Welcome to NCRA’s Strategic Alliances & Advocacy E-Newsletter. Recognizing NCRA’s work with its strategic partners requires timely communications with members, and NCRA has established the e-brief to highlight key updates and news from its work with industry partners. 

The content covered will be from NCRA’s formal liaisons to partner organizations and Adam Ebbin, NCRA’s Public Policy and Strategy Consultant. NCRA may also include information from its federal partners at the CDC and NCI on occasion.

Public Policy and Strategy

NCRA's Public Policy and Strategy and Policy Consultant: Adam Ebbin

Get ready to weigh in with your federal representatives on key policies and funding impacting cancer surveillance! NCRA will be following up with you and enabling an easy-to-use email tool this month. Members of Congress need to hear from us, and we will make it easy to amplify your voice through an NCRA Advocacy Now campaign. The campaign will focus on:

• Once again, allowing external communications by federal employees at DHHS.
• Adequately funding cancer surveillance functions of the federal government, including addressing the recent SEER 35% potential funding reduction.
• Restoring and retaining our critical federal employees at the Centers for Disease Control and Prevention, the National Institutes of Health/National Cancer Institute and the Department of Veterans Affairs.
• Repeal the administration’s executive orders mandating return to in-office work for federal employees.

Stay tuned for updates next week as to how you can share your voice on these important issues to our membership and our profession. 

Stay up to date on NCRA advocacy activities at www.ncra-usa.org/advocacy.

Cancer PathCHART

NCRA’s Cancer PathCHART Liaison: Janet Reynolds, BA, ODS

Cancer PathCHART (CPC) updated standards for tumor site and morphology combinations and associated terminology and coding. The Cancer PathCHART ICD-O-3 Site Morphology Validation Lists (CPC SMVLs v2) replaced the 2023 ICD-O-3 SEER Site/Histology Validation List, which served as the basis for the 2023 Primary Site, Morphology-Type, Behavior ICDO3 (SEER IF25) and 2023 Primary Site, Morphology- Impossible ICDO3 (SEER IF38) edits. The CPC SMVLs v2 are to be used by Cancer registrars for cases diagnosed in 2024 and 2025. 

The CPC*Search tool, released in mid-2024, can be used when seeking validity status for tumor site and histology combinations, and will be updated annually as needed- Cancer PathCHART Search. CPC*Search is not to be used as a primary source for determining site and histology, but as a confirmatory tool. The Solid Tumor Rules should be used for coding. 

Enhancements for 2025 include separate tabs for search results by diagnosis year, pediatric flag, pediatric WHO terminology, and a flag for tumor sites to be reviewed. 

American College of Surgeons Programs

Cancer Surgery Standards Program (CSSP)

NCRA’s CSSP Liaison: Kim A. Rodriguez, BSPH, CPH, RHIT, ODS-Certified

Impact of the CoC Operative Standards

To evaluate the implementation and impact of the CoC operative standards, the National Cancer Institute awarded grant funding in 2024 to co-principal investigators Lesly Dossett, MD, MPH, FACS (University of Michigan) and Daniel Boffa, MD, MBA, FACS (Yale School of Medicine). Their five-year study, “Assessing the Effectiveness and Significance of the Operative Standards Program (AESOP)” (R01 CA288625), aims to assess the implementation of the CoC operative standards across different cancer and hospital types, identify barriers and facilitators of compliance, and determine the standards’ impact on cancer outcomes.  

In collaboration with the ACS, the research team will conduct a CoC Special Study to investigate the impact of the operative standards on oncologic outcomes, such as cancer recurrence. Registrars at CoC-accredited programs will be asked to abstract and submit specific data elements defined by the research team. To prepare for the full study launch, a pilot involving 25 programs will begin in April 2026. We are seeking volunteers to participate in this pilot study. If you are interested in joining the AESOP Special Study pilot, please complete this interest form. For any questions, contact us at AESOP@facs.org.  

Commission on Cancer Lung Nodal Operative Dissection Evaluation and Staging (NODES) National Quality Improvement Project 

In January 2024, the American College of Surgeons Cancer Programs launched an optional national quality improvement (QI) initiative to support CoC accredited programs in identifying areas for improvement in compliance with Standard 5.8 Pulmonary Resection.  

Specifically, this standard requires that the surgical pathology report associated with any curative intent pulmonary resection for primary lung malignancy must report the oncologic status of lymph nodes from at least one (named and/or numbered) hilar station and at least three distinct (named and/or numbered) mediastinal stations. 

The QI collaborative, which enrolled over 345 CoC programs, sought to assist programs in identifying root causes in achieving compliance, identify sustainable solutions to barriers, and support programs in achieving ≥80% overall adherence and/or improve adherence to this standard by an absolute value of >20%.  

From January to December 2024, compliance from participating hospitals increased from 40.7% to 67.2%. Factors that contributed to program compliance included garnering surgeon buy-in, proactive specimen labeling, and strengthening multidisciplinary communication. Programs could “opt in” to participation of a second year of Lung NODES participation. Year two (January to December 2025) will continue to focus on spreading promising practices and achieving sustainability of ≥80% compliance. For more information on this collaborative, visit the project website. 

American College of Surgeons Commission on Cancer (CoC) 

NCRA’s CoC Liaison: Cheryl Sheridan, ODS-C 

Nominate an Outstanding CLP 

If you have an outstanding CLP, please take the time to nominate for the Cancer Liaison Physician (CLP) Outstanding Performance Award. The nomination is currently open until May 6, 2025. Go to the survey and make your submission here CLP nomination.

CoC Operative Standards  

I encourage you to read the March issue of the Bulletin of the American College of Surgeons. The article is titled- Assessing the Effectiveness and Significance of the Operative Standards Program (AESOP) study. AESOP article. 

AESOP Pilot Study 

As noted in the CSSP article above, the CoC will launch a special study to focus on additional data collected by ODS-certified registrars for the EMR’s of patients who are in their Cancer Registry. A pilot study will begin April of 2026. They are asking for any facility interested in participating in this pilot to complete a survey here AESOP Pilot Study Interest Form. 

NCDB Highlights 

Quality measures- standard 7.1 will be reinstated and measured during 2026 accreditation surveys. Mid-summer 2025- benchmarks and compliance data will be released for 4 quality measures. Please review the Cancer Program News- dated February 20, 2025.  

RCRS Data Submission Update  

To accommodate the transition away from the Call for Data, Standard 6.4: RCRS: Data Submission will be revised. It is anticipated that Standard 6.4 will require that the case count submitted by December 31 of a given year equals or exceeds 90% of the average of the total case counts from the previous three diagnosis years. To prepare for these future requirements, refer to the Submission Compliance Report on the RCRS platform for more information about your hospital’s current state. Site visits in 2025 will continue to assess a hospital’s 6.4 compliance based on their participation in the 2024 Call for Data, not the draft standard described above. For those programs that were not able to meet their submission threshold by the December 31, 2024, cutoff, this is a reminder to submit any remaining diagnosis year 2023 cases to RCRS so that this patient data will be included in your personalized NCDB reports as well as our national research data sets. 

I encourage you to be sure you are receiving the Cancer Program news that is distributed monthly. For past publications you can find them here. Cancer Programs News | ACS 

National Accreditation Program for Breast Centers (NAPBC) 

NCRA’s NAPBC Liaison: Penne J. Perry, RHIT, ODS-C 

The NAPBC announced in February 2025 plans to bring NAPBC under the Commission on Cancer (CoC) umbrella. Up until now, NAPBC has operated as a separate entity. As part of the NAPBC & CoC Unification process, CoC and NAPBC will share select governance committees, but NAPBC will still have its own Executive Committee and Member Council. There will also be a harmonization of the NAPBC and CoC standards that will involve an extensive review of the current Optimal Resources for Breast Care (2024 Standards) to remove duplicate standards that are also part of the Optimal Resources for Cancer Care (2020 Standards). This work is slated to begin in 2025 with an anticipated timeline for implementation of the new standards by January 2027.   

What does this mean to new and current NAPBC programs? There will be no impact on current NAPBC programs, at this time. All existing NAPBC programs without CoC accreditation will remain accredited. However, CoC accreditation will be required eventually. Once the NAPBC Standards are revised, programs without CoC accreditation will be expected to meet select CoC standards. All new NAPBC programs applying after January 1, 2026, and beyond will need to be CoC accredited.  

Why is this change happening? This change will eliminate duplicate work for programs holding both CoC and NAPBC accreditations. This will also allow the NAPBC standards to focus more solely on breast care issues/requirements much like is seen with the NAPRC standards for rectal cancer. Attaching the NAPBC accreditation to the program’s CoC accreditation will allow usage of National Cancer Database (NCDB) tools that will provide better monitoring and feedback for NAPBC accredited programs.  

For more information, see the attached NAPBC & CoC Unification FAQ or contact NAPBC@facs.org with any additional questions or concerns.

American Joint Committee on Cancer (AJCC)

NCRA’s AJCC Liaison: Vonetta L. Williams-Smith, PhD, MPH, ODS

Here’s an update on the AJCC Executive Committee and Subcommittee meetings. I will start with what has been completed and what’s to come in the near future regarding AJCC Version 9 protocols. 

The release of AJCC Version 9 protocols by year are as follows: 

2001: Cervix uteri 

2023: Appendix; Anus; Brain and Spinal Cord 

2024: Neuroendocrine Tumors of the Stomach; Neuroendocrine Tumors of the Duodenum and Ampulla of Vater; Neuroendocrine Tumor of the Jejunum and Ileum; Neuroendocrine Tumor of the Appendix; Neuroendocrine Tumor or the Colon and Rectum; Neuroendocrine Tumors of the Pancreas; Vulva 

2025: Thymus; Diffuse Pleural Mesothelioma; Lung; Nasopharynx 

There will be additional AJCC version 9 protocols released in 2026 and 2027. AJCC is currently working with the cancer site experts and all sites that will be included in 2026 and 2027 will be shared as soon as this information is available. All future AJCC version 9 protocols will be included in AJCC Staging Online platform.  

In addition, the AJCC Education Subcommittee evaluated various opportunities to provide education to all AJCC member organizations, including NCRA members. AJCC communicates with NCRA members through The Connection newsletter, social media, the AJCC-NCRA Liaison, and educational sessions at each NCRA Annual Education Conference.    

Lastly, I had an opportunity to interview Marty Madera, CPHIMS, Senior Manager at the American Joint Committee on Cancer. Linked below you will find an update on the great collaboration between NCRA and AJCC and how the NCRA members participated in the beta testing for AJCC Staging Online Connection Winter 2025.

Stay up to date with all NCRA advocacy activities at

www.ncra-usa.org/advocacy.