November 19, 2020
November 2020
Vol 9 Issue 2
From the Editor

I think we can all agree that 2020 has been a rough year: Covid, devastating fires, social and racial injustice, political hatred, extreme weather. Some days it's hard to stay focused and keep a positive spirit and other days, the simplest of things brings us joy - a flower blooming in spite of the weather, a hello from a fellow dog walker, the smell of homemade cookies.

Since this is the season for gratitude, I thought it would be fitting that we lead off with an article and letter of appreciation from CRGC's management team. This was sent separately to each of you, but in case it was missed, we wanted to include it here. As I've stated many times in Chats, CRGC couldn't do what we do without the work of all of you! In addition, Rosemary Cress, Research Program Director and our SEER PI, describes the challenges of conducting research in these times of Covid.

Winny shares details about our recent annual submission to SEER including some data quality issues that were identified. Please take a minute to review the specific issues cited and double check that the data you provide is accurate.

Kyle gives us an inside look at how the data collection side of our operations work especially now with AB2325 in place and how they intersect with you and your work.

And last, but certainly not least, Theresa Alfaro-Velcamp and Rob McLaughlin provide an interesting look at occupation and industry in the times of a pandemic.

We hope you find these articles interesting and informative. We all recognize and appreciate the efforts each of you have given to your work in providing accurate, complete and timely cancer data. Thank you!

We wish you all the best in the upcoming holiday season! Stay healthy and safe.

Special Thank You
Rosemary D. Cress, DrPH
CRGC Research Program Director

The CRGC management team would like to extend our deepest thanks to all our registrars. Last week CRGC submitted data to the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program that met their high standards of quality and completeness. This annual data submission contained information for over 100,000 residents of the CRGC catchment area who were diagnosed, treated or seen with cancer in 2018. This would not have been possible without the efforts of dedicated registrars who meticulously abstract information from medical records in facilities large and small across our region. Data from California, compiled with data from other registries across the country, are the basis for an enormous amount of research evaluating trends in cancer incidence and mortality as well as disparities in incidence, treatment and survival for cancer patients in diverse populations. Please see the letter from CRGC’s Interim Senior Director of Operations here.  
Data Quality Corner
Winny Roshala, BA, CTR
Director, CRGC Data Quality Control and Facility Reporting Compliance Officer 

The CRGC has successfully submitted the 2018 data submission file to the National Cancer Institute’s SEER Program! Thank you to all the CRGC registrars who worked tirelessly through challenging situations to submit the 2018 cases, leading to a CRGC 2018 completeness rate of 99.25%! Phenomenal work effort by everyone! This is a testament to the level of professionalism, resolve and dedication by the registry community. This is also a good time to identify some data quality issues, including those noted for the 2018 data items. Please review the issues cited below and check your own database, to ensure proper coding, making the necessary revisions as needed.

To continue this article, click here
Challenges Conducting a SEER POC Study During COVID
Rosemary D. Cress, DrPH
CRGC Research Program Director

CRGC research staff, with help and support from the Data Collection Unit, are hard at work collecting and abstracting medical records for this year’s SEER POC study. SEER Patterns of Care/Quality of Care Studies (POC/QOC) studies are mandated by the NCI to describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. This activity requires us to contact hospitals and physicians to enhance the information that we received. CRGC has participated in all POC studies since it became part of the SEER program in 2001.

The purpose of this year’s POC study is to investigate patterns of care, including biomarker testing and targeted cancer therapy, for patients with advanced non-small lung cancer and advanced melanoma diagnosed in 2017-2018. CRGC was asked to abstract information for 432 lung cancer patients and 130 melanoma patients. Not only is information collected on treatment and staging that is used to evaluate the quality and completeness of CRGC data, this year NCI asked us to collect information about palliative care and financial discussions contained in the medical record for these patients. 

Conducting a SEER POC study this year has been especially challenging because of the COVID pandemic. Like CRGC, many hospital registrars and medical records staff are working at home and thus have less access to the medical records needed for this study. CRGC staff are allowed only very limited time in the office (2 to 4 hours a week) which means they must organize their work from home to optimize time in the office. Our exceptionally large catchment area, extending from the Mexican border to the Oregon border, makes it extremely difficult for our staff to travel to facilities. This means that CRGC is dependent on the help of hospital registrars to provide paper or electronic copies of requested medical records, or access to electronic medical records. Requests for medical records have been sent to hospital registry and medical records departments and currently are arriving by the box load. These are being distributed to the CTRs who will be abstracting the information and entering it into the SEER abstracting software. We want to extend our thanks to all registrars who have contributed to the study this year.
Hospital Followback Process
Kyle Ziegler, BS, CTR
Director, CRGC Cancer Data Management

One of the fundamental activities CRGC performs is the review of pathology reports. With the passage of AB2325, we now receive pathology reports, in electronic format, from all hospitals and independent laboratories in California. This law went into effect on January 1, 2019 and since we have just begun to process 2019 cases, we are now processing a significantly higher number of pathology reports from new sources.  Among those sources are the hospital labs. This means you will probably begin to receive more inquiries on potentially missed cases that we have identified in our pathology review. 

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Cancer Surveillance and the 2020 Economy: Thinking about Industrial/Occupational (I/O) Data in the
COVID-19 Pandemic
Robert McLaughlin, JD, PhD, CRGC Interim Senior Director of Operations and
Theresa Alfaro-Velcamp, PhD, Program Manager, User Experience Research, CRGC

The ongoing COVID-19 pandemic elevates the importance of understanding occupation and employment data in relation to public health. Cancer registries and surveillance programs are now challenged to evaluate the effects of the global COVID-19 pandemic on cancer incidence, including 22 million job losses in April 2020 (See Table 1). Surveillance programs will seek to describe how the abrupt cessation of economic activities has changed routine environmental exposure risks for immunocompromised patients and survivors, especially those who may be or have recently been working in retirement or participating in the “gig” economy. Attention to industrial and occupational (I/O) data may enhance the long-term capacity for research and understanding of the cancer burden. As epidemiologists have shown in Japan, occupational exposures and the stress associated with job losses and financial insecurity may be significant risk factors for cancer.

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If you have questions or concerns regarding any of the content of this CRGC communication please contact me.

Mignon Dryden, CTR
Director, E-Reporting
Cancer Registry of Greater California