|Posted on August 16, 2018 at 7:10 AM|
NCDB Announcement: Publication of the STORE 2018
Over the years, the Commission on Cancer (CoC) has received valuable feedback to improve the data collected by the National Cancer Database (NCDB), which directly impacts the patients we all serve. The CoC acknowledges the magnitude of the 2018 changes, which seem overwhelming especially with the unexpected delay in the release of the tools and references that facilitate the task of abstraction including the STandards for Oncology Registry Entry (STORE) effective for cases diagnosed January 1, 2018 and later. The CoC recognizes the challenges faced by our dedicated hospital registrars who continue to work tirelessly to ensure timeliness and accuracy of recording data; however, it is also part of the CoC's commitment to provide clear and up-to-date instructions based on the collaborative effort of the experts involved in the development of the STORE. While all suggestions could not be implemented immediately with the current version of the STORE, significant changes have been made.
• Implementation of the AJCC Eighth Edition Staging System: Originally scheduled for release in 2017, the CoC worked directly with AJCC and its surveillance partners to delay implementation until 2018. The lessons learned and experience will guide future efforts and updates.
• Because sentinel lymph node biopsies have been generally under-reported and the timing and results of sentinel lymph node biopsy procedures are used in multiple CoC Quality of Care Measures, the CoC developed six new data items for collection of more specific information on sentinel and regional nodes.
• Reclassification of the Collaborative Stage (CS) Site-Specific Factors (SSF) as discrete data items: The majority of these data items have not changed in terms of the information collected, except for the codes used to document the data. In addition, all of the CS SSFs were reviewed in conjunction, and aligned with, the CAP Protocols. It is the CoC's hope that this will facilitate the abstraction work necessary for the Site-Specific Data Items (SSDI), enabling rapid abstraction into the hospital registry from the CAP checklist. This alignment will become instrumental to the eventual direct filling of values from the electronic health record (EHR) into the registry and will eventually save abstraction efforts and time.
• Implementation of the new data collection infrastructure for Grade: The new way of collecting grade will greatly simplify the abstractor's task. There is no more guessing at whether you are dealing with a 2, 3, or 4 level grading system; there will be no more manual "calculation" of what value to enter for grade. The new site-specific look-ups for grade leave no room for error and will result in high quality grade data.
• New radiation data items from CoC: When the CoC re-engineered the way radiation data are collected, we did so with several higher goals in mind. At the same time that CoC developed the new data items, we have been working with radiation oncology groups at the national level to adopt and implement a standard End of Treatment Summary (EOTS) to be used by all radiation oncologists across the nation and by all EHRs. This standardized template is directly aligned with the new radiation data items and, when fully implemented, will greatly facilitate abstraction of radiation therapy and communication between registrars and radiation oncologists. As with the SSDIs, this alignment will become instrumental to the eventual direct filling of values from the EHR into the hospital registry database and will save abstraction efforts and time.
• The codes for the following data items are currently under review by SEER, CoC and NAACCR. Updated instructions will be released in the near future.
o Surgical Margins of the Primary Site 
o Scope of Regional Lymph Node Surgery 
o Scope of Regional Lymph Node Surgery at this Facility 
o Surgical Procedure/Other Site 
o Surgical Procedure/Other Site at this Facility 
• CoC does not anticipate any changes in the collection of cancer data until 2020. CoC will be using the NAACCR Version 18 standards throughout 2019.
The different standard setters continue to work together to provide support and education in ensuring a smooth transition as we implement these updates. The CAnswer Forum has been set up to include new sub-forums to accommodate STORE-specific questions. For any other questions or concerns, please contact the NCDB at [email protected]
The NCDB would not exist without the efforts of cancer registrars across the nation, and the CoC thanks the registrars at all CoC-accredited programs for their perseverance and patience during these difficult, but necessary, times of change.