North American Association of Central Cancer Registries GUIDELINES FOR ICD-O-3 IMPLEMENTATION Prepared by the NAACCR ICD-O-3 Implementation Work Group November 27, 2000 Guidelines for ICD-O-3 Implementation NAACCR, Inc TABLE OF CONTENTS 1 INTRODUCTION ................................................................................................................................. 3 2 BACKGROUND AND IMPLEMENTATION ISSUES....................................................................... 4 2.1 Why ICD-O-3? ........................................................................................................................... 4 2.2 How sweeping is the change? ..................................................................................................... 4 2.3 When will the ICD-O-3 manual be available? ............................................................................ 4 2.4 What about training for data collectors? ..................................................................................... 4 2.5 What impact does the delayed release of the ICD-O-3 manual have on case finding on or after January 1, 2001? ...................................................................................................................................... 5 2.6 What impact does the delayed release of the ICD-O-3 manual have on cancer registry software development and release? ........................................................................................................................ 5 2.7 What are the conversion issues? ................................................................................................. 5 2.8 How should reporting facilities and central/state registries abstract and report cases coded to ICD-O-3 in the interim? ........................................................................................................................... 5 2.9 What about the 2001 Calls for Data? .......................................................................................... 6 2.10 What is the relationship between the implementation of ICD-O-3 and NAACCR’s data exchange record layout, version 9? .......................................................................................................... 6 3 STATEMENTS FROM STANDARD-SETTING ORGANIZATIONS ABOUT ICD-O-3 IMPLEMENTATION ................................................................................................................................... 7 3.1 The American College of Surgeons Commission on Cancer (CoC) Approved Hospital Registries ................................................................................................................................................. 7 3.2 Centers for Disease Control and Prevention, National Program of Cancer Registries (NPCR) . 7 3.3 National Cancer Institute, SEER Registries ................................................................................ 8 3.4 Statistics Canada ......................................................................................................................... 8 4 NAACCR CONSENSUS RECOMMENDATIONS ........................................................................... 10 4.1 Reporting facilities (includes CoC approved hospitals) ........................................................... 10 4.2 Vendors ..................................................................................................................................... 12 4.3 Population-Based Central/State Registries ............................................................................... 13 4.4 Recommendations for EDITS Software Users ......................................................................... 15 5 QUESTIONS AND ANSWERS ......................................................................................................... 16 6 APPENDIX A: ICD-O-3 Supplemental Case List .............................................................................. 19 7 APPENDIX B: Y2001 Case finding List ............................................................................................ 48 8 APPENDIX C: Layout and Coding ICD-O-3 conversion flags .......................................................... 50 9 APPENDIX D: NPCR-State (Territory) Specific Planning Points ...................................................... 52 10 APPENDIX E: Reporting of Juvenile Astrocytoma in ICD-O-3 ..................................................... 53 November 27, 2000 Page 2 Guidelines for ICD-O-3 Implementation NAACCR, Inc 1 INTRODUCTION These consensus guidelines, developed by the North American Association of Central Cancer Registries (NAACCR) ICD-O-3 Work Group and approved by the NAACCR Board of Directors, address implementation of ICD-O-3 for cases diagnosed on or after January 1, 2001. Members of the work group are listed below and they include standard setting organizations, central registries, and cancer registry software vendors. Implementation of new standards is never 100 percent problem-free. The concept of ICD-O-3 was first presented to the Uniform Data Standards Committee in February 2000. The need for a revised morphology section to more accurately code current diagnoses described in the terms of the World Health Organization’s Classification of Hematopoietic Neoplasms was recognized. At this time, the new manual and electronic tables were projected to be available in the summer of 2000. Unfortunately, unforeseen delays occurred at the international level that affects preparations for data collection, software upgrades, and data reporting. NAACCR revisited the implementation issue in August 2000 and concluded that it would be better to proceed with the understanding that a coordinated plan for implementation would be developed and distributed to reporting facilities, cancer registry software vendors, and central and state cancer registries. The ICD-O-3 Work Group was formed for this purpose and it will also act as the clearinghouse for review and resolution of ICD-O-3 implementation questions during 2001 and for updates on training opportunities. If there are any questions, email them to JoAnne Sylvester at [email protected]. Updates will be posted on NAACCR’s web site (www.naaccr.org), SEER’s web site (www.seer.cancer.gov), and the American College of Surgeon’s web site (www.facs.org). The work group will advise about updates through email notices using the NAACCR listserv and mailing lists of all organizations involved. ICD-O-3 WORK GROUP MEMBERS JoAnne Sylvester, MA, Chair Barry Gordon American College of Surgeons C-NET Toshi Abe, MSW, CTR Dianne Hultstrom, CTR New Jersey State Cancer Registry Medical Registry Services, Inc. Susan Capron Annette Hurlbut, RHIT, CTR North American Association of Central IMPAC Medical Systems, Inc. Cancer Registries Betsy Kohler, CTR, MPH Ingrid Friesen, HRT New Jersey State Cancer Registry Statistics Canada Jan Snodgrass, CTR April Fritz, RHIT,CTR Illinois State Cancer Registry National Cancer Institute Surveillance Epidemiology & End Results Patricia Tary, CTR American College of Surgeons Ken Gerlach, MPH,CTR Centers for Disease Control and Prevention National Program of Cancer Registries November 27, 2000 Page 3 Guidelines for ICD-O-3 Implementation NAACCR, Inc 2 BACKGROUND AND IMPLEMENTATION ISSUES 2.1 Why ICD-O-3? Development of ICD-O-3, an international coding scheme, has been underway for more than two years. It is an update of the morphology codes because lymphoma and leukemia codes were not adequate to code current diagnoses described in terms used by the World Health Organization’s Classification of Hematopoietic Neoplasms. Topography codes have not changed. Approximately 750 new morphology terms and synonyms have been added. About one-third of these are benign and borderline conditions that do not affect most cancer registries. Of the malignant terms, 44 percent of the changes occur in the lymphomas, leukemias and lymphoreticular diseases. 2.2 How sweeping is the change? The change from ICD-O-2 to ICD-O-3 is less drastic than that from ICD-O-1 to ICD-O-2. $ About 95 percent of all cancer codes (morphology and behavior) will not change. $ None of the coding rules will change. $ No topography codes will be added. $ Most of the new morphology terms will be hematopoietic and lymphoreticular, estimated at approximately 4 percent of all cancers. Many of these cases are rare and only seen at tertiary care facilities. $ Eighteen terms will be changed from malignant to borderline and 24 codes from borderline to malignant. This change may affect some reporting requirements for cancer registries. New reportable cancers are a subset of hematopoietic cancers which are estimated to account for approximately 0.5 percent of all cancers. $ Other changes include terms that will change morphology codes and will delete a few terms from ICD-O-2. 2.3 When will the ICD-O-3 manual be available? The hard copy version of the ICD-O-3 manual has been sent to WHO for printing and is scheduled to be available in January 2001. Publication price is $54.00 U.S. and the World Health Organization is accepting orders now. Books ordered now will be shipped as soon as they are available. SEER is checking with WHO on availability of an electronic version. Bulk purchases of ICD-O-3 are encouraged by WHO with quantity discounts up to 60%. To order in the U.S., contact: WHO Publications Center, USA 49 Sheridan Ave Albany , NY 12210 Tel: (518) 436-9686 Fax: (518) 436-7433 email: [email protected] 2.4 What about training for data collectors?