July 2016
    Vol 5 Issue 2
From the Editor  
Happy Summer and Happy 4th of July! We hope you are able to take a little time off to enjoy all that summer offers with your friends and family, and then, once refreshed and re-energized, get back into the heat of things at work. 

To start things off, we'd like to thank and congratulate all of you for your part in CRGC obtaining NAACCR GOLD certification! This classification is based on meeting and exceeding their quality indicators (such as 95% or higher in case completeness, 100% of variables used to create incidence statistics by cancer type, sex, race, age, and county are error-free, etc.) for 2013 data and we couldn't do that without your efforts to collect high quality data.

In this issue we showcase how the data we collect is utilized for research in a variety of different ways. Rosemary Cress, Director of Research, shares an article which appeared in the US World and News Report about Advanced Lung Cancer Treatment results.
Winny Roshala, Director of Data Quality Control, describes a recent data quality assurance activity on thyroid cases coded to papillary carcinoma in her article, "Did Someone Miss the Memo?"

John Morgan, our epidemiologist for Regions 4, 5, and 7/10 shares recent results of a population-based study of treatment of gastric cancer that was conducted by two of his graduate students and himself. It showed very interesting results that could be generalized to the California population.

Scott Riddle, System Support Manager, informs us about a rich resource for follow-up information and Rebecca Cassady, Director of Region 5, talks about their recent Educational Workshop.

We hope you enjoy these articles. Thanks again for all you do to provide accurate, complete and timely cancer data!

Advanced Lung Cancer Treatment
Rosemary Cress, DrPH
Director of Research, CRGC

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide.  Unfortunately, the vast majority of patients are diagnosed with Stage III or IV disease, which dramatically reduces the chance for cure or meaningful survival. The overall 5-year survival rate is approximately 16%.
The incorporation of surgery into a multidisciplinary treatment plan is associated with increased overall survival, but very few patients receive surgery.  The purpose of this study was to assess use of surgery for patients diagnosed with advanced stage NSCLC in California.  This was a collaboration between Dr. Rosemary Cress at the CRGC and Dr. Elizabeth David, a thoracic surgeon at the UC Davis Medical Center.

Did Someone Miss the Memo?
Winny Roshala, BA, CTR
Director, Data Quality Control, CRGC

In December of 2015, CRGC issued a guideline document specific to histology coding for papillary carcinoma involving one of the following primary sites: Thyroid, bladder and breast. The guideline document provided abstractors with histology coding instructions based on the SEER Multiple Primary and Histology Rules and SINQ citations for each of the 3 primary sites mentioned. Based on these coding guidelines, we also corrected the data in the central database with erroneous histology codes. CRGC has taken this "fix and prevent" approach as part of our data quality assurance activities.

We recently ran the same data query to see if the histology coding error was still occurring, based on cases entered and coded after the guideline document was distributed on December 14, 2015. Specifically, we reviewed thyroid cases with a diagnosis of papillary carcinoma, NOS, erroneously coded to histology code 8050.

Adjuvant Chemoradiation Therapy for Resected Gastric Cancer: A Population-based Study
Brice Jabo, MD, MPH, Liang Ji, MBA, MPH
Loma Linda University, School of Public Health
John W. Morgan, DrPH, CPH,
Loma Linda University, School of Public Health and SEER Cancer Registry of Greater California

Background: Results from a clinical trial published in 2001 documented improved survival in gastric cancer surgery patients receiving post-operative (adjuvant) chemoradiation (CRT), compared to those that received surgery alone. Findings published in 2012 showed sustained benefits of adjuvant CRT with a median follow-up of 10.3 years. Our study was initiated to examine whether this same benefit would be evident in a population-based setting using statewide California Cancer Registry (CCR) data. If so, the broad representation of gastric cancers in the entire California population would support generalization of the clinical trial findings to a large and diverse population setting.   
Have you requested a shared follow up file lately?
Scott Riddle
System Support Manager, CRGC

Did you know that the Cancer Registry of Greater California (CRGC) has the ability to create a file that can be used by your hospital abstracting software to update follow up information (read: vital status and last patient contact date)? This file is called a Shared Follow Up file.
Our Database Management System, Eureka, can be configured to be on the lookout to capture follow up information for any cases that your facility has reported in the past. The sources for this information vary - it could come from our annual Death Clearance, linkages with State Voter Registration, Department of Motor Vehicles, or the Office of Statewide Health Planning and Development (OSHPD). We occasionally get follow up from a neighboring healthcare facility through their internal follow up activities.
The file is available to any CRGC facilities that report cancer cases. If you have not received a file within the last 2 years then we may have disabled the follow up gathering switch for your facility. If you would like to start receiving a file then contact me and I can let you know if your facility already has the switch "turned on", who will be sending it to you, and when you can expect to receive a file.
If you have any questions about how your hospital software processes the file (for example: What does the software do if our database has a more recent date than is on the file?) then contact your software vendor for clarification.
Region 5 Education Program - May 18, 2016
Rebecca Cassady, RHIA, CTR
Director, DSCSP

DSCSP, Region 5 hosted their annual education program on May 18, 2016 at Loma Linda University Medical Center.  There were 50 registrars in attendance from Regions 5, 7/10 and 9.   Donna Hansen, CTR, Trainer and Auditor, California Cancer Registry, presented the 2016 Data Changes, TNM Staging and SEER Summary Staging to the group.  Dan Curran, MS, CTR, Special Projects Manager, C/NET Solutions, updated the attendees with features of the new 2016 CNExT Version.   The attendees appreciated the opportunity to interact with each other and with the speakers.

Cancer Registrar Feedback
If you have questions, comments, or suggestions for Chats contact Mignon Dryden at
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Cancer Registry of Greater California
Public Health Institute
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