1. Kentucky Cancer Registry
Spring Training 2016
Phase II – Using Edits v16

2. Phase ii
Customized choice lists from the CDC’s NPCR program will be incorporated into the CPDMS software for the AJCC data items. These will be specific to each site/histology combination as defined in the AJCC Manual, 7th ed. These are still not yet available to KCR yet.
Customized choice lists will be available to KCR from the CDC’s NPCR program. These will be specific to each site/histology combination. These will be similar to the web pages for Collaborative Stage, with Notes at the top and the Stage categories, codes and definitions in a Table underneath.
All tables display attribution to AJCC in Note 1
Categories and their descriptions are taken directly from the AJCC manual, some may be reformatted for clarity, such as using bullet points
Additional notes will be taken directly from AJCC manual or other official communication, such as CAnswer forum
Any added words or codes are indicated by square brackets. For example an implied statement from an earlier paragraph in the Manual might be repeated in the code definition for the sake of clarity.
It’s important to note that AJCC is licensing CDC to use parts of their manual in our software, and the licensing agreement will stipulate the specific uses and limits on distribution .

3. Phase ii
The Edits program for 2016 cases is now available!
They will be implemented in CPDMS internally with the Aug. 9 release, and externally with the Aug. 16 update.
When this update is implemented, your CoC Edits reports will be placed on FES.

4. Overview of Edits version 16a
There are now 1,677 edits in the GenEdits Program; 192 of these are newly added in v16.
Most of the new edits are checking Summary Stage 2000 and AJCC stage elements.
You will receive 3 Edits Reports: one for 2016 cases; one for cases, and one for pre-2015 cases.
The requirements for staging were different in these years, and this will allow you to prioritize your efforts to fix the errors.

5. Agenda
Resources for resolving Edits Frances
NAACCR Vol IV – Standard Data Edits
SEER Summary Stage 2000 Manual
Examples for resolving Edits; pre Frances
Common errors for cases
Common errors for 2015 cases
Examples for resolving Edits; 2016 cases Tonya

6. NAACCR Vol. IV STAndard Data Edits
The complete documentation of all edits – what they are checking for, how they are checking for consistency between data elements, what are the valid values, etc. is obtainable from the NAACCR web site. From the home page ( your would mouse over the heading ‘Standards and Registry Operations’ and the blue drop down window appears. Then you click on Volume IV Standard Data Edits, indicated by the red arrow.

7. This screen appears next, and you will want to click on the third line down – NAACCR v16a Edits Detail Report. If you click here, you will download the full document, as shown on the next screen.

8. You are immediately taken to the Table of Contents, which has every edit listed in alphabetical order. This is the easiest way to find information about an edit error, if you do not know how to fix it.

9. For example, if your Edits report has an error called ‘Accession number, Class of Case, Sequence Number’ you would find it in the Table of Contents and then click on that edit name.

10. The next screen will take you to the detailed explanation about that edit, what it is checking for, what variables are involved in that edit, and what combination of values are valid or invalid.

11. Common errors – pre 2015 cases
Edit: Birthplace--Country, State (NAACCR) E:Birthplace--Country and Birthplace--State conflict Birthplace--Country (444) = [CAN] _ _ _ Birthplace--State (442) = [YY] _ _
Code  
Description for State of Birth from Abstractor’s Manual KY
If the state in which the patient was born is Kentucky, then use the USPS code for the state of Kentucky. XX
State of birth other than the U.S. (including it territories, commonwealths, or possessions) or Canada and the country is known. YY
State of birth other than the U.S. (including it territories, commonwealths, or possessions) or Canada and the country is unknown. US
Born in the U.S. (including it territories, commonwealths, or possessions) and the state is unknown.
CD   
Born in Canada and the province is unknown.
ZZ   
State of birth and country are unknown.
So let’s start with this edit for Birthplace. This usually comes up when someone is known to be born outside the US. For example, if you enter the country as Canada, you would enter the state as the correct Canadian province. But if you do not know in which province the patient was born, then you need to use a code from this table, which can be found in the CPDMS Abstractor’s Manual. You can see why YY is incorrect. It stands for … The correct code is CD.

12. Common errors – pre 2015 cases
EXPLANATION FOR EDIT
C182 is Ascending colon
8144 is Adenocarcinoma, intestinal type
Instruction from SEER MP/H Manual:
Colon Equivalent Terms, Definition, and Illustrations
Adenocarcinoma, intestinal type (8144) is a form of stomach cancer. Do not use this code when the tumor arises in the colon.
Review text and change the histology code appropriately.
Edit: Primary Site, Morphology-Type ICDO3 (COC) E:Site & Morphology conflict - ICDO Primary Site (540) = [C182] _ _ _ _ Histologic Type ICD-O-3 (550) = [8144] _ _ _ _ Date of Diagnosis (530) = [Y:2011 M:02 D:19] _ _ _ _ _ _ _ Over-ride COC-Site/Type (1893) = [<BLANK>] _ _ _ _ _ _ _ Over-ride Site/Type (1900) = [<BLANK>] _ _ _ _ _ _ _
Here is another common error found for cases diagnosed before The error listing as it would look on your report is on the left hand side; my explanation for resolving the edit is on the right hand side of the slide. <read slide>

13. Common errors – pre 2015 cases
EXPLANATION FOR EDIT
C349 is Lung, NOS
Diagnostic confirmation code 9 is Unknown
Sequence number is 2
This edit requires you to review this case and make sure the lung cancer is a new primary and not mets from sequence 1.
Review text and change the case appropriately, or if it is correct as coded, set the Override Flag to 1.
Edit: Diagnostic Confirm, Seq Num--Hosp (COC) E:Conflict among Primary Site, Diagnostic Confirmation and Sequence Number--Hospital Primary Site (540) = [C349] _ _ _ _ Diagnostic Confirmation (562) = [9] _ Sequence Number--Hospital (740) = [02] _ _ Over-ride HospSeq/DxConf (1892) = [<BLANK>] _ _
Another common error is Diagnostic Confirmation and Sequence number check. <read slide>

14. Common errors – pre 2015 cases
Edit: Class of Case, Date of 1st Contact, Date of DX (COC)
If Class of Case = 30-32, Date of 1st Contact must be > or = Date of Diagnosis Class of Case (776) = [32] _ _ Date of 1st Contact (745) = [Y:2001 M:12 D:01] Date of Diagnosis (530) = [Y:2001 M:12 D:03]
EXPLANATION FOR EDIT
The Date of First Contact is DEC. 1st, but the Date of Diagnosis is DEC. 3rd.
For a class 32, the Date of First Contact CANNOT BE BEFORE the Date of Diagnosis.
And another example is Class of Case, Date of 1st Contact and Date of Diagnosis. <read slide>

15. Common errors – 2015 cases
Most of the 2015 errors involve either the Summary Stage 2000 data or the AJCC T, N, or M data fields.
The Summary Stage 2000 Manual is available on line from the SEER web site.
Now, let’s take a look at common errors found for the 2015 cases. Most of the 2015 errors involve either the Summary Stage 2000 data or the AJCC T, N, or M data fields. The Summary Stage Manual is available from the SEER web site for download.

16. From the SEER home page, www. seer. cancer
From the SEER home page, Click on the Blue heading at the top ‘For Cancer Registrars.’ This page will come up, and the Summary Staging Manual 2000 is listed along the left hand side. Click on it to get to the next screen.

17. From this screen, you can bring up specific chapters on the Summary Stage Manual or you can click by the red arrow and download the entire book.

18. If you download the book, this screen is found on page 3, which shows you where to find the correct Summary Stage codes by site. Unfortunately, this document does not contain links, so once you find the site you need, you will have to scroll down to the page where it can be found.

19. Common errors – 2015 cases Hematopoietic Disease
Edit: Summ Stg 2000, Site, Hist ICDO3, Class (NAACCR) E:If Primary Site = C421 and Histologic Type ICD-O-3 = 9863, SEER Summary Stage 2000 must = Primary Site (540) = [C421] Histologic Type ICD-O-3 (550) = [9863] SEER Summary Stage 2000 (904) = [9] Class of Case (776) = [14] Behavior Code ICD-O-3 (554) = [3]_
Hematopoietic Disease
Allowable SS2000 codes
Kaposi sarcoma
1, 2, 3, 4, 7, 9
Hodgkin & Non-Hodgkin Lymphoma
1, 5, 7, 9
Plasmacytoma, Malignant histiocytosis, Langerhans cell histiocytosis
1, 7, 9
Hematopoietic, Reticuloendothelial, Immunoproliferative, and Myeloproliferative neoplasms
(other than those listed above) 7
Other and Ill-defined sites, and Unknown Primary 9
This was a very commonly found error in the CPDMS databases. Most of the errors involve hematopoietic malignancies. For example, this is a case of CML, so the summary stage must be 7. The table is a short hand view of the allowable codes. The SEER Summary Stage Manual would have the details in the Section on ‘Other Sites’. See also the Edits documentation shown on the next slides. FOR THOSE CASES THAT MUST BE 7 OR 9, KCR WILL AUTOMATICALL FIX THE ERROR, BUT THE OTHER CASES MUST BE REVIEWED!!

20. This is from the v16 Edits document for this particular edit
This is from the v16 Edits document for this particular edit. You can see that some of the hematopoietic diseases allow only certain SS2000 codes. More detail is spelled out on the next slide.

21. The specific histologies and the required Summary Stage code can be found further in the v16 Edits detail document from the NAACCR web site.

22. Common errors – 2015 cases EXPLANATION FOR EDIT
This case is lower esophagus. The Summary Stage is 7, Distant, but the clinical M is 0 and the pathologic M is blank.
This would appear to be inconsistent, so a review of the text and Manuals is necessary. In this case, a para-tracheal lymph node was involved. This is a regional lymph node for AJCC, but considered a distant lymph node for SS2000. So this is correct as coded, and the Override should be set.
Edit: Summary Stage 2000, TNM M Conv (NAACCR) Conflict among Primary Site, SEER Summary Stage 2000, TNM Path M and TNM Clin M Primary Site (540) = [C155] SEER Summary Stage 2000 (904) = [7] _ TNM Path M (948) = [<BLANK>]_ TNM Clin M (966) = [c0] Over-ride SS/TNM-M (1890) = [<BLANK>] Date of Diagnosis (530) = [Y:2015 M:11 D:13] Type of Reporting Source (563) = [1] _ Behavior Code ICD-O-3 (554) = [3] _
Another common error in 2015 data is Summary Stage and the TNM M value. <read slide>

23. Common errors – 2015 cases EXPLANATION FOR EDIT
This case is tail of pancreas. The Summary Stage is 2, Regional by Direct Extension, but the clinical M is 1 and the pathologic M is blank.
This would appear to be inconsistent, so a review of the text and Manuals is necessary. In this case, there were documented liver mets. So this is incorrect as coded, and Summary Stage should be 7, Distant.
Edit: Summary Stage 2000, TNM M Conv (NAACCR) Conflict among Primary Site, SEER Summary Stage 2000, TNM Path M and TNM Clin M Primary Site (540) = [C252] SEER Summary Stage 2000 (904) = [2] _ TNM Path M (948) = [<BLANK>] TNM Clin M (966) = [c1] _ Over-ride SS/TNM-M (1890) = [<BLANK>]
Date of Diagnosis (530) = [Y:2015 M:12 D:09] Type of Reporting Source (563) = [1] _ Behavior Code ICD-O-3 (554) = [3] _
Another example <read slide>

24. Common errors – 2015 cases EXPLANATION FOR EDIT
Edit: Summary Stage 2000, TNM N Conv (NAACCR) E:Conflict among SEER Summary Stage 2000, TNM Path N and TNM Clin N SEER Summary Stage 2000 (904) = [1] TNM Path N (944) = [p1] TNM Clin N (962) = [c1] Over-ride SS/TNM-N (1889) = [<BLANK>]_ Date of Diagnosis (530) = [Y:2015 M:11 D:19]
Type of Reporting Source (563) = [1] Behavior Code ICD-O-3 (554) = [3]
EXPLANATION FOR EDIT
The Summary Stage is 1, Local, but the clinical N is 1 and the path N is 1, so lymph nodes are involved. This therefore cannot be Local for SS2000.
Case needs to be reviewed and corrected.
This edit checks Summary Stage against the TNM N value <read slide>

25. Common errors – 2015 cases EXPLANATION FOR EDIT
Edit: Primary Site, AJCC M - Ed 7, ICDO3 (COC) E:TNM Path M code is invalid for site/hist combination Date of Diagnosis (530) = [Y:2015 M:12 D:18] TNM Edition Number (938) = [07] Primary Site (540) = [C541] Histologic Type ICD-O-3 (550) = [8380] Behavior Code ICD-O-3 (554) = [3] Age at Diagnosis (193) = [042] CS Site-Specific Factor10 (1030) = [988] CS Site-Specific Factor25 (1075) = [988] Grade (555) = [1] _ TNM Clin M (966) = [c0] TNM Path M (948) = [c0]
EXPLANATION FOR EDIT
The Path M code of c0 is invalid for cases diagnosed before 2016!
KCR will automatically fix these errors and replace the c0 with a blank for 2015 cases.
However, if this edit is based on any other value in the Path M field, it will have to be reviewed and manually fixed.
This was another very common error: TNM Path M code is invalid for site/hist combination. Most of these were because a value of c0 was entered into the pathologic M field. But this is NOT allowed for 2015 cases! It is only part of the valid choice list for 2016 cases, but many of you were still entering 2015 cases when the 2016 changes were implemented. Obviously, we were not clear that this could only be allowed for 2016 cases, and since we did not have edits, these values were allowed. It is not because the c prefix has been added; the Edits are written to expect that. It is because the only valid M value for many sites is 1 or blank. So this is an error that the CPDMS programming team will globally fix – if the case is failing the edit because it contains a c0. If the case fails this edit for another invalid value, the case will have to be reviewed.

26. In the Edits document, you can see the instructions and valid values
In the Edits document, you can see the instructions and valid values. It says the M may be blank, but if it is not, then there are only specific values that it may contain based on the primary site. Some sites allow M1a or M1b, for example. This document will list all of the valid values for M for each site.

27. There are other edits and errors for 2015 which are similar to the pre-2015 edits.
Now, Tonya will discuss the new edits and most common errors found in the 2016 cases.