SCCRA/GATRA Regional Conference North Charleston, SC 11/6/2018 Steven Peace, CTR 1 CDC & Florida DOH Attribution Funding for this conference was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the US Government. FCDS would also like to acknowledge the Florida Department of Health for its support of the Florida Cancer Data System, including the development, printing and distribution of materials for the 2018 FCDS Annual Conference and the 2018-2019 FCDS Webcast Series under state contract CODJU. The findings and conclusions in this series are those of the author(s) and do not necessarily represent the official position of the Florida Department of Health. 2 1
Outline Introduction General Instructions Colon - Major - Major Breast - Major Urinary System - Minor Head & Neck - Minor Kidney - Minor Brain/CNS Malignant - Minor Brain/CNS Non-Malignant Other Solid Tumor Modules Questions 3 2018 Solid Tumor MP/H Rules https://seer.cancer.gov/tools/solidtumor/ Text Only no flowchart or matrix Updates to 2007 Solid Tumor MP/H Rules Takes into account problems from 2007 MPH Rules Takes into account All of the WHO Classification, 4 th ed. Series Takes into account two revisions to the WHO 4 th ed. Series 2016 Revision to WHO Classification of Neoplasms of Brain and CNS Original 4 th edition Classification published in 2007 2016 Revision to WHO Classification of Hematopoietic & Lymphoid Neoplasms Original 4 th edition Classification published in 2008 4 2
2018 Solid Tumor MP/H Rules WHO Classification of Tumors New or Revised Since 2010 Digestive System (2010) Breast (2012) SoftTissue and Bone (2013) Female Reproductive Organs (2014), Pleura, Thymus & Heart (2015) Urinary System & Male Genital (2016) Central Nervous System (2016 revision) Hematopoietic & Lymphoid (2016 revision) Head & Neck (2017) http://codes.iarc.fr/usingicdo.php 5 2018 Solid Tumor MP/H Rules https://seer.cancer.gov/tools/solidtumor/ 6 3
2018 Solid Tumor MP/H Rules 7 2018 Solid Tumor MP/H Rules Published June 2018 but still had MAJOR changes in October 2018 be sure you have the correct set of rules 328 pages 8 4
2018 Solid Tumor MP/H Rules 9 General Instructions TEXT ONLY RULES INCLUDE: General Instructions PLUS 10 Sets of Solid Tumor MP/H Rules Each Module includes Multiple Sections (Notes/Site/MP/Histology) Code subtypes/variants when definitively described (no modifiers) Do Not Use Ambiguous Terminology to Code Histology Ambiguous terminology is used to determine case reportability Ambiguous terminology is not to be used to determine histology Ambiguous terminology such as with features of, etc. are no longer used to determine a subtype OR to determine which histology should be coded. See the following histology rules for instructions on coding multiple histologies. Use the Histology (H) Rules to determine when to use or not use any ambiguous terminology when an ambiguous term is used to describe a histologic type sometimes you use the ambiguous term to code a subtype or variant or mixed histology -- and sometimes you do not. 10 5
General Instructions Introduction Changes from 2007 MPH Rules Definitions Equivalent or Equal Terms Terms that are NOT Equivalent or Equal Table and Instructions for Coding Primary Site Table: Specific Histologies, NOS and Subtypes Variants Table: Combination/Mixed Histology Codes Table: Histologies Not Reportable for This Site Illustrations Multiple Primary Rules Histology Coding Rules 11 Multiple Primary Rules Remember: Most People Have Only One Cancer 12 6
Some People or Their Families Have More Than One Cancer https://www.curetoday.com/journey/cancer-guides/at-diagnosis/ 13 General Instructions 14 7
General Instructions 15 General Instructions 16 8
General Instructions 17 General Instructions 18 9
Colon and Rectum MOST of the Changes to the Colon/Rectum Rules are HISTOLOGY RULES CHANGES and they are big. Use each set of rules as intended for the sites and/or histology combinations in the header of each module. Each set of rules is available only in sentence format. There are no logic charts to follow or reference. Rules are to be shared to hospital and central registries Periodic updates are necessary to maintain methods ICD-O-3 is working on ICD-O-3.2 for 2019. ICD-O-5 will begin work in 2020. ICD-11 is also coming with fewer major changes. http://safetyca.info SEER is planning Training Webinars and Reliability Studies on their website at some time in the future dates unknown. 19 Colon and Rectum 20 10
Colon and Rectum 21 Colon and Rectum 22 11
Colon and Rectum 23 Colon and Rectum 24 12
Colon and Rectum 25 Colon and Rectum 26 13
Colon and Rectum 27 Colon and Rectum 28 14
Colon and Rectum 29 Colon and Rectum 30 15
Colon and Rectum 31 Colon and Rectum 32 16
Colon and Rectum 33 Colon and Rectum 34 17
Colon and Rectum 35 ICD-O-3 Updates - Thymus 36 18
37 38 19
39 40 20
41 Combination Histology or Subtype/Variant Table 2 or Table 3 42 21
43 44 22
45 46 23
47 48 24
49 Biomarkers Path Clinical 50 25
51 52 26
53 Breast 54 27
ICD-O-3 Updates - Breast 55 Breast 56 28
Breast 57 Breast 58 29
Breast - FINAL 59 Breast 60 30
Breast 61 Breast 62 31
Breast 63 Breast 64 32
Breast 65 Breast 66 33
2018 Solid Tumors Database Genetics Data & Biomarkers Treatment(s) STDB is Still Under Construction Abstractor Notes Signs & Symptoms Diagnostic Exams Recurrence & Metastasis Epidemiology & Mortality 67 Questions 68 34