Providers/Facilities

Traditional cancer data collection has been primarily from hospitals. As medical advances have occurred, diagnosis and treatment of certain cancers have moved from the acute care setting to being fully cared for within a physician/medical office and therefore was never received and counted by the registry.

In addition, death certificates and pathology laboratory reports are used to help identify cases that are missed in this routine reporting by providers/facilities. Any duplicate reports are consolidated in the data editing process. The purpose of this concerted effort is to alleviate under-reporting or a delay in reporting which can adversely affect incidence rates and research from incomplete data collection.

Physicians in private or group practice must report all required cancer cases.  This includes:

• Patients who are clinically diagnosed and receive no further work-up or treatment, or who have been referred to another physician.
• Patients who are newly diagnosed in the physician’s own laboratory or by sending a specimen from the office to an outside laboratory, whether hospital or independent
• Patients whose first course of treatment is initiated in the physician’s office or clinic.  This includes cancer treatment by surgery, radiation, chemotherapy, immunotherapy, or hormones.

Dentists must report all required cancer cases that are diagnosed and/or treated in their practice, or who have been referred to another physician.  This includes:

• Patients who are diagnosed or treated by a dentist who performs a biopsy and/or receives a pathology report of a reportable case.

Dermatologists must report all required cancer cases diagnosed and/or treated in their practice.  This includes:

• Patients who are diagnosed or treated by a dermatologist who performs a biopsy and/or receives a pathology report of a reportable case.

Freestanding radiation or medical oncology clinics must report any patient initially diagnosed with a reportable cancer or when the physician initiates the first course of treatment (FCOT).  This includes cancer treatment by surgery, radiation, chemotherapy, immunotherapy, or hormones.

Surgery Centers – Freestanding surgery centers-includes plastic reconstructive, oral and maxillofacial surgery centers (independent centers not affiliated with any hospital) must report any patient undergoing a biopsy or other surgical procedure at the facility for a newly diagnosed reportable cancer. This includes cases also reported by either a hospital based or a private/independent medical laboratory.

Other Facilities – Facilities that provide cancer screening services, diagnostic services, or therapeutic cancer services must report confirmed cancer cases which are subject to reporting. This includes facilities that provide mammography or radiology services, palliative, prophylactic, or adjuvant therapy for reportable cases.

Long-term acute care hospitals, hospices and skilled nursing facilities must report the following types of diagnosed reportable cancer cases:

• Cases clinically diagnosed but not confirmed through biopsy, cytology, or other microscopic methods.
• Cases for whom the first course of cancer treatment is initiated at the facility (treatment may include chemotherapy, immunotherapy, or hormone therapy), and
• Cases admitted with active cancer for the purpose of receiving supportive care, palliative care, pain management and/or hospice services.

The timeframe for reporting cancer cases to NCCR from non-hospital sources is defined in NAC 457.050. This includes all cases diagnosed and/or treated for cancer, having a cancer-related health visit while undergoing cancer treatment, or having any evidence of disease at the time of the encounter.

• Providers/Facilities with no cases for a given month need to send a letter to the NCCR stating that there were no cases to report.
• If the patient has a biopsy and needs additional procedures, wait until all procedures are completed before starting an abstract.
• If a patient has a procedure and needs an additional procedure(s) for this cancer at another facility or hospital, please report the case.

The NCCR operates under the Standards set by the National Program of Cancer Registries (NPCR) and the North American Association of Central Cancer Registries (NAACCR).

Required data items by Non-Hospital Reporters:

• Facility/Provider information
• Patient demographic information
• Date of diagnosis
• Cancer site and cell type
• Diagnostic information, including pathology report data
• Staging data to assess the extent of the disease
• Treatment(s)
• Date of last contact and vital status

Accuracy and consistency are essential components of any central registry. The data must be accurate, complete, and timely. Visual editing is conducted at NCCR on a percentage of all reported cases.

To streamline resources and workload the NCCR will move to an electronic reporting system and phase out paper reporting. The registry offers different electronic reporting options depending on your office environment. While we are in the development stages of this transition, we ask that you please continue to submit your cases in your current format.

Options available:

Electronic:

• Electronic reporting through your EHR/EMR software system. This would be an extract (HL7 CDA document) from your system. Please contact your vendor to discuss this option.
• Direct abstracting to the Registry Web Plus software module.

Non-Electronic:

• Paper report submission. All cancer reporting forms must be uploaded to the registry Web Plus module.
• Excel report submission. All cancer reporting forms must be uploaded to the registry Web Plus module.

Please contact the registry by email: dpbhNCCR@health.nv.gov or by phone 775-684-5968 to initiate reporting. One of our NCCR representatives will contact you with instructions and resources to start reporting.

Providers/facilities who do not comply with the timeline schedule will be notified of the delinquency and asked for corrective action to be taken immediately, but no later upon 30 days of receipt of notification.

Any provider/facility not in compliance with the notification may be asked to develop a remedial plan to bring reporting back into compliance.

The plan must include at minimum:

• A detailed overview of the root cause of the underlying delays in reporting, and specific action steps that will outline how the provider/facility will address the issues to improve reporting timelines.
• Action steps could include, but are not limited to resource allocation, training and development, and process improvement measures. In summary, the provider/facility at question will need to indicate how the plan will correct their non-reporting status and stay in compliance once the current reporting year has been completed, and compliance has been reached.
• At the discretion of the Cancer Registry Program Manager, the plan will be monitored and evaluated monthly.

If the provider/facility fails to comply with the remedial plan, the NCCR will move forward to impose an administrative penalty as per NAC 457.145.