next E-Update issue, we want you to send us an . Please to ElaineFlores@westat.com for more info. 13

14 Page 14 U pcoming Events : SAVE THE DATE 14

15 Page 15 ont. Announcement Helpful Resources Maryland ancer Registry HOME phpa.dhmh.maryland.gov/ cancer/sitepages/ mcr_home.aspx Point of ontact: Kimberly Stern, MHA, TR Program Manager Maryland ancer Registry 201 W. Preston St. Rm 400 Baltimore, MD Phone: (410) Fax: (410) Tumor Registrars Association of Maryland Follow on Facebook: NAAR D NRA National ancer Institute National ancer Institute, Shady Grove ampus National ancer Institute News and Public Affairs On @NIBulletin Send us your Feedback: ElaineFlores@westat.com NAAR WEBINAR SHEDULE 10/1/15 Room 200 ollecting ancer Data: Unusual Sites and Histologies 11/5/15 Room 124 ollecting ancer Data: Pharynx 12/3/15 Room 100 Directly oded ancer Stage...NOW (An in-depth look at AJ and Summary Stage) 1/7/16 Room 200 ollecting ancer Data: Bone and Soft Tissue 2/4/16 Room 200 ollecting ancer Data: Breast 3/3/16 Room 200 Abstracting and oding Boot amp 4/7/16 Room 200 ollecting ancer Data: Ovary 5/5/16 Room 200 ollecting ancer Data: Kidney 6/2/16 Room 200 ollecting ancer Data: Prostate 7/7/16 Room 200 Patient Outcomes 8/4/16 Room 200 ollecting ancer Data: Bladder 9/1/16 Room 200 oding Pitfalls Note: Alwebinarsareheldat:201W.PrestonStreet,Balmore,MD Interested? ontact Delores delores.rich@maryland.gov Maryland ancer Registry Research Blvd., Rockville, MD Tel#