April 2020
    Vol  9 Issue 1
From the Editor  
Happy National Cancer Registrars Week (NCRW)!  Even though we are all dealing the best that we can with the COVID-19 pandemic by sheltering in place and social distancing, it's important to try to keep a sense of normalcy, keep connected with each other, and learn to be patient while we get to the other side. And yes, we will get through this - together.

Celebrating NCRW is important because the work that you each do is important! While we can't all be physically together to celebrate, take a moment to appreciate all that YOU do and all that your fellow cancer registrars do. Hear that applause? That's for you!

In case you missed NCRA's ideas on how to celebrate NCRW virtually, we've included a link to their document here. Now is a good time to think creatively! 

In this issue, we bring you an article on the incidence of Myelodysplastic Syndrome in SEER regions from 2001-2016 by our Research group. Lead author, Dr. Anshu Shrestha, describes a change in the pattern of incidence which the authors noted was for both sexes, all racial/ethnic groups, and among the 65 and over age group.

Winny Roshala, Director of Data Quality Control and Reporting Facility Compliance Officer for CRGC, discusses cancer reporting through these challenging times and how to prioritize your work effort.

And finally, we would like to thank you for the work you do. Your careful eye for finding each reportable case, documenting the diagnosis and treatment, and accurately coding each data item is important in our fight against cancer. We couldn't do it without YOU!
Stay healthy. Stay safe. Be kind. Check on others. Take breaks. Be flexible. Keep your sense of humor. Be optimistic. Take care!

Patterns of Incidence Rates of Myelodysplastic Syndromes in SEER 21 Regions: 2001 - 2016
Anshu Shrestha, MPH, PhD, Senior Cancer Epidemiologist, CRGC
Rosemary D. Cress, DrPH, Research Program Director, CRGC
Eric Stewart, Research Associate, CRGC
Myelodysplastic syndrome (MDS) is a poorly understood malignancy consisting of a diverse group of bone marrow disorders. The disorder is defined by how it impacts stem cells in the blood. The stem cells will either fail to mature, leading to accumulation of immature blood cells (blasts) or become defective (dysplastic cells), leading to formation of faulty blood cells with a shortened life span. Prior to 2000, MDS was considered preleukemic conditions because a high proportion of patients with MDS eventually progress to acute myeloid leukemia (AML). In 2001, after it was reclassified as a neoplasm, MDS became a reportable malignancy in the Surveillance, Epidemiology, and End Results (SEER) Program. Since then, all participating registries have been tracking MDS occurrence in their catchment areas. Estimates of disease incidence, derived from such surveillance data, are important in understanding the burden of disease, whereas changes in patterns of incidence over time can provide valuable insight on effects of early screening as well as changes in disease diagnosis and coding guidelines. In the case of MDS, while annual incidence rates have been reported, changes in rates over time have not been analyzed. Since it first became a reportable malignancy, several new diagnostic tools have become available, which have improved our understanding of this disease, as reflected by multiple changes in the WHO classification guidelines since 2001. This analysis was performed to assess trends in overall incidence rates for MDS from 2001 to 2016 and assess any difference that may exist across sex, age groups, race/ethnicity, and histologic type.

Cancer Reporting Through the Storm 
Winny Roshala, BA, CTR
Data Quality Control and Reporting Facility Compliance Offi cer 

We know you are all encountering challenges on both a personal and professional level during this unprecedented international health crisis.  The stakes have truly never been higher.  As we all do our best to adhere to the State mandates to protect our safety, we recognize this situation has impacted every aspect of daily life.  As such, please keep us apprised of any potential impact on cancer reporting at your facility, while we all "weather the storm." Comments and concerns can be sent to Winny Roshala at  We will come out on the other side. 
Although the CCR Timeliness requirements have not changed, we strongly encourage everyone to prioritize and complete their 2018 cases first, then focus all efforts on the 2019 and forward cases.   Being complete for 2018 and 2019 cases by June 30th is the goal, however, all efforts should be made to prioritize completing all 2018 first before moving on to completing the 2019 and forward cases.  We appreciate all efforts to work on the backlog of cases and hope that this information is helpful to prioritize the work effort at your facility.
In the meantime, thank you all for your undaunting commitment and dedication to ultimately benefit cancer patients!  By continuing to provide complete, high quality data, you are truly the foundation for our "2020 Vision for the Future!"  We honor, recognize and celebrate the valiant, unwavering efforts of all cancer registrars!  Thank you all, be safe and stay well!
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Cancer Registry of Greater California
Public Health Institute
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Sacramento, California 95835