On Behalf of NAACCR, NCI SEER, and CDC NPCR we would like to share the following information.
COORDINATED RELEASE OF REGISTRY SOFTWARE UPDATES SCHEDULED FOR SEPTEMBER 4, 2019
In April, 2019, cancer surveillance leadership decided to delay changes to the NAACCR data exchange layout until 2021 in order to allow the registry community to focus on collection and processing of 2018 cases. While this decision minimizes software changes, over the last few months it has become clear that registries will benefit from updating some of the existing software routines, coding manuals and edit sets to address errors and clarify coding instructions. These updates will help registries to collect and report high quality cancer data.
NAACCR, NCI SEER and CDC NPCR are collaborating to provide these modifications in a single release for vendors on September 4, 2019, which will include:
1. Clarifications to SSDI coding instruction
a. Updates will be posted at https://apps.naaccr.org/ssdi/list/
2. EOD and Summary Stage Updates
a. Updates will be posted at https://seer.cancer.gov/tools/staging/
3. Edits Metafile
a. Updates will be posted at https://www.naaccr.org/standard-data-edits/
4. Solid tumor rules
a. Updated rules are available at https://seer.cancer.gov/tools/solidtumor/
CDC's DLL will include the Site-Specific Data Item (SSDI) and EOD updates. The links provided will include contact information for feedback and questions.
What does this mean for my registry?
· Registrars are not required to change previously abstracted cases based on revised coding instructions and/or code definitions for SSDIs, EOD data items and updated Solid Tumor Rules.
· Central registries may upgrade to the v18D edits metafile prior to the NAACCR Call for Data or the NPCR-CSS Data Submission but they are not required to do so.
We will not have any further updates until the release of v21 in the second half of 2020 for implementation in 2021.
We are working on a better process for the future. The Mid-Level Tactical Group (MLTG), a coordination body with representation from standard setters and stakeholders, will be inviting vendors to a meeting on September 9th to describe the software updates and discuss how to best coordinate changes in the future. We hope that by initiating coordinated releases for registry software updates we will minimize the burden of software updates for vendors, hospitals and central registries, while enabling corrections and clarifications that will facilitate coding and increase data accuracy.
The updates for v18 include:
Clarifications to coding instructions for SSDIs and Grade Data Items:
Clarifications to general coding instructions and data item-specific coding instructions were made by the NAACCR SSDI Work Group based on questions received from registrars in CAnswer Forum and the results of a Reliability Study conducted by NCI SEER. These clarifications will synchronize coding instructions between the CAnswer forum, AJCC Staging Manual 8, AJCC API, SSDI and Grade coding manuals and registry software.
No changes have been made to the codes for these data items. Registrars are not expected to change previously abstracted cases based on revised coding instructions.
The change log will be posted on the NAACCR website on Sept. 4, 2019: https://apps.naaccr.org/ssdi/list/
Updates to EOD and Summary Stage:
Clarifications to coding instructions for EOD and Summary Stage to Schema Specific sites were made by NCI SEER based on questions received from registrars and the results of a Reliability Study conducted in the Spring of 2019. These modifications were made to clarify current coding instructions or codes, and to better align with the AJCC Staging Manual (when applicable). Some of the code definitions were modified to provide clarification; however, the overall meaning of the codes has not changed.
Registrars are not expected to change previously abstracted cases based on revised coding instructions and/or code definitions.
The change log for EOD and Summary Stage will be posted on the SEER website under News and Announcements at https://staging.seer.cancer.gov/eod_public/home/1.7/ on Sept 4, 2019. In addition, Registrars can use SEER*RSA, Version 1.7 (to be released on September 4) to see the updated code definitions and the change log. An updated Summary Stage 2018 Manual (PDF) will be posted on the SEER website on Sept. 4, with changes noted in the change document.
Updates to solid tumor rules:
On July 17, 2019, SEER posted an update to the Solid Tumor Rules based on questions and suggestions from registrars and educators. Most changes are minor, such as changes in terminology, additional definitions, and new notes and examples. However, there were major changes related to the Lung H and the Lung M rules (see: https://seer.cancer.gov/tools/solidtumor/).
New Edits Metafile:
A new Edits Metafile (v18D) will be included in the September 4 release. The Edits Metafile is a compendium of edits that have been developed by the NAACCR Edits Work Group (WG). The Edits WG is comprised of 47 representatives from hospital and central registries, vendors and standard setters. The edits workgroup has been routinely posting updated versions of the most comprehensive edits library in North America (4 updates in 2016, 2 updates in 2017, 2 updates in 2018).
Some of the updates in the new Edits Metafile correct errors in the v18C edits metafile that would result in cases with valid codes being rejected. Thus, application of the new metafile will reduce the number of valid cases failing edits and implicitly help with lowering the number of cases reviewed for edits corrections. Detailed information concerning the changes will be posted with the Edits metafile.
Standard setters and central registries may choose to implement v18D of the Edits metafile at any time. Registries may continue to use v18C for cases diagnosed 2019 and prior; however, delays in implementation may require corrections for cases already abstracted. Central registries may upgrade to v18D prior to the NAACCR Call for Data or the NPCR-CSS Data Submission, but they are not required to do so.
We hope that this communication will help registrars and central registries to prepare for upcoming updates and that the synchronized release of software updates and coordination with registry vendors will simplify the process of updating registry software.
Betsy A. Kohler, MPH, CTR