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Editor's note: This article is a complement to an article in our May print edition, "What to Expect in 2010."

Major changes are coming to cancer registries next year. The American Joint Committee on Cancer (AJCC) will publish the AJCC Cancer Staging Manual, 7th edition at the end of 2009, heralding in new guidelines, Collaborative Stage Data Collection System Version 2 (CSv2) for registrars. The National Cancer Institute/Surveillance Epidemiology and End Results (NCI/SEER) program will open the Hematopoietic Multiple Primary and Histology (MP/H) database, and the North American Association of Central Cancer Registries Inc. (NAACCR) will nearly triple the size of its data exchange record layout.

NAACCR and standard setters in cancer surveillance chose to implement major changes every 3 years to hopefully lighten the load on registrars and give them time to get ready for the new guidelines. Some in the cancer registry field have expressed concerns about the bulk of the changes coming in 2010.

Fielding Feedback
Lori Havener, CTR, program manager of standards with NAACCR, said the cancer registry community is a bit overwhelmed. "They hear of all the changes coming for 2010, and there are concerns about time to abstract a case, and there are concerns at the central registry level as far as implementing the extended layout," Havener noted. "It's just overwhelming. There's a lot coming down the road at one time."

NAACCR and the standard setting organizations are striving to pass along as much information as possible to registrars about the coming changes. Leaders in the cancer registry realm are also devising plans for implementation and working to provide education and training materials to all registries, Havener explained.

Lynda Douglas, CTR, National Cancer Registrars Association (NCRA), said all of the standard setters have concerns about the amount of work registrars will have come 2010. "There are a lot of ideas being discussed at high-level meetings about how we manage data collection in the future," Douglas explained. "Limiting changes to once every 3 years was an attempt by NAACCR to curtail major data changes from happening every year. This year, we have huge changes that are difficult to manage."

Suzanna Hoyler, BS, CTR, project leader for CS data collection with the AJCC, has heard some concerns about how short implementation will actually take for the CSv2 changes. The AJCC didn't do a time study on it, but chose the timeline because that's when the AJCC's 7th edition manual will be published. Implementation for one stage of the CSv2 project was delayed until Jan. 1, 2011, and that's the pre- and post-treatment staging categories. "We did make that one change," Hoyler said. "I don't know if we'll be making any others at this point."

Lynn Jusinski is an associate editor with ADVANCE.

Resources and Training
Want to get a feel for the changes that are coming in 2010? Here are some helpful links and education dates:

At this year's NCRA conference, May 31-June 3, the AJCC will host a session on the value of the registrar in the data collection process and why certain data is pertinent to staging. Then, an introduction to CSv2 will be held, and the third presentation, "Collaborative Staging Version 2: Coming Attractions," will focus on what's new in the coding rules and offer an overview of the changes. You can find out more at NCRA's Web site.

The 2010 Implementation Guidelines will be published in July and will be available on the NAACCR Web site.

NAACCR will host a post-conference workshop this year on June 20 on managing change, and specifically on managing the changes in the NAACCR Standards for Cancer Registries, Volume II, Version 12. The workshop follows NAACCR's annual conference. Get more information here, and download the program guide. 

The 2009-2010 Webinar series run by NAACCR will begin with a look at the 2010 changes. Find out more at NAACCR's Web site.

The AJCC is hosting a "train the trainers" session in Chicago in July for CSv2. Approximately 75 trainers will attend, and then they'll share the standard information they receive throughout the cancer surveillance community. Keep an eye out for a session near you, or sign up for a Webinar.